Predictive value of persistent NS1 antigen positivity beyond 3rd day for dengue haemorrhagic fever in Sri Lankan children

Mihira ManamperiView ORCID ID profile,
Bernard Deepal Wanniarachchi JayamanneEmail author View ORCID ID profile,
Thilini SomaratneView ORCID ID profile,
Natasha Perera and
LakKumar Fernando

BMC Research Notes201912:214

https://doi.org/10.1186/s13104-019-4250-z

Received: 16 March 2019
Accepted: 3 April 2019
Published: 8 April 2019

Abstract

Objective

Dengue haemorrhagic fever (DHF) is a major public health concern responsible for significant morbidity in both adult and paediatric populations in Sri Lanka. This study examined if persistent non structural protein 1 (NS1) antigen positivity beyond day 3 was predictive of the occurrence of dengue haemorrhagic fever. The patients were followed up during their in-hospital stay and the severity of the illness was classified according to the WHO classification. The NS1 antigen test was repeated after day 3 of the onset of illness, at least 2 days after the initial test.

Results

One hundred and fifty-seven patients were enrolled. Persistent NS1 antigen test positivity after day 3 of the illness was not predictive of subsequent development of DHF. Out of multiple other demographic and illness related factors assessed, only having a secondary dengue infection was associated with a high risk of DHF (relative risk = 3.077, 95% CI 1.361, 6.954). Persistent NS1 positivity on day 3 may not be indicative of disease severity. However results need to be confirmed by a larger study with quantitative NS1 testing.