{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:08:27Z","timestamp":1792022907928,"version":"4.4.0"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Dengue fever, with a high proportion of asymptomatic infections, poses a major global public health challenge that traditional surveillance systems frequently underestimate. Wastewater-based epidemiology (WBE) has emerged as a promising approach to monitoring infectious diseases beyond enteric viruses. Dengue virus is shed in urine, feces, and saliva, providing a biological basis for wastewater detection alongside clinical surveillance. This systematic review and meta-analysis synthesize current evidence on dengue virus (DENV) detection in wastewater and evaluate methodological factors influencing detection success in WBE. A systematic literature search using selected databases and predetermined keywords, followed by eligibility screening, resulted in ten studies being included, covering community surveillance and experimental trials. DENV ribonucleic acids (RNA) were most consistently detected and enriched in wastewater solids, indicating this matrix as the most reliable for surveillance. Among concentration methods, ultrafiltration achieved the highest viral recovery efficiency, while reverse transcription digital polymerase chain reaction (RT-dPCR) demonstrated superior sensitivity and precision compared to those of reverse transcription quantitative polymerase chain reaction (RT-qPCR), particularly at low viral concentrations. Storage at \u221280 \u00b0C was critical for preserving RNA integrity. The meta-analysis yielded a pooled DENV positivity rate of 24% (95% CI: 20\u201328%) after exclusion of outliers. Overall, solid-phase analysis combined with RT-dPCR represents the most sensitive methodological approach across the included studies. Harmonized protocols are needed to support future translation of dengue WBE into community surveillance as current evidence mainly demonstrates methodological feasibility and provides a technical foundation for future public health integration. Therefore, further longitudinal and multi-site validation is required to establish its broader applicability for dengue surveillance.<\/jats:p>","DOI":"10.3390\/v18050531","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:33:17Z","timestamp":1777627997000},"page":"531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Methodological Approaches to Dengue Virus Detection in Wastewater: A Systematic Review and Meta-Analysis of Positivity Rate"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6609-1529","authenticated-orcid":false,"given":"Siti Aishah","family":"Rashid","sequence":"first","affiliation":[{"name":"Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2260-8821","authenticated-orcid":false,"given":"Sakshaleni","family":"Rajendiran","sequence":"additional","affiliation":[{"name":"Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul Farehah","family":"Shahrir","sequence":"additional","affiliation":[{"name":"Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul Athirah","family":"Naserrudin","sequence":"additional","affiliation":[{"name":"Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-7435","authenticated-orcid":false,"given":"Terence Tan Yew","family":"Chin","sequence":"additional","affiliation":[{"name":"Integrative Health Information Unit, Herbal Medicine Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4954-8950","authenticated-orcid":false,"given":"Janice Chan Sue","family":"Wen","sequence":"additional","affiliation":[{"name":"Integrative Health Information Unit, Herbal Medicine Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-6382","authenticated-orcid":false,"given":"Imanul Hassan","family":"Abdul Shukor","sequence":"additional","affiliation":[{"name":"Institute for Health Management, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9704-5026","authenticated-orcid":false,"given":"Nurul Amalina","family":"Khairul Hasni","sequence":"additional","affiliation":[{"name":"Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1038\/nature12060","article-title":"The Global Distribution and Burden of Dengue","volume":"496","author":"Bhatt","year":"2013","journal-title":"Nature"},{"key":"ref_2","unstructured":"World Health Organization (2026, February 23). 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