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

Seroprevalence of dengue virus infection and associated risk factors in a malaria-endemic country : a community-based cross-sectional survey in Burkina Faso | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Seroprevalence of dengue virus infection and associated risk factors in a malaria-endemic country : a community-based cross-sectional survey in Burkina Faso Siaka Debe, Guillaume Sylvestre Sanou, Tiandiogo Isidore Traore, and 19 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8740684/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Epidemiological data on dengue remain limited in west African settings. To support policymakers with robust evidence on the burden of dengue, this study was conducted to estimate the seroprevalence of dengue infection and to identify its potential risk factors. Methods We conducted a nationwide, community-based cross-sectional survey in May 2022 in all the Burkina Faso 13 regions, including both urban and rural areas. A multistage stratified cluster sampling design was used to select participants aged ≥ 5 years. Data were collected through standardized questionnaires and blood samples. Anti-dengue IgG antibodies were detected using a rapid diagnostic test. Weighted analyses accounted for the complex survey design, and multivariate logistic regression identified factors associated with dengue seropositivity. Results Overall DENV IgG seroprevalence was 45% (95% CI: 42–48) and was consistently higher in urban areas (52%) than in rural areas (26%). Seroprevalence varied geographically, ranging from 12% in the East region to 62% in the Centre region, and was highest in moderate climate zones (55%). In multivariable analysis, urban residence was significantly associated with seropositivity (aOR 2.0, 95% CI: 1.4–2.8). Increasing age showed a strong association, with the highest odds among participants aged ≥ 55 years (aOR 12.1, 95% CI: 7.4–20.1). Conclusion Findings indicate moderate-intensity dengue transmission in Burkina Faso, suggesting that the country is not currently eligible for WHO dengue vaccine implementation. On the other hand, adults population residing in urban areas may need dengue vaccination programmes. Epidemiology seroprevalence dengue virus cross-sectional survey risk factors Figures Figure 1 Figure 2 What is already known on the topic Dengue fever is an emerging and increasingly recognised public health problem in Africa, but its true burden remains underestimated due to limited surveillance and widespread under-reporting; Population-based dengue seroprevalence data are scarce in Burkina Faso and across most African countries, limiting accurate assessment of transmission intensity, population immunity, and eligibility for dengue vaccination according to WHO recommendations. What this study adds This study provides the first nationally representative estimates of dengue virus seroprevalence in Burkina Faso and regional settings based on a community-based seroepidemiological survey; It identifies key demographic and socioeconomic factors associated with dengue seropositivity, highlighting population groups and settings at increased risk of dengue infection. How this study might affect research, practice or policy The findings offer essential evidence to inform national dengue surveillance, vector control strategies, and considerations for targeted dengue vaccination in line with WHO recommendations. Introduction Bakground and rationale Dengue fever is a neglected tropical disease caused by four antigenically distinct dengue virus serotypes (DENV-1 to DENV-4), infection with which does not confer cross-protective immunity [ 1 ]. The virus is transmitted primarily by Aedes aegypti , a mosquito highly adapted to urban environments, and secondarily by Aedes albopictus [ 1 ]. Over recent decades, dengue incidence has increased substantially worldwide, although the true burden remains underestimated due to under-reporting and misclassification. Current estimates suggest approximately 390 million dengue infections occur annually, with nearly 4 billion people at risk globally [ 1 – 3 ]. In Africa, dengue transmission is increasingly recognised but remains poorly characterised [ 2 , 4 ]. Burkina Faso is among the African countries reporting dengue outbreaks, with documented epidemics in 1925, 2016, and 2017, the latter resulting in over 15,000 suspected cases and multiple deaths [ 5 – 7 ]. Despite these outbreaks, dengue