Evaluation of molecular and serological diagnostics for dengue during the 2023 outbreak in Jember, East Java,...

Dengue virus (DENV) is a major public health concern in Indonesia, with all four serotypes contributing to recurrent outbreaks. This study evaluated molecular diagnostic tests for DENV and identified circulating serotypes despite limited national surveillance.

Clinically diagnosed dengue patients were recruited during the 2023 outbreak in Jember, Indonesia. Dengue was confirmed using Rapid Diagnostic Tests (RDTs) for NS1, IgM, IgG, and RT-PCR assays (Fast Track Diagnostics (FTD) and DENV in-house RT-qPCR), with diagnostic accuracy assessed using a composite reference standard. DENV serotypes were identified using Altona, CDC, and Serotype in-house RT-PCR.

The FTD RT-PCR test showed higher sensitivity (100 %) than the DENV in-house test (78 %). All RDTs-positive cases were confirmed as DENV RNA-positive by RT-PCR. Serotyping detected all four DENV serotypes, with DENV-3/4 co-infections in seven patients. While the CDC and Serotype in-house tests effectively identified DENV-2, DENV-4, and DENV-3/4; DENV-1 was better detected by the Altona and Serotype in-house tests. The Altona test failed to detect DENV-4 in our study.

All four DENV serotypes were detected during the 2023 outbreak, with possible re-emergence of DENV-4. The FTD dengue test proved effective for confirming infections, though rapid serological tests remain a practical but less precise alternative.