Evidence map›Paper›PMID 40811666›Full record

ArticleThe Journal of infectious diseases2026

Diagnostic Performance and Kinetics of Hepatitis E Viral RNA and IgM Antibody Test Positivity in a Genotype 1 Outbreak in South Sudan.

Aybüke Koyuncu, Robin C Nesbitt, Catia Alvarez, Kinya Vincent Asilaza, Joseph Wamala, Melat Haile, Etienne Gignoux, Manuel Albela, Emily S Gurley, Frederick Beden Loro and 6 more

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Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Aybüke KoyuncuDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0002-3060-6279
Robin C NesbittEpicentre, Paris, France.
Catia AlvarezGeneva Centre for Emerging Viral Diseases, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
Kinya Vincent AsilazaMédecins Sans Frontières, Juba, South Sudan.
Joseph WamalaWorld Health Organisation, Juba, South Sudan.
Melat HaileMédecins Sans Frontières, Geneva, Switzerland.
Etienne GignouxEpicentre, Paris, France.
Manuel AlbelaMédecins Sans Frontières, Geneva, Switzerland.
Emily S GurleyDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.
Frederick Beden LoroWorld Health Organisation, Juba, South Sudan.
Duol BiemSouth Sudan Ministry of Health, Juba, South Sudan.
Monica RullMédecins Sans Frontières, Geneva, Switzerland.
John RumunuSouth Sudan Ministry of Health, Juba, South Sudan.
Iza CigleneckiMédecins Sans Frontières, Geneva, Switzerland.ORCID 0000-0003-0406-5218
Isabella EckerleGeneva Centre for Emerging Viral Diseases, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.
Andrew S AzmanDepartment of Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0001-8662-9077

Funding

Médecins Sans FrontièresWorld Health Organization 001
6 · The paper itself

Abstract

backgroundDiagnostics are essential for understanding hepatitis E epidemiology, but the field performance of available tests remains unclear. We evaluated the performance of polymerase chain reactions (PCR), IgM ELISA, and the Assure hepatitis E virus (HEV) IgM rapid diagnostic test (RDT) during a HEV genotype 1 outbreak and assessed the duration of viremia and antibodies responses.

methodsWe used data from enhanced surveillance at a health facility in Bentiu internally displaced persons camp, South Sudan (March-December 2022). As part of a vaccine effectiveness study, suspected hepatitis E cases underwent testing with all 3 diagnostics at enrollment with a follow-up sample. We used a latent class model to estimate test performance and accelerated failure time models to estimate time from jaundice onset to a negative test for PCR and ELISA. RESULTS AND

conclusionsAmong 893 suspected cases, test sensitivity declined with time from jaundice onset. Within 30 days of jaundice onset, PCR sensitivity was 73% (95% Credible Interval [CrI] 27, 90), compared to 86% for RDT (95% CrI: 74, 93), and 95% for ELISA (95% CrI: 91, 98). Specificity was high across tests: PCR at 98% (95% CrI: 98, 99), RDT at 95% (95% CrI: 93, 96), and ELISA at 95% (95% CrI: 93, 96). Median time from jaundice onset to negative test was 19 days (95% CI: 17, 21) for PCR and 113 days (95% CI: 87, 163) for ELISA. The Assure IgM RDT showed higher sensitivity for identifying hepatitis E than PCR and similar specificity to IgM ELISA, supporting its use in surveillance. Care seeking delays can greatly influence the interpretation of diagnostic tests.

Indexed as

Disease OutbreaksHepatitis AntibodiesHepatitis EHepatitis E virusImmunoglobulin MRNA, ViralAdolescentAdultChildChild, PreschoolEnzyme-Linked Immunosorbent AssayFemaleGenotypeHumansMaleMiddle AgedHepatitis AntibodiesImmunoglobulin MRNA, Viraldiagnosticshepatitis Ehepatitis E virus (HEV)

Identifiers

PMID40811666
PMCPMC12811865

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.