surveillance in Burkina Faso relies largely on facility-based reporting, which fails to capture community infections and may substantially underestimate population-level transmission [ 8 – 13 ]. In the absence of specific antiviral treatment, dengue prevention depends on vector control measures and, in high-transmission settings, vaccination. The World Health Organization (WHO) recommends dengue vaccination in populations with high transmission intensity (seroprevalence ≥ 60%) [ 14 ], underscoring the need for population-based seroepidemiological data to guide policy decisions. However, such data remain scarce in Burkina Faso and most African countries. Nationally representative seroprevalence estimates are therefore essential to assess transmission intensity, population immunity, and priority groups for targeted interventions. Objectives The objectives of this study were to estimate the national seroprevalence of dengue virus infection and to identify demographic and socioeconomic factors associated with dengue seropositivity in Burkina Faso. The findings were expected to inform national dengue control strategies, including the potential implementation of targeted vaccination programmes. Methods Study design We conducted a national, community-based cross-sectional seroepidemiological survey to estimate the seroprevalence of dengue virus infection and to identify associated demographic and socioeconomic risk in the general population of Burkina Faso. Setting and Coverage The study was conducted in all the 13 adminsitrative regions of Burkina Faso ensuring nationwide geographic coverage. Both urban and rural areas were included to capture heterogeneity in dengue transmission related to population density, environmental conditions, and access to infrastructure. The country administrative regions included Boucle du Mouhoun, Cascades, Centre, Cente-East, Centre-North, Centre-West, Centre-South, East, Haut-Bassin, North, Plateau-Central, Sahel and South-West regions (Fig. 1). They representes geaographical divisions with different climatic, socio-economic and cultural characteristics. Burkina Faso has a tropical climate with a long dry season from November to May and a short rainy season from June to October. The country is divided into three climate zones. The humid zone, located in the south part, receives the highest rainfall (1,000–1,300 mm over at least five months) and has dense vegetation such as savannahs and forests, with humidity rising from about 23% in the dry season to 75% in the wet season. The intermediate zone, located in the central part, experiences moderate rainfall (600–1,000 mm over three to four months), supports tiger bush and savannah vegetation, and has higher wet-season humidity of up to 85%. The dry zone, located in the north part, receives the least rainfall (400–600 mm over three to four months), has sparse thorny shrub vegetation and few trees, and is mainly suitable for cereal cultivation. Study population The target population consisted of individuals aged 5 years and above whore are permanent residents of selected households in Burkina Faso. Eligibility Inclusion criteria Residence in the selected household for at least six months prior to the survey Ability and willingness to provide informed consent (or parental consent for minors) Exlucion criteria Individuals with medical conditions contraindicating blood collection Severe illness requiring urgent medical care Sampling Design A multistage stratified cluster sampling design was used to obtain a representative sample of the national population while maintaining operational feasibility. The country was first stratified by region. A two-stage cluster sampling approach was then applied. In the first stage, enumeration areas in rural and urban zones were selected using simple random sampling within each stratum based on the most recent census data. In the second stage, households were selected by systematic random sampling from a complete household listing. Within each selected household, all eligible household members were invited. Outcomes measures The primary outcome was dengue virus seropositivity, defined as the presence of anti-dengue IgG antibodies. The secondary outcomes included region-specific, urban-rural and climate zones seroprevalence estimates and identification of factors associated with dengue seropositivity. Data collection Questionnaires administration Trained field workers administered a standardized, pre-tested questionnaire through