Biomedicine and Neglected Tropical Diseases: Advances in Diagnosis and Control

Neglected Tropical Diseases (NTDs) comprise a set of infectious diseases that persist in conditions of poverty and social exclusion, disproportionately affecting vulnerable communities in lowand middle-income countries. According to the World Health Organization (WHO), these diseases affect more than one billion people worldwide and are intrinsically related to precarious sanitation, housing and access to health services. In Brazil, the epidemiological scenario of these diseases is aggravated by regional inequalities and disorderly urban growth [1,2].

Among the most relevant NTDs in the Brazilian context are Dengue, Chikungunya and Zika, all transmitted by mosquitoes of the Aedes genus, especially Aedes aegypti. These arboviruses have caused recurrent outbreaks with significant health, economic and social impacts. The increasing incidence of these diseases, associated with the difficulty of sustainable vector control, makes it urgent to adopt integrated strategies for early diagnosis, monitoring and rapid response [3,4].

Biomedicine, as a science applied to health, has positioned itself as a central element in the fight against NTDs. Biomedical activities range from research and development of diagnostic tools to the operationalization of laboratory tests at different levels of health care. Biomedical professionals play a strategic role in laboratory environments, surveillance centers, and epidemiological emergency response teams [5,6].

The evolution of diagnostic technologies in recent decades has allowed significant advances in the detection of NTDs. The introduction of real-time RT-PCR, for example, has revolutionized the early identification of viruses such as ZIKV and CHIKV, especially in the early stages of infection, when symptoms are still nonspecific. This technology, combined with the use of biosensors and microfluidics techniques, has expanded diagnostic capacity even in places with limited infrastructure [7,8].

Additionally, the use of rapid serological tests in health units has proven essential for mass diagnosis, allowing large-scale case tracking and the implementation of control measures quickly. Such tests are essential especially in contexts of epidemic outbreaks, where response time is a critical factor in preventing the spread of the virus [8,9].

The role of biomedical professionals also extends to laboratory epidemiological surveillance, an area responsible for monitoring viral circulation and issuing alerts to health authorities. The integration of biomedical professionals with information systems and reference laboratories strengthens the capacity of the Unified Health System (SUS) to face health crises related to NTDs [2,10]. It is important to highlight that, despite scientific advances, challenges persist in combating NTDs. The scarcity of laboratory resources in remote regions, the dependence on imported inputs for molecular diagnosis and the turnover of trained professionals limit the effectiveness of actions. Strategies for continuous training, internalization of technologies and strengthening of the biomedical career are necessary to ensure the sustainability of actions [2].

The Brazilian context, marked by structural inequalities, requires that technological innovation be accompanied by integrated public policies. Vector control programs, active surveillance, health education and incentives for applied research must go hand in hand with the development of new laboratory tools. Biomedicine is at the center of this process as an articulator of scientific knowledge and practices in public health [1,2].

Internationally, there is a growing effort to strengthen global health through interdisciplinary approaches. Initiatives such as One Health and the UN 2030 Agenda, through the Sustainable Development Goals (SDGs), reinforce the importance of controlling NTDs as a key element for health equity. In this scenario, the biomedical contribution transcends the laboratory and becomes part of international cooperation networks [1,11]. This article aims to analyze the advances promoted by Biomedicine in the diagnosis and control of the NTDs Dengue, Chikungunya and Zika, with an emphasis on emerging technologies and practices applied in Brazil. Thus, it seeks to contribute to the consolidation of a critical, innovative and scientifically based approach to the role of the biomedical professional in tackling neglected infectious diseases, articulating science, technology and public health.

This study constitutes a narrative literature review, an appropriate methodology for surveying and discussing relevant scientific evidence on a given topic, without requiring systematic selection and analysis criteria. The choice of this approach is justified by the complexity and multidimensionality of the role of Biomedicine in tackling Neglected Tropical Diseases (NTDs), especially Dengue, Chikungunya and Zika, in the Brazilian context [12,13]. The review was conducted between January and April 2025, with an emphasis on national and international sources that addressed diagnostic, technological, laboratory and epidemiological aspects related to NTDs and biomedical performance. The scientific databases PubMed, Scopus, SciELO, Web of Science, LILACS and Google Scholar were consulted, using the combined descriptors: “Biomedicine”, “Laboratory Diagnosis”, “Neglected Tropical Diseases”, “Dengue”, “Zika virus”, “Chikungunya”, “Diagnostic Technology” and “Brazil”, in Portuguese and English [1,14].

