ArticleIJID regions2026
Diagnostic performance of the Dengue NS1 Ag Rapid Test during early-stage infections at epidemic-affected health care facilities in northeastern and eastern Ethiopia.
Article in IJID regions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Early detection of dengue through the non-structural protein 1 (NS1) antigen is critical for timely diagnosis. Although polymerase chain reaction (PCR) remains the reference standard, its cost and technical requirements limit routine use in many epidemic-prone settings. Rapid diagnostic tests (RDTs) provide a practical alternative but require validation against reference assays. This study aimed to evaluate the diagnostic accuracy of the STANDARD Q Dengue NS1 Ag RDT compared with the Trioplex real-time PCR assay for early dengue detection in healthcare facilities in northeastern and eastern Ethiopia between April and August 2024. Methods: A cross-sectional diagnostic accuracy study was conducted using consecutive sampling of 339 febrile patients aged over 1 year who presented within 5 days of suspected dengue infection. Diagnostic performance was assessed using contingency table analysis, with sensitivity, specificity, predictive values, likelihood ratios, receiver operating characteristic curve analysis, and Cohen κ. Results: Most participants were urban residents (90%) and aged 20-29 years. The NS1 Ag RDT demonstrated 82.9% overall accuracy, with a sensitivity of 82.6% (95% confidence interval [CI]: 76.3-87.8) and a specificity of 83.2% (95% CI: 76.4-88.7). Positive and negative predictive values were 85.4% (95% CI: 79.3-90.2) and 80.1% (95% CI: 73.1-86.0), respectively. The positive likelihood ratio was 4.92, receiver operating characteristic area was 0.829, and Cohen κ indicated substantial agreement (κ = 0.656). Test positivity peaked on illness days 2 and 3. Conclusion: The NS1 Ag RDT demonstrated moderate diagnostic accuracy, supporting its application for early-phase dengue detection in epidemic-prone, resource-limited health care facilities where Trioplex reference real-time PCR is not feasible.
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