face-to-face interviews. Data were collected electronically using KoboCollect platform, intalled on electronic tablets. The household questionnaire captured information on household conditions and socioeconomic characteristics : housing features (wall, ceiling, and floor type); main sources of water, fuel, and energy; household assets (livestock including cattle, donkeys, horses, goats, fowl, pigs, sheep and household goods such as radios, televisions, telephones, refrigerators, bicycles, motorcycles, tricycles, carts, cars, trucks, and canoes). The individual questionnaire captured demographic data, including age, sex, marital status, professional occupation, and education level. History of febrile illness was self-reported and current body temperature was measured with an axillary thermometer. Biological sample collection A venous blood (5 mL) was collected from each participant under aseptic conditions. For young children, finger-prick samples were used. Serum samples were processed and stored following standard biosafety protocols. Laboratory methods Serum samples were tested for anti-dengue virus IgG antibodies using the CTK Onsite Dengue IgG Rapid Test (R0065C) following the manufacturer instructions. This test developed by CTK Biotech (inc., USA) has a reported sensitivity of 95% and specificity of 82%[ 15 , 16 ]. To perform the test, 5µL of blood were placed into the designated well of the test cassette. Then one drop of the buffer solution was added to the buffer well. The result was obtained in 20–25 minutes. The test was considered valid if the Control Line (C) was visible. Invalid tests were repeated using a new kit. The test was interpreted as positive when the IgG Line (G) appeared on a valid test. Samples size calculation The sample size was calculated using standard formulas for prevalence estimation in complex survey design, assuming : an expected dengue seroprevalence of 50%, a 95% confidence level, a margin of error of 5%, a design effect of 2 and anticipated non-response rate of 20%. This was expected to yield a final sample size of approximately 5,255 participants nationwide, allowing precise national and regional estimates. Statistical methods Data analysis accounted for the complex survey design inclusinf clustering, stratification and sampling weights. Descriptive statistics summarized demographic and socioeconomic characteristics in frequency and mean for categorial and numerical variables respectively. Principal Component Analysis (PCA) was used to classify socioeconomic status (SES) into three categories (poor, intermediate and rich classes) based on possession of goods and house features. Variance estimations accounted for sampling weight and confidence level of 95%. In a bivariate analysis, associations between sociodemographic characteristics and DENV seropositivity were evaluated using Chi-square test adjusted on design-effect. Multivariate logistic regression model was used to assess independent associations between dengue seropositivity and potential risk factors. The Akaike Information Criterion (AIC) was used to selecting the final parcimonuous model. Resultas were presented with adjusted odds ratios and 95% Confidence intervals. Ethical Considerations The project protocol was approved by the National Ethic Committee before the implementation of project-related activities (Approval Letter No. 2020-9-195, dated September 2, 2020). The study was authorized by the administrative, health, and security authorities in each region. Prior to any data collection, household heads and participants consented. Confidentiality was maintained through assignment of unique identifier to each participant. Participants with acute illness were referred to the closest health facility for provision of appropriate healthcares. Patient and Public involvement Study participants or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Results Participants A total of 6,006 residents from 1,601 households were recruited across the 13 administrative regions of Burkina Faso, including 3,001 individuals from rural areas and 3,005 from urban areas (Fig. 2). Of these, 481 individuals were excluded due to refusal to participate (380), blood collection failure (60), severe illness at the time of survey (25), and missing individual-level data (16). The final analytical sample therefore comprised 5,525 participants, with an almost equal distribution between rural (2,751 participants) and urban (2,774 participants) areas. All regions