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A New Approach to Dengue Fatal Cases Diagnosis NS1 Antigen Capture in Tissues 英文参考文献
ANewApproachtoDengueFatalCasesDiagnosis:NS1
AntigenCaptureinTissues
MoniquedaRochaQueirozLima1,RitaMariaRibeiroNogueira1,HermannGonc?alvesSchatzmayr1 ,Ana
MariaBispodeFilippis1,DanielLimonta2,FlaviaBarretodosSantos1*
1FlavivirusLaboratory,OswaldoCruzInstitute,RiodeJaneiro,Brazil,2NationalReferenceLaboratoryforDengue,VirologyDepartment,PAHO/WHOCollaboratingCenter
fortheStudyofDengueandItsVector,PedroKour?′InstituteofTropicalMedicine,Havana,Cuba
Abstract
Abstract/Background:Dengueisthemostimportantarthropodborneviraldiseaseworldwideintermsofmorbidityand
mortalityandiscausedbyanyofthefourserotypesofdenguevirus(DENV-1to4).Brazilisresponsibleforapproximately
80%ofdenguecasesintheAmericas,andsincetheintroductionofdenguein1986,atotalof5,944,270caseshavebeen
reportedincluding21,596denguehemorrhagicfeverand874fatalcases.DENVcaninfectmanycelltypesandcausediverse
clinical and pathological effects. The goal of the study was to investigate the usefulness of NS1 capture tests as an
alternativetooltodetectDENVintissuespecimensfrompreviouslyconfirmeddenguefatalcases(n=23)thatoccurredin
2002inBrazil.
Methodology/PrincipalFindings:Atotalof74tissuespecimenswereavailable:liver(n=23),lung(n=14),kidney(n =04),
brain(n=10),heart(n=02),skin(n=01),spleen(n=15),thymus(n=03)andlymphnodes(n=02).Weevaluatedthreetests
forNS1antigencapture:firstgenerationDengueEarlyELISA(PanBioDiagnostics),PlateliaNS1(BioRadLaboratories)andthe
rapid test NS1 Ag Strip (BioRad Laboratories). The overall dengue fatal case diagnosis based on the tissues analyzed by
DengueEarlyELISA,PlateliaNS1andtheNS1AgStripwas34.7%(08/23),60.8%(14/23)and91.3%(21/23),respectively.The
DengueEarlyELISAdetectedNS1in22.9%(17/74)ofthespecimensanalyzedandthePlateliaNS1in45.9%(34/74).The
highestsensitivity(78.3%;58/74)wasachievedbytheNS1AgStrip,andthedifferencesinthesensitivitieswerestatistically
significant(p,0.05).TheNS1AgStripwasthemostsensitiveinliver(91.3%;21/23),lung(71.4%;10/14),kidney(100%;4/4),
brain(80%;8/10),spleen(66.6%,10/15
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