Original articles, literature reviews, technical guides, institutional guidelines and official documents published in the last ten years (2014–2024) were included. To ensure thematic relevance, priority was given to the critical reading of materials that directly addressed the interface between diagnostic innovations and biomedical practices in the face of arboviruses in the national territory [2]. The inclusion criteria were: publications addressing laboratory diagnosis of Dengue, Chikungunya or Zika; studies that highlighted the role of biomedical professionals or their professional performance in the health system; texts focusing on emerging technologies or NTD control policies. Documents that dealt only with vector control or clinical aspects without an interface with laboratory practice were excluded [3,10]. The study selection process took place in two stages: screening by reading the title and abstract, based on adherence to the proposed theme; full reading of the selected texts to extract relevant data. The extracted information was organized into thematic categories: types of diagnostic tests used, emerging technologies applied, challenges faced in biomedical practice and proposals for strengthening diagnosis in the SUS [4,7]. The content analysis was performed qualitatively, based on the principles of theoretical triangulation. This approach allowed the construction of a critical and interpretative overview of the trends, limitations and opportunities of biomedical action in the field of NTDs. The aim was to highlight the contributions of cutting-edge technologies – such as RT-PCR, biosensors, point- of - care platforms – and their applicability at different levels of health care [6,8]. As this is a study based on secondary data available in the public domain, there was no need for submission to the Research Ethics Committee, in accordance with CNS Resolution No. 510/2016. All documents analyzed are duly referenced in this article [15].

Although the narrative review does not follow systematic protocols such as PRISMA or Cochrane, the careful selection and the basis in consolidated scientific literature give validity to the analysis process. This methodology makes it possible to capture nuances and gaps that are still little explored in the national literature, reinforcing the importance of a critical and contextualized approach to the topic [16]. LACENs) were used, aiming to incorporate the applied perspective of biomedical practice into the daily life of the SUS [17]. This methodological approach seeks not only to systematize recent advances in the diagnosis of NTDs, but also to point out guidelines and future paths for the consolidation of biomedical protagonism in tackling these neglected diseases [1,2].

The literature review showed a significant expansion in the technological tools used for the diagnosis of Neglected Tropical Diseases (NTDs), especially in relation to Dengue, Chikungunya and Zika. Among the main advances, the growing adoption of the realtime RT-PCR technique stands out, which enables the early detection of viral genetic material in clinical samples, contributing to faster and more accurate diagnoses, particularly in the early stages of infections [7,8]. The use of rapid serological tests has also gained prominence in the Brazilian context. Immunochromatographic tests for the detection of IgM and IgG antibodies provide results in minutes and are essential for screening in basic health units, especially during outbreaks. However, the literature points to limitations regarding the sensitivity of these tests in certain immunological windows, reinforcing the importance of their use in addition to molecular methods [2,9].

The development and application of biosensors, especially those based on nanotechnology and microfluidics, represented a qualitative leap in point- of - care diagnostic capabilities. These portable devices, which combine low cost and high specificity, have been successfully tested in field environments and in regions with limited laboratory infrastructure, expanding the scope of active surveillance [1,6]. Another significant result concerns the expansion of the scope of action of the biomedical professional. Studies indicate that biomedical professionals have been playing strategic roles not only in carrying out laboratory tests, but also in developing diagnostic kits, training multidisciplinary teams, organizing laboratory flows and participating in epidemiological surveillance committees [2,10].

The analysis of official documents from the Ministry of Health highlighted the progressive inclusion of biomedical professionals in the technical teams of the central public health laboratories (LACENs), especially in the Vector-Borne Disease Centers and in the situation rooms. This inclusion has contributed to the improvement of the institutional response to health emergencies [1,17]. Regarding laboratory infrastructure, it was found that many Brazilian states have implemented mobile diagnostic units in recent years, allowing the processing of samples in remote areas. Such initiatives have expanded the operational capacity of health services and have had the active participation of biomedical professionals in the execution and technical coordination [1,3].

Technological innovation programs were also identified that have direct involvement of biomedical researchers, both in academia and in partnership with public and private institutions. These programs have been promoting the development of new reagents, sensors and integrated laboratory analysis platforms [2,6]. Qualitative studies have revealed a positive perception among health system managers and users regarding the contribution of biomedical professionals in the context of NTDs. Reports indicate greater agility in the diagnostic flow, improvement in the quality of the tests performed and strengthening of the articulation between laboratory and territorial surveillance [14,16]. Although the results are promising, gaps were also identified, such as the lack of continuous training in molecular diagnosis for professionals in the public network, the inequality in the distribution of technologies between Brazilian regions and the dependence on imported inputs to carry out complex exams [1,2]. In general, the findings of this review point to the central role of Biomedicine in the modernization of diagnostic systems and in responding to epidemiological emergencies, with a direct impact on reducing underreporting, speeding up control actions and promoting equity in access to health [1,2].

The findings of this review indicate relevant advances in diagnostic capacity and biomedical action against Neglected Tropical Diseases (NTDs), especially Dengue, Chikungunya and Zika. The consolidation of molecular technologies such as RT-PCR and the development of rapid tests and biosensors configure a new scenario for laboratory diagnosis, more agile and accurate, even in remote areas. Such innovations have contributed to a rapid response in emergency situations and to the effective redirection of public health policies [1,7,8].

The increasingly active presence of biomedical professionals in laboratory surveillance services highlights the strengthening of their role within the Unified Health System (SUS). This expansion is not only technical, but also strategic, as it allows for greater integration between diagnosis, notification, and outbreak control. The literature indicates that biomedical work has enhanced the articulation between the local and national spheres, favoring the territorialization of public health actions [2,10].

