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Background: Nonstructural protein 1 (NS1) Ag-based tests are useful for detecting dengue virus (DENV), but there is lack of evidence on the diagnostic accuracy of NS1 Ag-based tests in Asian population. Thus, we conducted this meta-analysis to obtain the overall estimated and summarized performance of the NS1 Ag-based tests in the detection of DENV in Asia. Methods: PubMed, Embase and Medline were searched for studies that evaluated the diagnostic validity of NS1 Ag-based tests between January 1990 and November 2014. Data were analyzed by Meta-Disc and STATA software. Results: A total of 18 studies including 3342 dengue cases and 1904 control cases which fulfilled the inclusion criteria were considered for analysis. The pooled sensitivity and specificity for NS1 Ag-based tests was 66 % (95 % CI 64.5-67.5) and 97.9 % (95 % CI 97.3-100), respectively. STRIP has the overall highest sensitivity (72.9 %, 95 % CI 70.1-75.5). According to viral serotype, the test with the highest sensitivity for DENV1, DENV2 and DENV3 were Platelia (83.7 %, 95 % CI 79.7-87.1), Panbio (71.8 %, 95 % CI 65.5-80.9) and STRIP (81.9 %, 95 % CI 75.5-87.2) respectively. The highest sensitivity for primary infection was Platelia (95.1 %, 95 % CI 92.6-96.9) and for secondary infection was STRIP (64 %, 95 % CI 53.2-73.9). Conclusion: Our meta-analysis suggests that NS1 Ag-based test is a good diagnostic method for DENV with a high specificity. However, viral serotype, serological status, clinical severity and the duration of illness are the main factors influencing the diagnostic accuracy.
Shan, X., Wang, X., Yuan, Q., Zheng, Y., Zhang, H., Wu, Y., & Yang, J. (2015). Evaluation of the diagnostic accuracy of nonstructural protein 1 Ag-based tests for dengue virus in Asian population: A meta-analysis. BMC Infectious Diseases, 15(1). https://doi.org/10.1186/s12879-015-1088-4
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