Abstract：Objective To evaluate the application value of positive predictive value of NS1 antigen in surveillance of dengue, to provide a scientific basis for early diagnosis and isolation of dengue cases, and to gain prime time for epidemic prevention and control. Methods Descriptive epidemiological analysis was used to analyze the surveillance data of dengue in Zhongshan City from 2017 to 2019. Binary logistic regression analysis was performed to examine the factors associated with positive predictive value of NS1 antigen. Colloidal gold and enzyme linked immunosorbent assay(ELISA)were used to detect dengue virus-NS1 antigen. Fluorescent quantitative RT-PCR (test of dengue virus nucleic acid) and ELISA (test of IgM and IgG antibodies) were used to recheck. Results The positive predictive value of NS1 antigen was 58.27% (634/1 088) in 1,115 suspected dengue fevercases. Multifactor logistic regression analysis showed that the factors influencing the positive predictive value of NS1 antigen included age (OR=1.021, 95%CI: 1.011-1.031), having a history of travelling within 14 days before the onset of the disease (overseas OR=54.993,95%CI:19.954-151.560, domestic OR=2.628, 95%CI: 1.630-4.238), local outbreaks occurring in communities (local epidemic OR=277.918, 95%CI: 75.691-1,020.444, local sporadic OR=13.831, 95%CI:3.937-48.583), and the count of white blood cell (decline OR=79.981, 95%CI: 31.963-200.140, normal OR=25.019, 95%CI: 10.471-59.783). Within 6 days of the onset, the proportions of leukocytopenia and thrombocytopenia in the confirmed cases gradually increased, as high as 92.00% (46/50) for leukocytopenia on day 6, but only 13.52%(71/525)cases showed thrombocytopenia within 5 days of the onset. Conclusion s Febrile illness cases that cannot be definitively diagnosed with other diseases, and with normal or reduced white blood cells within 6 days of the onset are the focus groups for NS1 antigen test. Different monitoring strategies should be adopted according to intensity of the epidemic. In communities that dengue is widespread, NS1 antigen positive results from medical institutions can be directly used as the basis for handing the epidemics.
毛云霞, 王曼, 罗乐, 冯志锋, 谢颖, 李映来. 2017—2019年登革病毒NS1抗原阳性预测值及影响因素分析[J]. 实用预防医学, 2021, 28(7): 826-830.
MAO Yun-xia, WANG Man, LUO Le, FENG Zhi-feng, XIE Ying, LI Ying-lai. Positive predictive value of dengue virus-NS1 antigen and its influencing factors, 2017-2016. , 2021, 28(7): 826-830.
[1] 周航,李昱,牟笛,等.中国2013年登革热流行病学分析[J].公共卫生与预防医学,2015,26(2):12-15. [2] 邹钦.广东省2014年登革热疫情防控实践与思考[J].中华卫生杀虫药械,2015,21(6):630-631. [3] 牛丛,王淼,万成松,等. 登革病毒非结构蛋白NS1在检测和免疫预防中的应用[J].热带医学杂志,2018,18(10):1394-1397. [4] Suleman M, Faryal R, Alam MM, et al. NS1 antigen: a new beam of light in the early diagnosis of dengue infection[J]. Asian Pac J Trop Med, 2016,9(12):1212-1214. [5] 国家卫生和计划生育委员会.登革热诊断标准:WS 216-2018[S].北京:中国标准出版社,2018:1-21. [6] 杨清明,王运超,万成松,等.疟区演变中发热病人血检疟原虫阳性预测值的变化[J].湖北热带医学杂志,1995,6(1):8-10. [7] 宁丹,孙九峰,彭志强,等.广东省登革热流行概况与流行特征[J].华南预防医学,2017,43(4):368-372. [8] 王慧敏,詹伟祥,陈培松,等.广州市区疑似登革热643例临床特征分析[J].热带医学杂志,2015,15(10):1396-1445. [9] 陈志高,孙梦婷,李媛,等.2014—2018年深圳市登革热疫情流行特征分析[J].实用预防医学,2020,27(2):176-179. [10] 叶应,何建安,刁慕言,等. 2012—2018年深圳口岸输入性登革热流行病学特征[J].中国国境卫生检疫杂志,2019,42(4):251-253. [11] 王陈龙,何思杰,顾大勇,等. 登革病毒NS1抗原捕获酶联免疫吸附试验在登革热实验室诊断中的应用价值[J].中国医学创新杂志,2018,15(22):137-140. [12] Anand AM, Sistla S, Dhodapkar R, et al. Evaluation of NS1 antigen detection for early diagnosis of dengue in a tertiary hospital in Southern India[J]. J Clin Diagn Res,2016,10(4):DC01-DC4. [13] 郭泽强,林健燕,罗必泰,等.全自动酶免方法检测登革病毒抗原抗体的有效性评价[J].现代预防医学,2017,44(19):3590-3592. [14] 曹毅敏,曾庆,刘文辉,等.NS1抗原在广州市登革热检测中的应用评价[J].热带医学杂志,2018,18(9):1210-1213. [15] 邓勤勤,刘琦.2014年广州登革热患者流行病学及实验室特征分析[J].国际检验医学杂志,2016,37(1):121-123. [16] 徐文体,陈燕清,梁文佳,等.87例登革热住院病例不同病程的临床特征分析 [J].华南预防医学,2007,33(5):18-21.
2021, Vol. 28 