were represented, with larger contributions from the South-West, Cascades, Centre-East and Centre-North regions. Population characteristics Table 1 describes the demographic and socioeconomic characteristics overall and by residence area. Females represented a higher proportion of participants than males, particularly in urban areas. The population was predominantly young, with participants aged 5–24 years accounting for more than half of the sample. Marked differences were observed between rural and urban areas for education level and socioeconomic status. Urban residents were more likely to have secondary or tertiary education, whereas rural residents were more frequently classified as having no formal education. Socioeconomic status also differed substantially by residence, with higher proportions of poor households in urban areas and higher proportions of rich households in rural areas. Marital status was fairly balanced, though a slight majority of participants were single, especially in urban areas. Overall seroprevalence The overall dengue IgG seroprevalence was 45% (95% CI 42–48). Seroprevalence was consistently higher in urban areas (52%) than in rural areas (26%) across all regions (Table 2 ). At the regional level, the highest seroprevalence was observed in the Centre (62%), Centre-North (48%), Centre-West (49%) and North (47%) regions, while the lowest were reported in the East (12%) and Cascades (18%) regions. An exception to the typical pattern was observed in the South-West, where rural prevalence (42%) slightly exceeded urban prevalence (37%). According to climate zones (Table 2 ), overall seroprevalence was highest in the intermediate climate area (55%), followed by the dry (37%) and humid (30%) areas. In all climate zones, seroprevalence was higher in urban than in rural areas. The largest urban–rural difference was observed in the dry and intermediate zones. Seroprevalence according to demographic and socioeconomic characteristics Table 3 presents the distribution of DENV IgG seropositivity according to demographic and socioeconomic factors, stratified by rural and urban residence. A consistent pattern emerges showing higher seropositivity in urban areas compared with rural areas across nearly all sociodemographic categories. Regarding sex, seropositivity was similar between females and males in both settings, although prevalence was markedly higher in urban areas for both sexes. Overall, females showed slightly higher seropositivity than males. A strong age-related increase in seropositivity was observed. In both rural and urban settings, DENV IgG prevalence increased progressively with age, from the lowest levels among children aged 5–14 years to the highest levels among adults aged 55 years and older. Urban residents consistently exhibited substantially higher prevalence than rural residents within each age group. With respect to education level, seropositivity varied across categories. Individuals with no education had relatively high prevalence in both rural and urban areas. In urban settings, very high seropositivity was observed among those with tertiary education, although confidence intervals were wide, likely reflecting small sample sizes. Overall, seropositivity tended to be higher among individuals with higher educational attainment in urban areas. Married individuals had higher seropositivity than single individuals in both rural and urban settings, again with urban residents showing substantially higher prevalence overall. Socioeconomic status showed mixed patterns. In urban areas, individuals with poor socioeconomic status had the highest seropositivity, while in rural areas differences between socioeconomic groups were less pronounced. Overall, dengue exposure appeared to be more strongly associated with urban residence and age than with socioeconomic status alone. Risk factors associated to DENV IgG seropositivity In bivariate analysis (Table 4 ), DENV IgG seropositivity was significantly associated with place of residence, ecological zone, age group, education level, marital status, and socioeconomic status (all p < 0.05). Seropositivity increased progressively with age. The average age was 37 years [95CI:35–39] in seropositive individuals compared to 22 years [95CI:21–23] for seronegative individuals. Sex was not associated with seropositivity (p = 0.093). After adjustment in multivariate logistic regression (Table 5 ), urban residence remained significantly associated with DENV IgG