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When dengue is not the answer: diagnostic anchoring bias in febrile illnesses in conflict-affected settings
Mumen Abdalazim Dafallah1, Fatima Abdelmonem Yousif Mohamed2, Eman Osama Mohammed Omer2
1Internal Medicine Department, Sudan Medical Specialization Board, Wad Medani, Sudan.
Abstract:
Dengue is an increasingly prevalent arboviral infection in tropical regions, with expanding geographic distribution and rising reports of atypical and severe manifestations, including neurological involvement. In endemic and resource-limited settings, particularly those affected by conflict, the widespread availability of rapid diagnostic tests and overlapping clinical presentations with other infectious diseases have led to a growing concern: diagnostic anchoring bias toward dengue. This bias may contribute to misdiagnosis, delayed treatment of alternative life-threatening conditions, and distorted public health data. This commentary highlights key diagnostic pitfalls, including coinfections, incidental dengue positivity, and neurological mimics, and proposes a pragmatic clinical approach to improve diagnostic accuracy and patient outcomes.
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