Bridging Gaps in Dengue Management: A Review of Diagnostics, Transfusion Needs, and Public Health Challenges

BACKGROUND: Dengue fever remains a major global public health challenge, particularly in endemic regions, due to its complex clinical presentation, diagnostic limitations, evolving epidemiology, and immunopathogenic mechanisms such as antibody-dependent enhancement (ADE). Despite advancements, integration among clinical care, diagnostics, transfusion practices, vector control, and public health systems remains limited. OBJECTIVE: This review aimed to synthesize current evidence on dengue management by integrating clinical, diagnostic, transfusion, and public health domains, highlighting persistent gaps and proposing coordinated, multidisciplinary response strategies. METHODS: A narrative review was conducted using peer-reviewed English-language literature published between 2018 and 2025. Databases searched included PubMed, Scopus, Web of Science, and Google Scholar. Search terms included "dengue diagnosis," "transfusion management," "vector control," and "public health intervention." A total of 30 studies were selected based on relevance to diagnostic practices, transfusion strategies, vector control, and systemic health responses. Thematic synthesis and quality assessment were applied. RESULTS: Findings confirm that ADE contributes to increased viral replication and severity, highlighting the need for individualized fluid management and evidence-based transfusion protocols. Rapid diagnostic tests and biomarkers such as C-reactive protein and IPF% facilitate early detection of severe dengue but are underutilized. Platelet transfusions are inconsistently applied, often without standardized clinical criteria. Integrated vector control strategies, including Wolbachia-infected mosquitoes, and community engagement approaches demonstrate effectiveness, although postpandemic disruptions and poor interagency coordination limit their impact. Cost-effectiveness studies support combined vaccination and vector interventions for optimal disease reduction. CONCLUSION: This review emphasizes the necessity of a unified, systems-based approach to dengue management. By integrating clinical staging, diagnostics, transfusion protocols, vector control, and public health frameworks, dengue outbreak responses can be substantially strengthened. Multidisciplinary coordination, behavior-informed health strategies, and sustained public health engagement are essential to improving preparedness and reducing the global burden of dengue.