seropositivity (adjusted OR [aOR] 2.2, 95% CI 1.6–3.2). Age showed a strong independent association, with increasing odds from 25 years onwards and the highest odds among participants aged ≥ 55 years (aOR 11.8, 95% CI 6.3–22.3). Secondary education remained associated with higher odds of seropositivity, while higher socioeconomic status was associated with lower odds. Sex and marital status were not associated after adjustment (Table 5 ). In the final parsimonious model (Table 5 ), urban residence, age, education level, and socioeconomic status remained independently associated with DENV IgG seropositivity. A clear age-related gradient was observed, and intermediate and high socioeconomic status were associated with reduced odds of seropositivity. Table 1 Sociodemographic characteristics of the study population Characteristics Categories Rural area Urban area Overall Freq (%) [95%CI] Freq (%) [95%CI] Freq (%) [95%CI] Sex female 55[53–58] 61[57–64] 59[56–62] male 45[42–47] 39[36–43] 41[37–43] Age groups (in years) 5–14 38[35–40] 27[ 24 – 30 ] 30[27–32] 15–24 18[ 16 – 20 ] 24[ 21 – 28 ] 23[ 20 – 25 ] 25–34 12[ 10 – 14 ] 15[ 12 – 18 ] 14[ 12 – 16 ] 35–44 13[ 11 – 14 ] 13[ 10 – 15 ] 12[ 11 – 14 ] 45–54 9[ 8 – 11 ] 10[ 8 – 13 ] 10[ 8 – 12 ] ≥ 55 11[ 9 – 12 ] 12[ 10 – 15 ] 11[ 10 – 14 ] Education level none 55[53–58] 29[26–33] 36[34–39] primary 34[32–37] 30[26–32] 31[29–34] secondary 9[ 8 – 12 ] 33[30–37] 27[ 24 – 30 ] tertiary 0.3[0.1-1] 8[ 6 – 10 ] 6[ 5 – 8 ] Marital status single 46[43–49] 55[51–59] 52[49–56] married 54[51–57] 46[42–50] 48[44–51] Socioeconomic status poor 3[ 2 – 3 ] 83[81–86] 62[59–64] middle 32[30–35] 16[ 13 – 18 ] 20[ 18 – 22 ] rich 65[62–67] 1[ 1 – 2 ] 18[ 17 – 20 ] Table 2 Dengue seroprevalence by region, climate zones and residence area Localities Rural area Urban area Overall RDT+ n Prev (%) [95%CI] RDT + n Prev (%) [95%CI] RDT + n Prev (%) [95%CI] Regions Boucle Mouhoun 36 226 16[ 12 – 21 ] 125 224 56[49–62] 161 450 31[27–35] Cascades 20 235 9[ 6 – 12 ] 44 227 19[ 15 – 25 ] 64 462 18[ 14 – 23 ] Centre 46 143 32[25–40] 148 220 67[61–73] 194 363 62[57–68] Centre-East 58 228 25[20–32] 64 206 31[25–38] 122 434 26[22–32] Centre-North 76 222 34[28–41] 152 227 67[61–73] 228 449 48[43–52] Centre-West 70 214 33[27–39] 115 222 52[45–58] 185 436 49[43–54] Centre-South 68 222 31[25–37] 111 231 48[42–55] 179 453 43[38–48] East 14 132 11[ 6 – 17 ] 14 108 13[ 8 – 21 ] 28 240 12[ 8 – 17 ] Haut-Bassins 55 230 24[ 19 – 30 ] 80 224 36[30–42] 135 454 34[29–40] North 26 230 11[ 8 – 16 ] 152 230 66[60–72] 178 460 47[42–52] Plateau-Central 41 226 18[ 14 – 24 ] 67 219 31[25–37] 108 445 23[ 20 – 28 ] Sahel 53 220 24[ 19 – 30 ] 96 206 47[40–53] 149 426 27[22–32] South-West 94 223 42[36–49] 85 230 37[31–43] 179 453 41[36–45] Climate zones Dry zone 155 672 23[ 20 – 28 ] 400 663 63[50–67] 555 1,335 37[34–40] Intermediate zone 297 1,165 28[34 − 32] 519 1,206 64[58–69] 816 2,371 55[51–60] Humid zone 205 914 23[ 21 – 26 ] 334 905 31[27–36] 539 1,819 30[26–32] Overall 657 2,751 26[ 23 – 28 ] 1,253 2,774 52[49–56] 1,910 5,525 45[42–48] Table 3 Dengue seroprevalence by demographic and socioeconomic factors Variables Categories Rural area Urban area Overall Prev (%) [95%CI] Prev (%) [95%CI] Prev (%) [95%CI] Sex female 25[ 22 – 29 ] 53[49–58] 47[43–50] male 26[ 22 – 30 ] 51[48–57] 43[39–48] Age groups (years) 5–14 10[ 8 – 14 ] 28[22–35] 22[ 18 – 27 ] 15–24 17[ 13 – 23 ] 42[34–50] 37[31–43] 25–34 23[ 18 – 30 ] 67[57–75] 57[49–64] 35–44 39[32–47] 65[54–74] 58[50–65] 45–54 51[42–60] 76[64–84] 69[61–77] ≥ 55 57[49–65] 79[71–86] 74[67–80] Education level none 32[29–36] 56[50–63] 47[42–50] primary 16[ 13 – 20 ] 39[32–46] 32[27–37] secondary 20[ 13 – 29 ] 56[49–63] 53[46–59] tertiary 3[0.3–23] 75[62–85] 74[61–84] Marital status single 21[ 17 – 25 ] 43[38–50] 39[34–43] married 38[34–42] 68[62–73] 60[55–64] Socioeconomic status poor 24[14–40] 55[51–59] 55[51–59] middle 23[ 19 – 27 ] 39[32–47] 32[28–37] rich 27[ 24 – 30 ] 32[24–41] 27[ 24 – 30 ] Table 4 Bivariate associations with DENV IgG seropositivity Variables Categories Seropositivty Coreected Chi2 p-value Negative (%) Positive (%) Place of residence rural 20 7 8.77 0.006 urban 35 38 Ecological Zone dry 7 4 4.26 0.027 moderate 25 31 humid 22 9 Sex female 32 28 3.05 0.093 male 23 17 Age groups (in years) 5–14 23 7 31.07 0.000 15–24 14 8 25–34 6 8 35–44 5 70 45–54 3 67 ≥ 55 3 9 Education level no education 19 17 12.51 0.000 primary 21 10 secondary 13 14 tertiary 2 4 Marital status not married 32 20 23.01 