Seroprevalence of dengue virus infection and associated risk factors: a community-based cross-sectional survey in Burkina Faso

Abstract

Introduction: Since 2017, dengue fever has been endemic in Burkina Faso. However, epidemiological data to guide effective dengue control policies remain limited in the country. To support decision-making with scientific evidence on the burden of dengue, this study aimed at estimating the seroprevalence of dengue infection in the population and to identify its potential risk factors. Methods: A nationwide, community-based cross-sectional survey including both urban and rural areas was conducted in May 2022 in Burkina Faso. A two-stage stratified cluster sampling design was used to select resident participants aged ≥5 years. Five millilitres of blood samples was obtained from each participant. Seroprevalence estimates were based on an IgG rapid test (sensitivity 95%, specificity 82%) and were not adjusted for misclassification. Data analysis accounted for the complex survey design including clustering, stratification and sampling weights. Multivariable logistic regression was used to identify factors associated with dengue seropositivity. Results: Overall seroprevalence was 39% (95% CI 37% to 41%) and was consistently higher in urban areas (50%) versus rural areas (24%). Seroprevalence varied significantly by geographic region, with the highest values observed in Centre, Centre-North and North. In multivariable analysis, urban residence was significantly associated with seropositivity (OR 2.35, 95% CI 1.81 to 3.05). Increasing age also showed a strong association, with the highest odds observed among participants aged ≥55 years (OR 10.32, 95% CI 7.42 to 14.35). Individuals with at least a primary education had higher odds of seropositivity (OR 1.25, 95% CI 1.01 to 1.55). In contrast, high socioeconomic status (SES) was associated with lower odds of seropositivity (OR 0.53, 95% CI 0.39 to 0.71). Conclusions: The observed seroprevalence suggests moderate transmission; however, interpretation for vaccination policy should be cautious given assay limitations and cross-sectional design. Findings indicate that urban residence, older age, lower SES and high education level are associated with higher dengue seroprevalence.