DENGUE AND ITS CLINICAL COMPLICATIONS: AN EPIDEMIOLOGICAL, CLINICAL, AND THERAPEUTIC UPDATE (2023-2026)

Abstract

DOI: https://doi.org/10.46296/gt.v9i17.0380

Abstract

Dengue remains one of the arboviral diseases with the greatest impact on global public health, with a burden that has intensified steadily over the past decade. The simultaneous circulation of the four dengue virus serotypes (DENV-1 to DENV-4), together with the geographic expansion of the Aedes aegypti vector and, to a lesser extent, Aedes albopictus, led the World Health Organization (WHO) to declare a grade 3 emergency in December 2023, the highest level on its emergency scale. In 2024 alone, nearly 13 million cases and more than 8,700 deaths were reported to WHO from 90 countries, far exceeding the historic record of 6.5 million cases reached in 2023. Ecuador has not been exempt from this trend: in 2024 the Ministry of Public Health (MSP) reported 61,352 confirmed cases and 76 deaths, 28 of them in children, with Manabí, Napo, Guayas, and Los Ríos among the most affected provinces, a situation that led to a national epidemic declaration in January 2025. This article updates the previous review of the clinical presentation of dengue, incorporating the 2023-2026 epidemiological picture, laboratory diagnostic criteria, current clinical management guidelines according to disease phase, and the current status of prevention, vector control, and vaccination strategies, including the tetravalent TAK-003 (Qdenga®) vaccine. It is concluded that, despite diagnostic advances and the availability of a partially effective, restricted-use vaccine, dengue control still depends largely on strengthened epidemiological surveillance, timely clinical recognition of warning signs, and integrated vector control.

Keywords: Dengue, clinical picture, epidemiology, diagnosis, vaccines, Ecuador.