0.000 married 19 28 Socioeconomic status poor 28 34 9.95 0.000 middle 14 6 rich 13 5 Table 5 Multivariable analysis of factors associated with DENV IgG seropositivity Variables Categories Univariate analysis Multivariate analysis Final Multivariate model OR IC95% p-value ORaj IC95% p-value ORaj IC95% p-value Place of Residence rural Ref Ref Ref urban 3.2 [2.6–3.9] 0.000 2.2 [1.6–3.2] 0.000 2.0 < 0,001 1.4–2.8 Ecological Zone dry Ref Ref moderate 2.1 [1.7–2.5] 0.000 10.0 [0.8–1.3] 0.918 humid 0.7 [0.6–0.9] 0.003 0.3 [0.2–0.4] 0.000 Sex female Ref Ref male 0.9 [0.7–1.1] 0.297 0.9 [0.7–1.2] 0.614 Age (in years) 5–14 Ref Ref Ref 15–24 2.1 [1.4-3.0] 0.000 1.4 [0.8–2.4] 0.219 1.5 0.09 0.9–2.4 25–34 4.7 [3.1-7.0] 0.000 3.7 [2.0–7.0] 0.000 3.6 < 0.001 2.2–5.9 35–44 4.8 [3.2–7.3] 0.000 5.4 [2.8–10.5] 0.000 5.2 < 0.001 3.2–8.5 45–54 8.0 [5.1–12.8] 0.000 8.7 [4.4–17.5] 0.000 9.1 < 0.001 5.3–15.7 ≥ 55 10.0 [6.6–15.3] 0.000 11.8 [6.3–22.3] 0.000 12.1 < 0.001 7.4–20.1 Education level none Ref Ref Ref primary 0.5 [0.4–0.7] 0.000 1.2 [0.7–1.9] 0.512 1.7 0.2 0.9–1.8 secondary 1.3 [0.9–1.7] 0.126 1.6 [1.1–2.5] 0.023 1.8 < 0.01 1.2–2.6 tertiary 3.2 [1.7-6.0] 0.000 2.0 [0.9–4.2] 0.053 2.4 0.01 1,2–4,8 Marital status not married Ref Ref married 2.3 [1.8-3.0] 0.000 0.9 [0.7–1.4] 0.864 Socioeconomic status poor Ref Ref Ref intermediate 0.4 [0.230.5] 0.000 0.6 [0.4–0.9] 0.071 0.5 0.001 0.4–0.8 rich 0.3 [0.2–0.4] 0.000 0.5 [0.4–0.8] 0.027 0.6 0.02 0.4–0.9 Discussions This study aimed to to provide estimates of dengue virus exposure and to identify key demographic and socioeconomic factors associated DENV IgG seropositivity using the CTK Onsite Dengue IgG Rapid Test, a tool suitable for detecting probable dengue cases. Overall seroprevalence was high (45%), with substantial heterogeneity across regions, climate zones, and areas of residence. These findings indicate that dengue fever has emerged as a major public health concern in the country, alongside malaria, consistent with evidence from multiple previous studies [ 1 , 17 , 18 ]. Dengue infection may contribute significantly to the onset, the persistence and the severity of fever in patients suffering from other infectious diseases, mainly malaria [ 19 – 22 ]. Previous study reported a high prevalence of malaria-dengue coinfection across African regions ranging from 16 per 1000 febrile cases (95% CI 6–45) in West Africa to 47 (95% CI 22–98) in Central Africa, with a marked increase over time from 0.9% during 2008–2013 to 5.5% during 2018–2021 [ 23 ]. In the absence of specific antiviral treatment for dengue, such coinfections are likely to complicate patient management. These findings underscore the importance for healthcare professionals to consider both malaria and dengue in the differential diagnosis of febrile illness. They also highlight the need for policymakers to strengthen health system capacity through training and provision of diagnostic tools. Following the 2017 outbreak, Burkina Faso adopted national guidelines for dengue case management; however, wider dissemination and comprehensive training of health workers remain necessary. Community sensitisation on dengue prevention, symptoms, and its potential coexistence with malaria is also essential. The results indicate that nearly half of the population in Burkina Faso has been exposed to the dengue virus. The estimated overall seroprevalence remains below the WHO threshold of 60% defining an high transmission intensity [ 14 ], suggesting moderate dengue transmission nationwide. Consequently, Burkina Faso does not currently meet WHO eligibility criteria for dengue vaccine introduction for the whole population. However, urban populations in the Centre, Centre-North, and North regions experienced high dengue transmission, suggesting that these areas may be suitable candidates for targeted dengue vaccination programmes. These programmes could also integrate adults in urban zones. In paralell, strengthening vector control interventions, including environmental sanitation, reduction of mosquito breeding sites around households, appropriate insecticide use, and installation of protective screens, remains a priority for the entire country. Urban residence was associated with DENV IgG seropositivity. Higher seroprevalence in urban compared with rural areas across most regions and climate zones suggests that urban environments play a central role in sustaining dengue transmission. This finding is consistent with the ecology of Aedes vectors, which