However, challenges persist. Inequality in access to diagnostic technologies is a significant barrier, especially in the North and Northeast regions of Brazil. The shortage of infrastructure, supplies, and specialized labor compromises the equity of the health system. Dependence on imported kits and reagents also weakens national diagnostic sovereignty and impacts the sustainability of control strategies [1,17]. Another critical point identified refers to the continuous training of professionals. Despite the increasing adoption of new technologies, many services still lack regular training for the proper use of available laboratory resources. Investments in continuing education are essential to ensure diagnostic quality and the safety of laboratory processes [2,16].

Biomedical action in the area of NTDs must be understood from an intersectoral perspective. Integration with surveillance, primary care, vector control and health education teams strengthens the capacity to deal with arboviruses. Integrated and decentralized management models are recommended to optimize the response to outbreaks and ensure the effectiveness of interventions [2,3]. The literature also highlights the potential of national technological innovation as a tool to overcome structural barriers. Encouraging applied research, local production of diagnostic supplies, and the implementation of social technologies can contribute to reducing external dependence and strengthening the health industry in Brazil. Biomedicine is at the center of this process of innovation and nationalization of solutions [6,14].

From a global health perspective, Brazil’s biomedical contribution can be expanded through international collaboration networks, technology sharing, and strengthening of regional capacities. The accumulated experience in managing arboviruses in tropical contexts makes Brazil a strategic hub for the development of solutions applicable to other countries in situations of epidemiological vulnerability [1,11]. It is also necessary to advance in the production of evidence on the effectiveness of the diagnostic technologies used. Comparative studies between different platforms, sensitivity in different clinical phases and cost-effectiveness of the tests are important to guide the rational allocation of public resources and the choice of strategies most appropriate to each territory [7,9]. Overcoming the challenges associated with NTDs requires recognizing the essential role of Biomedicine, not only as a technical field, but as a fundamental actor in the construction of evidence-based public policies. The valorization of the profession and its integration into the strategic agendas of the SUS must be priorities to increase the capacity to respond to health threats [2,17]. In summary, the discussion of the results reinforces the centrality of Biomedicine as an articulating axis between science, technology and public health. The diagnostic advances observed in recent years are promising, but their consolidation depends on structural investments, professional development policies and continuous inter-institutional articulation [1,2].

This review reinforces the leading role of Biomedicine in tackling Neglected Tropical Diseases (NTDs), especially with regard to the diagnosis and control of arboviruses such as Dengue, Chikungunya and Zika. The incorporation of new laboratory technologies and the improvement of biomedical performance have contributed significantly to expanding the response capacity of the health system in the face of outbreaks and epidemiological emergencies [1,2,6]. Evidence suggests that the use of tools such as real-time RTPCR, field biosensors and rapid serological tests has strengthened diagnostic processes, reducing the time between infection and laboratory confirmation. This advance has a direct impact on the effectiveness of surveillance, prevention and control actions, in addition to contributing to the reduction of underreporting of cases [7-9].

At the same time, the expansion of the biomedical professional’s duties in central laboratories, health services and surveillance programs demonstrate the importance of qualified training and institutional appreciation of this category. Their inclusion in multidisciplinary teams has promoted important synergies between laboratory diagnosis, epidemiological analysis and public health actions [2,10,17]. Despite the advances, structural challenges persist, such as regional inequality in the distribution of diagnostic technologies, dependence on imported inputs, and the need for continuous training of professionals in the public health system. These barriers require coordinated responses between government agencies, educational and research institutions, and productive sectors [1,16].

Therefore, it is recommended to strengthen public policies aimed at technological innovation in health, as well as to create mechanisms that stimulate the national production of laboratory supplies. The articulation between science, technology and service is essential to consolidate the country’s health sovereignty and expand equitable access to quality diagnosis [3,6,14]. Furthermore, it is essential to integrate Biomedicine into global strategies for controlling NTDs, promoting technical-scientific exchange and participation in international cooperation networks. Brazilian expertise in tackling these diseases can contribute significantly to the advancement of global health in tropical and subtropical contexts [1,11]. In short, the role of Biomedicine in NTDs transcends the laboratory: it is a critical and strategic action that connects scientific production to the reality of health services. The consolidation of this leading role depends on continued investments in infrastructure, training and professional development [2,16].

This study contributes to the recognition of the relevance of Biomedicine in facing historical challenges in Brazilian public health, highlighting the need for structuring policies that guarantee its full action at all levels of the health system [1,17]. It is expected that the findings presented here will serve as a basis for new studies, systematic reviews and analyses of the effectiveness of the technologies applied, supporting the construction of an integrated national agenda committed to the control of NTDs [7,9]. Finally, it is reaffirmed that tackling NTDs requires not only technical innovation, but also political commitment, social equity and appreciation of health professions, among which Biomedicine stands out as a fundamental pillar for diagnosis, surveillance and the construction of a more resilient and inclusive health system [1,2].

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