Evidence map›Paper›PMID 42851854›Full record

ArticleOpen forum infectious diseases2026

Rethinking Clinical Trial Design to Accelerate Therapeutics for Arboviral Epidemics.

Andrea Alemany, Maria Paula Mourão, Ami Fazlin Bt Syed Mohamed, Steven Lim Chee Loon, Zaril Harza Bin Zakaria, Adriane Alves de Oliveira, Rozainanee Mohd Zain, Sergio Sosa-Estani, Manoel Barral-Netto, Meiruze Sousa Freitas and 11 more

Abstract read
In one paragraph

Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Andrea AlemanyDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).ORCID https://orcid.org/0000-0001-8379-6857
Maria Paula MourãoDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).ORCID https://orcid.org/0000-0002-6458-0900
Ami Fazlin Bt Syed MohamedDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).ORCID https://orcid.org/0000-0003-2747-951X
Steven Lim Chee LoonDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Zaril Harza Bin ZakariaDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Adriane Alves de OliveiraAgência Nacional de Vigilância Sanitária (Anvisa), Brasilia, Brazil.
Rozainanee Mohd ZainDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Sergio Sosa-EstaniDrugs for Neglected Diseases Initiative (DNDi), Rio de Janeiro, Brazil.
Manoel Barral-NettoDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Meiruze Sousa FreitasDepartamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia e Inovação e do Complexo Econômico-Industrial da Saúde do Ministério da Saúde (Decit/SECTICS/MS), Brazil.
Marcus Vinicius Guimarães de LacerdaDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Quique BassatISGlobal, Barcelona, Spain.ORCID https://orcid.org/0000-0003-0875-7596
Ganesan KarthikeyanDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Prasert AuewarakulDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).ORCID https://orcid.org/0000-0002-4745-4291
Nor Fariza NgahDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).ORCID https://orcid.org/0000-0003-4760-2271
Isabela RibeiroDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Andre M SiqueiraDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Mauro M TeixeiraDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Viviane Sampaio BoaventuraDengue Alliance (Geneva, Brazil, India, Malaysia and Thailand).
Dengue Alliance Clinical Experts Meeting Group
Dengue Alliance Clinical Experts Meeting Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Arboviral diseases represent an escalating global health threat, yet therapeutic development has been markedly slower than for other viral illnesses. Key barriers include the unpredictability and variability of arbovirus transmission, which complicate site selection, limit recruitment, and increase delays and the risk of inconclusive trials. Additional challenges include maintaining trial-ready sites, recruitment within the narrow therapeutic window, ensuring rapid diagnostics, and including high-risk groups. To address these barriers, we propose several innovative strategies based on a Clinical Experts meeting convened by the Dengue Alliance. These include pre-activated trial networks for rapid initiation during outbreaks; early-warning surveillance to guide geographic activation using real-time transmission signals; decentralized trial models to expand recruitment beyond major research centers; platform trial designs that allow treatment arms to be added or discontinued adaptively; and participant inclusion based on clinical syndrome supported by rapid diagnostics. Their successful adoption requires regulatory harmonization, ethical oversight, and emphasis on equity.

Indexed as

arbovirusesclinical trialdengueglobal health

Identifiers

PMID42851854
PMCPMC13646642

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.