Dengue is a major public health problem worldwide, particularly in tropical and subtropical regions. The disease is caused by the dengue virus (DENV), which belongs to the Flaviviridae family and is primarily transmitted to humans by Aedes aegypti and Aedes albopictus mosquitoes [1]. DENV has four antigenically distinct yet genetically related serotypes, referred to as dengue serotypes 1 to 4 (DENV-1, DENV-2, DENV-3, and DENV-4) [1].

Infection with any of the four DENV serotypes can lead to a range of clinical signs and symptoms, most commonly presenting as an acute febrile illness accompanied by high fever, headache, vomiting, malaise, and body pain. Nonetheless, the clinical manifestation can progress to severe, life-threatening conditions including shock or multi-organ failure if not properly managed [1]. Dengue diagnosis relies on a combination of clinical assessment and laboratory confirmation, however the nonspecific symptoms throughout disease progression poses a challenge to physicians in making an accurate diagnosis [2]. Misdiagnosis of dengue with other arboviral infections was reported, particularly in areas where multiple viruses co-circulate [3,4].

Indonesia, one of the most hyper-endemic countries for dengue, has experienced a rising number of cases over the past decade [5,6]. Our recent study highlights the diagnostic challenges of arboviral infections in febrile patients in East Java, Indonesia, emphasizing the urgent need for improved diagnostic strategies [3]. Implementing serological or nucleic acid-based methods could enhance arbovirus detection and improve patient outcomes in the region. Nonetheless, despite the increasing annual incidence of dengue, laboratory confirmation using serological tests, such as non-structural protein 1 (NS1), antibody tests for Immunoglobulin G (IgG) and Immunoglobulin M (IgM) remains limited in Indonesia [3]. Dengue diagnosis in Indonesia has primarily relied on clinical evaluation, while nucleic acid-based diagnostic methods for DENV detection and serotype identification are also not widely utilized in the country [7].

Several DENV nucleic acid detection tests are now available and capable of delivering reliable results during the early stages of the disease [8], but the performance of these tests may vary significantly [9,10]. Therefore, this study aimed to evaluate and compare the performance of commercially available and in-house designed tests for DENV detection and serotype identification in Indonesian patients.