thrive in densely populated settings with abundant artificial breeding sites [ 2 , 24 – 26 ]. Poor wastewater management, accumulation of water containers, and household gardening practices most occurring in uarban settings, may favour mosquito proliferation and increase human–vector contact [ 24 , 25 ]. However, some studies have reported homogeneous dengue exposure across rural and urban settings, suggesting that dengue transmission may no longer be exclusively urban [ 27 ]. Further research is needed to clarify these patterns in different ecological contexts. Seropositivity increased steadly, showing a stron dose-response relationship and remaining the strongest independent predictor of dengue exposure, in line with previous studies [ 8 , 27 – 30 ]. This pattern is indicative of cumulative lifetime exposure and supports the presence of long-standing endemic transmission rather than sporadic outbreaks. Higher exposure among adults may reflect increased outdoor activities, occupational exposure, mobility, and travel to dengue-endemic areas. Adults may spend more time in environments where mosquitoes are prevalent, such as gardens, markets, or construction sites. Ongoing urbanisation, climate change, and changes in mosquito populations may further amplify adult exposure, particularly in urban settings. Education level and socioeconomic status were independently associated with seropositivity. Higher education was associated with increased odds of dengue exposure, while intermediate and high socioeconomic status appeared protective. These associations may reflect complex interactions between mobility, housing quality, living environments, and access to vector control measures, although residual confounding cannot be excluded. This study has some limitations. First, the cross-sectional design precludes causal inference between identified risk factors and dengue seropositivity. Second, sampling was restricted to regional capital cities, which may limit representativeness at sub-regional level. Third, the use of anti-dengue IgG antibodies reflects past exposure and does not capture recent or acute infections. Consequently, infections detectable by IgM antibodies and/or NS1 antigen may have been missed, potentially leading to an underestimation of the true seroprevalence. Finally, cross-reactivity with other flaviviruses cannot be completely excluded, although available evidence suggests that such cross-reactivity is uncommon [ 16 ]. This study provides nationally representative estimates of dengue virus seroprevalence in Burkina Faso, offering a comprehensive assessment of population-level exposure in a malaria-endemic setting. The community-based design allows detection of asymptomatic and past infections that are typically missed by routine facility-based surveillance systems. In addition, the study identifies demographic and socioeconomic factors associated with dengue seropositivity, thereby generating robust evidence to support evidence-based dengue surveillance, vector control, and vaccination strategies. Conclusions This nationwide study demonstrates substantial exposure to dengue virus in Burkina Faso, with nearly half of the population showing evidence of past infection. Dengue transmission remains of moderate intensity but is widespread, with marked variation by region, climate zone, age, and place of residence. Urban residence and increasing age were the strongest independent predictors of DENV IgG seropositivity, highlighting the central role of urban environments and cumulative exposure in sustaining dengue transmission. Although current seroprevalence levels do not meet World Health Organization criteria for dengue vaccine introduction, the high burden of exposure underscores dengue as an important public health concern alongside malaria. Adults residing in urban areas most affected may need dengue vaccine as supplementary strategy. Strengthening integrated surveillance, improving diagnostic capacity, expanding health worker training, and reinforcing vector control interventions (particularly in urban settings) are essential. Targeted community sensitisation and sustained implementation of national dengue management guidelines will be critical to reducing dengue-related morbidity and improving febrile illness management in Burkina Faso. Declarations Competing interests The authors declare that they have no competing interests. Data sharing Technical appendix, statistical codes and dataset are available upon reasonable