Laboratory Biomarkers and Emerging Diagnostic Technologies for Dengue, Zika, Chikungunya, and Yellow Fever: a Scoping Review
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Background The co-circulation of dengue, Zika, chikungunya, and yellow fever viruses poses a major challenge to laboratory diagnosis due to overlapping clinical manifestations and laboratory findings. Although novel diagnostic technologies have emerged in recent years, the diagnostic performance of laboratory biomarkers and their clinical applicability remain incompletely characterized. Objective To map the available evidence on laboratory biomarkers used for the diagnosis of the major endemic arboviral infections, identifying research trends, emerging diagnostic technologies, and knowledge gaps that may hinder their implementation in routine laboratory practice. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology, conducted according to a prespecified protocol and reported following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. The research question was developed using the Population-Concept-Context (PCC) framework. Literature searches were performed in PubMed/MEDLINE, LILACS, and SciELO, complemented by a gray literature search through Google Scholar, including studies published from January 2020 through March 2025. Study selection was independently performed by two reviewers using the Rayyan® platform, followed by standardized data extraction. Results A total of 142 studies from 38 countries were included, with the highest scientific output originating from Brazil (16.2%), the United States (14.7%), and India (7.0%). Publication output peaked in 2020 (31.7%), followed by a steady decline in subsequent years. Dengue was the most extensively investigated arboviral disease (46%), followed by Zika (22.5%), chikungunya (9.2%), and yellow fever (1.4%); 29 studies simultaneously investigated two or more arboviral diseases. Molecular diagnostic approaches based on viral nucleic acid detection predominated (66/142 studies). In addition, innovative diagnostic platforms, including multiplex assays, biosensors, microfluidic devices, CRISPR-based technologies, and aptamer-based systems, were increasingly reported. Discussion The predominance of molecular diagnostic approaches, together with the growing interest in innovative diagnostic platforms, underscores the ongoing evolution of arboviral diagnostics toward more sensitive and specific technologies. However, the evidence also reveals persistent barriers to clinical implementation, including cross-reactivity among flaviviruses, methodological heterogeneity, lack of standardized protocols, limited multicenter validation, and the scarcity of studies addressing yellow fever. Conclusions The current evidence highlights an ongoing transition from conventional serological assays to molecular and precision diagnostic technologies for arboviral diseases. Despite these advances, broader implementation in routine laboratory practice will require robust clinical validation and methodological standardization. This scoping review synthesizes the current evidence, identifies critical knowledge gaps, and defines priorities for translational research to support the development of robust, standardized, and clinically translatable diagnostic strategies for regions where multiple arboviruses co-circulate.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223084379