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Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 17 / No. 1 / Published : 2010-01

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Original Article :

Cut off Value Dengue Quantitative NS1 Antigen As Predictor Severity of Dengue Viral Infection in Children

Nilai Batas Antigen NS1 Dengue Kuantitatif Sebagai Prediktor Keparahan Jangkitan/Tularan (infeksi) Virus Dengue Anak

Author :

  1. Betty A Tambunan --> Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  2. Aryati --> Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  3. D Husada --> Departemen Ilmu Kesehatan Anak UNAIR-RSUD Dr. Soetomo, Surabaya

Abstract :

  The diagnosis of viral dengue infection is very important for the management of dengue patients. In acute phase infection circulating NS1 antigen can be detected in the sera of patients with dengue viral infection. This study is evaluating the NS1 antigen level in dengue patients using antigen captured ELISA Platelia TM Dengue NS1 Ag (Bio-Rad Laboratories).In this 30 examined dengue patients consisting of 3(10%) undifferentiated fever, 10(33.33%) dengue fever, 12(40%) DHF grade I, 2(6.66%) DHF grade II, 2(6.66%) DHF grade III, 1(3.33 %) DHF grade IV. The result revealed that NS1 antigen was positive in 12 among 30 patients (40%) which were  diagnosed as Dengue Viral infection based on 1997 WHO criteria. The sensitivity of NS1 antigen in these patients as confirmed with IgM and IgG antidengue serology test was 52.2%. The highest positivism of NS1 antigen was on the third day of fever. The results analyzed by Spearman correlation test revealed that there was no significant correlation between NS1 antigen level and the severity of dengue viral infection. The cut-off value of quantitative NS1 antigen could not be determined because they were no significant correlation shown for NS1 antigen as the predictor for the severity of dengue viral infection. The conclusion of the study so far shown that the quantitative NS1 antigen level could not be used as the predictor for the severity of dengue viral infection. The cut-off value of quantitative NS1 antigen could not be determined because there were no significant correlation shown for NS1 antigen as the predictor for the severity of dengue viral infection.       Diagnosis dini jangkitan/tularan (infeksi) virus dengue (IVD) diperlukan untuk penatalaksanaan penderita. Antigen NS1 yang beredar di peredaran (sirkulasi) selama tahap (fase) akut dapat ditemukan (-deteksi) dalam serum penderita yang terinfeksi virus dengue. Penelitian ini betujuan untuk memeriksa kadar antigen NS1 di penderita IVD dengan memakai antigen captured ELISA Platelia TM Dengue NS1 Ag (Bio-Rad Laboratories). Sebanyak 30 penderita IVD diambil sebagai terokan (sampel) penelitian yang terdiri dari demam tidak berpola jelas/dapat dibedakan (undifferentiated fever) 3 kasus (10%), demam dengue 10 kasus (33,33%), DBD derajat I 12 kasus (40%) dan DBD derajat II 2 kasus (6,66%), DBD derajat III 2 kasus (6,66%) dan DBD derajat IV 1 kasus (3,33 %). Antigen NS1 positif ditemukan di 12 di antara 30 penderita (40%). Kepekaan (sensitivitas) antigen NS1 di penderita yang dikukuhkan (- konfirmasi) keadaan  IVD dengan uji serologis IgM dan IgG antidengue 52,2% (12 dari 23 penderita). Antigen NS1 paling tinggi ditemukan pada hari ke 3 demam. Kenasaban (korelasi) tidak bermakna didapatkan antara kadar antigen NS1 dengan derajat keparahan setelah dianalisis dengan uji korelasi Spearman. Nilai batas (cut-off) antigen NS1 terkait jumlah (kuantitatif) tidak dapat dipakai karena tidak didapatkan korelasi yang bermakna untuk antigen NS1 sebagai peramal (prediktor) keparahan. Kadar antigen NS1 dengue kuantitatif  tidak dapat dijadikan peramal keparahan infeksi virus dengue. Nilai batas antigen NS1 kuantitatif  tidak didapatkan karena dijumpai kadar antigen NS1 yang bervariasi dan tidak menggambarkan keparahan penyakit.

Keyword :

Cut off value Predictor Severity of Dengue Viral Infection, Quantitative NS1 Antigen Dengue Viral Infection,


Daftar Pustaka :

  1. Soegijanto S, (2006). Bahaya yang mengintai endemisitas DBD di Indonesia. Surabaya : Airlangga University Press
  2. Agus SB, (2009). Waspada terhadap Demam Berdarah. Kominfo Newsroom. Jakarta : Badan Informasi Publik Departemen Komunikasi dan Informatika
  3. Aryati, (2008). The Role of Dengue NS1 Antigen as Diagnostic Tool. In: National Emerging and Re-Emerging Infectious Disease Update. Surabaya : Convention Hall Husada Utama Specialist Hospital
  4. Ramirez A, Moros Z, Comach G, Zambrano S, Bravo L, Pinto B, Vielma J.S, (2009). Evaluation of dengue detection test with acute sera from patients infected with dengue in Venezuela. Venezuela : Diagnostic and Infectious Disease
  5. Libraty DH, Young PR, Pickering D, Endy TP, Kalayanarooj S, Green S, et al, (2002). High Circulating Levels of the Dengue Virus Nonstructural Protein NS1 Early in Dengue Illness Correlate with the Development of Dengue Hemorrhagic Fever. USA : Journal of Infectious Disease


   


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Volume : 17 / No. : 1 / Pub. : 2010-01
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  6. Correlation Between Serum Neuron-specific Enolase And Glasgow Coma Scale In Traumatic Head Injury
  7. Cut Off Value Dengue Quantitative Ns1 Antigen As Predictor Severity Of Dengue Viral Infection In Children
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