Impact of Reactive Dengue NS1 Antigen with Time for Hospital Admission in Dengue Viral Infection Patient

Abstract

Dengue is the most rapidly spreading mosquito-borne viral disease worldwide with estimated 30-fold increase in incidence over the last five decades. The recent study had found an increase in the number of admissions of cases of dengue fever with reactive NS1 antigen. The aim of this study was to evaluate the utility of NS1 antigen as a diagnostic marker and to determine whether there is a higher risk of severe dengue infection for patient with positive NS1 antigen. This was a retrospective analysis study conducted in 7 referral Hospitals in Bandung, West Java, Indonesia. The medical records of all the individuals admitted to the Hospital from 1 January to 31 December 2015 were evaluated. We used a questionnaire as a tool for data collection consisted of the epidemiological, clinical manifestation, laboratory results and final diagnosis data that were collected during the period of hospitalizing. In 2015 there were 4.096 cases of dengue viral infection hospitalized. Most of the patients with positive NS1 antigen were admitted at early phase (0-2 days) and regular phase (3-5 days). Platelet count >100.000/mm3 was significantly associated with positive NS1Ag assay, while lower thrombocytopenia (platelet count 3) was significantly associated with positive IgM dengue antibody. Severe cases of dengue viral infection of DHF significantly more often happen on patient with IgM antibody dengue positive (P<0.005). NS1 Ag assay is useful, sensitive and specific for the diagnosis of dengue detection, with good sensitivity and specificity during acute phase when detectable antibodies still negative.