Innovations and Implementation Challenges in Dengue Diagnostics: A 21st Century Perspective on a Neglected Tropical Disease

Abstract

Background: Dengue fever is a rapidly spreading mosquito-borne viral infection and one of the most prevalent neglected tropical diseases (NTDs), affecting over 100 countries and causing an estimated 390 million infections annually. Despite its global impact, dengue remains underfunded and insufficiently prioritized in public health agendas. Objective: This review aims to provide a comprehensive overview of recent advancements in dengue diagnostic technologies, assess their clinical and public health relevance, and identify persistent barriers to their implementation, particularly in low-resource settings. Methods: We critically examined current diagnostic modalities—including molecular, antigen-based, and serological tools—by evaluating their sensitivity, specificity, operational feasibility, and suitability for outbreak response. The review also incorporates recent WHO recommendations following the 2024–2025 dengue emergency, during which seven diagnostic products were approved for global use. Findings: While significant progress has been made in the development of rapid and accurate diagnostic tools, challenges such as limited access, affordability, and infrastructural constraints continue to hinder widespread adoption. Regional disparities in diagnostic capacity further exacerbate the burden of dengue in vulnerable populations. Conclusion: Addressing the diagnostic gap in dengue requires integrated, equity-driven strategies that prioritize accessibility, affordability, and sustainability. Strengthening diagnostic infrastructure is essential for effective clinical management, timely outbreak containment, and long-term vector control. This review underscores the urgent need for global health systems to elevate dengue diagnostics within broader NTD control frameworks.