Integrative Advances in Dengue Virus Diagnostics: From Technological Innovation to Tiered Diagnostic Systems.

Dengue virus (DENV) represents an escalating global public health threat, with rising incidence and expanding geographic distribution. Early and accurate diagnosis remains the cornerstone of effective outbreak management in the absence of universally accessible vaccines or antiviral therapies. Conventional diagnostic methods including viral nucleic acid detection, antigen/antibody testing have achieved substantial progress but still face limitations in sensitivity, speed, and applicability within resource-limited settings. Recent technological innovations are reshaping the diagnostic landscape. Advances in isothermal amplification, CRISPR-based detection, and NGS have markedly enhanced the sensitivity, specificity, and rapidity of DENV detection. In addition, the incorporation of noninvasive samples such as saliva and urine, together with home-based and POCT systems, is expanding diagnostic accessibility. The WHO's REASSURED framework further provides essential guidance for developing affordable, rapid, and field-deployable diagnostic tools. This review summarizes current DENV diagnostic strategies, spanning nucleic acid and serological detection, and highlights recent innovations that integrate these approaches into tiered diagnostic systems. By combining technological advancement with clinical and public health applicability, these strategies hold great promise for strengthening early detection, improving outbreak surveillance, and supporting the global effort toward dengue elimination.