Breakthrough from NTU Singapore's LKCMedicine in Dengue Diagnostics

Researchers at Nanyang Technological University's Lee Kong Chian School of Medicine (LKCMedicine) have made a significant advancement in dengue diagnostics through a study focused on urine-based testing. This dengue urine test research identifies specific proteins in urine that not only confirm dengue infection but also indicate the likely severity of the disease. Led by Dr. Andrew Teo, a senior research fellow at LKCMedicine, and involving collaboration with the National Centre for Infectious Diseases (NCID), the study analyzed samples from 125 dengue patients in Singapore.

The findings, published in the peer-reviewed journal Open Forum Infectious Diseases on January 9, 2026, highlight the potential for a simple, non-invasive test that could transform how dengue is managed, especially in high-burden areas like Singapore. This innovation comes at a time when Singapore recorded a notable decline in dengue cases in 2025, with 3,990 to 4,036 cases—a 70% drop from 13,651 in 2024—but experts caution that emerging strains could reverse this trend.

Understanding Dengue in Singapore: A Persistent Public Health Challenge

Dengue fever, caused by the dengue virus (DENV) transmitted by Aedes mosquitoes, remains a major concern in tropical regions, including Singapore. The disease manifests in phases: febrile (days 1-5), critical (days 5-7), and recovery. Severe dengue, previously known as dengue hemorrhagic fever or dengue shock syndrome, can lead to plasma leakage, organ impairment, and even death. In Singapore, proactive measures like the National Environment Agency's (NEA) vector control and Project Wolbachia have helped reduce cases, but vigilance is key amid climate change influences.

Historically, Singapore has seen epidemics, such as over 14,000 cases in early 2014. The 2025 decline to historic lows offers breathing room, with January 2026 reporting 149 cases. Yet, with four serotypes (DENV-1 to DENV-4), secondary infections increase severe risk due to antibody-dependent enhancement (ADE). Current diagnostics rely on blood tests for NS1 antigen or IgM/IgG antibodies, but these are invasive and don't predict severity reliably.

Key Urine Biomarkers: NS1, NGAL, and suPAR Explained

The core of this dengue urine test research lies in three proteins: dengue virus non-structural protein 1 (NS1), neutrophil gelatinase-associated lipocalin (NGAL), and soluble urokinase plasminogen activator receptor (suPAR). NS1, secreted by infected cells, appears in urine during early infection, enabling detection within four days of symptoms.

NGAL, a marker of kidney stress and neutrophil activation, and suPAR, indicating systemic inflammation and endothelial dysfunction, show elevated levels in severe cases. The study demonstrated strong predictive power: urinary NGAL had an area under the receiver operating characteristic curve (AUROC) of 0.88, and suPAR 0.79 for severe dengue in the febrile phase. These outperform many existing markers by providing prognostic insights early.

• NS1: Confirms active dengue infection (viral marker).
• NGAL: Signals renal tubular damage and inflammation severity.
• suPAR: Reflects vascular permeability risk, key to severe dengue.

This combination allows differentiation between mild dengue fever (DF) and severe forms, guiding triage.

Research Methodology: From Patient Samples to Statistical Validation

The prospective cohort study enrolled 125 adults with confirmed dengue at Singapore hospitals. Urine samples were collected during the febrile phase and analyzed via enzyme-linked immunosorbent assay (ELISA) for NS1, NGAL, and suPAR concentrations. Severity was classified per World Health Organization (WHO) 2009 criteria: dengue without warning signs, with warning signs, or severe dengue.

Researchers normalized protein levels to creatinine for accuracy and used logistic regression models to assess predictive value. Results showed significantly higher NGAL and suPAR in severe cases (p < 0.001). Validation included receiver operating characteristic (ROC) analysis, confirming high sensitivity and specificity. No adverse events from sampling highlighted urine's non-invasive appeal.

Affiliations included NTU LKCMedicine and collaborators from the University of Melbourne's Doherty Institute, underscoring international ties in Singapore's higher education research ecosystem.

Advantages of Urine-Based Dengue Testing Over Blood Tests

Traditional dengue diagnostics require venous blood draws or finger pricks, processed in labs, causing patient discomfort and clinic overload. Urine tests are painless, self-collectable, and stable for transport—ideal for point-of-care (POC) use.

• Non-invasive: No needles, suitable for children and frequent monitoring.
• Prognostic: Predicts hospitalization need early, unlike NS1 blood tests.
• Cost-effective: Potential for lateral flow assays like COVID rapid tests.
• Accessible: Home kits empower patients in rural or outbreak settings.

In Singapore, where daily clinic visits stress patients amid fever and myalgia, this reduces burden. Dr. Chia Po Ying noted the anxiety of repeated testing; urine kits offer control.

Photo by CHUTTERSNAP on Unsplash

Path to Commercial Take-Home Dengue Test Kits

Building on this, researchers envision rapid test strips detecting all three biomarkers, akin to pregnancy tests. Dr. Teo emphasized: concentrations guide home vs. hospital decisions. Validation trials planned with Sri Lanka's University of Sri Jayewardenepura. Estimated timeline: 5 years to market, pending regulatory approval.

Singapore's biomedical hub status, with A*STAR and universities, positions it for development. This aligns with global needs, as dengue affects 400 million annually, per WHO.

NTU LKCMedicine's Role in Infectious Disease Innovation

NTU's LKCMedicine exemplifies Singapore's higher education commitment to translational research. Prior studies from the school identified blood sST2 and suPAR for severity prediction. This urine focus builds momentum, attracting funding and talent.

Singapore universities like NTU, NUS, and Duke-NUS lead dengue efforts, from modeling outbreaks to vaccine trials. For academics, such projects offer PhD/postdoc opportunities in virology and biomarkers.Explore research jobs in higher education.

Broader Implications for Public Health and Healthcare Systems

Beyond diagnosis, this reduces hospitalization rates (10-20% of cases severe), easing Singapore's system. Integrates with NEA surveillance and Wolbachia releases. Globally, aids low-resource settings.

Stakeholders: MOH praises innovation; experts like Prof. Leo Yee Sin (NCID) advocate combo strategies. Challenges: serotype variability, kit sensitivity in low viremia.

Career Opportunities in Dengue and Infectious Disease Research

Singapore universities drive demand for experts. NUS seeks research fellows in dengue modeling; NTU hires postdocs for biomarkers. Roles span lab techs to PIs, with salaries SGD 5,000-15,000 monthly.

• Virologists: Virus-host interaction studies.
• Bioinformaticians: Biomarker data analysis.
• Clinicians: Translational trials.

Aspire to join? Check postdoc positions or academic CV tips. Singapore's ecosystem offers grants like NMRC.

Future Outlook: Integrating Urine Tests into Dengue Management

Prospects include multiplex kits for Zika/chikungunya, AI-enhanced severity scores. Challenges: large-scale trials, cost below SGD 10/test. Optimism high, with global partnerships.

For higher ed, boosts Singapore's rep as Asia's research hub. Students: pursue biomed eng or public health for impact.

Photo by Scribbling Geek on Unsplash

Conclusion: Empowering Prevention and Response Through Research

This NTU-led dengue urine test research exemplifies university innovation addressing real needs. By detecting infection and severity via urine proteins, it promises safer, efficient care. Stay informed via Rate My Professor, explore higher ed jobs, or career advice. For Singapore roles, visit AcademicJobs Singapore or university jobs.

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