Evaluation of Dengue NS1 ELISA as a Diagnostic Tool for Early Detection of Dengue Virus Infection: A Cross-Sectional Diagnostic Accuracy Study at Mayo HospitalPathology Lab

Abstract

Objective: To assess the diagnostic accuracy (sensitivity, specificity, positive predictive value, and negative
predictive value) of dengue NS1 ELISA in detecting early dengue infections. And evaluate the correlation
between NS1 antigen detection and the clinical manifestations of dengue fever.
Study Design: Cross-sectional study.
Place and Duration of Study: This study was conducted at the Pathology Laboratory of King Edward Medical University, Lahore, Pakistan, from November 2024 to February 2025.
Methods: A total of 150 patients presenting with febrile illness and suspected dengue infection were included. Blood samples were collected, and serum was tested for NS1 antigen using a commercially available ELISA kit. Clinical data, including the onset of fever and other symptoms, were documented. Statistical analysis was performed using SPSS software.
Results: Out of 150 patients, 98 tested positive for the NS1 antigen, while 52 were negative. The NS1 ELISA test demonstrated a sensitivity of 68.0% and a specificity of 80.9%. The positive predictive value (PPV) was 90.9%, while the negative predictive value (NPV) was 47.4%. The most common symptoms among NS1-positive patients were fever (90%), headache (75%), and myalgia (60%). A significant association was found between NS1 positivity and clinical diagnosis of dengue (χ² = 33.75, P < 0.001). However, there was a weak correlation between age and NS1 antigen levels (Pearson's r = 0.15).
Conclusion: The NS1 ELISA test is a reliable and rapid diagnostic tool for the early detection of dengue virus infection, particularly in endemic regions. While it demonstrates moderate sensitivity and high specificity, its lower negative predictive value suggests the need for adjunctive diagnostic methods, such as IgM/IgG serology or RT-PCR, to improve diagnostic accuracy. The findings support the integration of NS1 ELISA into routine diagnostic protocols for early dengue detection, facilitating timely clinical intervention and reducing the risk of severe complications.

How to cite this: Haq I, Malik M, Aftab K, Khan SH, Heral HR, Yousaf M. Evaluation of Dengue NS1 ELISA as a Diagnostic Tool for Early Detection of Dengue Virus Infection: A Cross-Sectional Diagnostic Accuracy Study at Mayo Hospital Pathology Lab. Life and Science. 2026; 7(1): 61-66. doi: http://doi.org/10.37185/LnS.1.1.1010