Background: Serological tests for IgM and IgG are routinely used in clinical laboratories for the rapid diagnosis of dengue
and can differentiate between primary and secondary infections. Dengue virus non-structural protein 1 (NS1) has been
identified as an early marker for acute dengue, and is typically present between days 1–9 post-onset of illness but following
seroconversion it can be difficult to detect in serum.
Aims: To evaluate the performance of a newly developed PanbioH Dengue Early Rapid test for NS1 and determine if it can
improve diagnostic sensitivity when used in combination with a commercial IgM/IgG rapid test.
Methodology: The clinical performance of the Dengue Early Rapid was evaluated in a retrospective study in Vietnam with
198 acute laboratory-confirmed positive and 100 negative samples. The performance of the Dengue Early Rapid in
combination with the IgM/IgG Rapid test was also evaluated in Malaysia with 263 laboratory-confirmed positive and 30
negative samples.
Key Results: In Vietnam the sensitivity and specificity of the test was 69.2% (95% CI: 62.8% to 75.6%) and 96% (95% CI:
92.2% to 99.8) respectively. In Malaysia the performance was similar with 68.9% sensitivity (95% CI: 61.8% to 76.1%) and
96.7% specificity (95% CI: 82.8% to 99.9%) compared to RT-PCR. Importantly, when the Dengue Early Rapid test was used in
combination with the IgM/IgG test the sensitivity increased to 93.0%. When the two tests were compared at each day postonset
of illness there was clear differentiation between the antigen and antibody markers.
Conclusions: This study highlights that using dengue NS1 antigen detection in combination with anti-glycoprotein E IgM
and IgG serology can significantly increase the sensitivity of acute dengue diagnosis and extends the possible window of
detection to include very early acute samples and enhances the clinical utility of rapid immunochromatographic testing for
dengue.