request. Supplementary and data raw The supplementary and data raw are placed alongside this article. Ethics approval and consent to participate Ethical clearance was obtained from the “Comité Ethique pour la Recherche en Santé (CERS)” before implementing the protocol-related activities. This committee belongs to the Burkina Faso Ministry of Health. All participants provided signed informed consent before any individual data was collected. The study adhered to the Declaration of Helsinki. Funding This work was funded by the World Bank Group under Grant No. GFF N°TF A7763-BF. The Burkina Faso Ministry of Health also contributed to the implementation of the project activities. Author Contributions SD made substantial contributions to the study's design, coordination of fieldwork, data analysis, and interpretation, as well as manuscript preparation. AG contributed to the design, project oversight, and substantive manuscript revision. RK, GWN, KY, FT, WB and SRI were responsible for data acquisition, supervision of fieldwork activities, and ensuring high-quality data collection. GSS, NO, HS, SS, HS, SM, MO, CWT, HJT and AO supervised blood sample collection, assisted with sample processing and storage, and provided laboratory results. MWG provided significant advices for the project design and implementation. AGo developed the electronic data collection tool used in the study. TIT and LBS provided technical assistance and contributed to the manuscript substantial revision. All authors revised the manuscript, approved the final submitted version, and agreed to be personally accountable for their respective contributions. Acknowledgements We extend our gratitude to World Bank Group, Burkina Faso Ministry of Health and its related institutions, national project partners, research group, regional administrative and security authorities, and project participants for their strong commitment in ensuring the success of this project. We also express our gratitude to CDC Dengue Branch for providing support on dengue diagnostic practices and the references of appropriate reagents. References Tinto B, Kania D, Samdapawinde Kagone T, Dicko A, Traore I, de Rekeneire N et al (2022) [Dengue virus circulation in West Africa: An emerging public health issue]. Med Sci (Paris) 38(2):152–158 Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL et al (2013) The global distribution and burden of dengue. Nature 496(7446):504–507 Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG et al (2012) Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis 6(8):e1760 Ridde V, Carabali M, Ly A, Druetz T, Kouanda S, Bonnet E et al (2014) The need for more research and public health interventions on dengue Fever in Burkina Faso. PLoS Negl Trop Dis 8(6):e2859 Amarasinghe A, Kuritsk JN, Letson GW, Margolis HS (2011) Dengue virus infection in Africa. Emerg Infect Dis 17(8):1349–1354 Health Mo. Annuaire statistique 2015: Direction des statistiques sectorielles (2016) 342 p Health Mo. Annuaire statistique 2016: Direction des statistiques sectorielles (2017) 315 p Inziani M, Adungo F, Awando J, Kihoro R, Inoue S, Morita K et al (2020) Seroprevalence of yellow fever, dengue, West Nile and chikungunya viruses in children in Teso South Sub-County, Western Kenya. Int J Infect Dis 91:104–110 Otu AA, Udoh UA, Ita OI, Hicks JP, Egbe WO, Walley J (2019) A cross-sectional survey on the seroprevalence of dengue fever in febrile patients attending health facilities in Cross River State, Nigeria. PLoS ONE 14(4):e0215143 Broban A, Olive MM, Tantely ML, Dorsemans AC, Rakotomanana F, Ravalohery JP et al (2023) Seroprevalence of IgG Antibodies Directed against Dengue, Chikungunya and West Nile Viruses and Associated Risk Factors in Madagascar, 2011 to 2013. Viruses. ;15(8) Bangoura ST, Sidibé S, Kaba L, Mbaye A, Hounmenou CG, Diallo A et al (2024) Seroprevalence of seven arboviruses of public health importance in sub-Saharan Africa: a systematic review and meta-analysis. BMJ Glob Health. ;9(10) Ali IM, Tchuenkam VPK, Colton M, Stittleburg V, Mitchell C, Gaither C et al (2022) Arboviruses as an unappreciated cause of non-malarial acute febrile illness in the Dschang Health District of western Cameroon. PLoS Negl Trop Dis 16(10):e0010790 Mwanyika GO, Sindato C, Rugarabamu S, Rumisha SF, Karimuribo ED, Misinzo G et al (2021) Seroprevalence and associated risk factors of chikungunya, dengue, and Zika in eight districts in Tanzania. Int J Infect Dis 111:271–280 Organisation WH (2025) Vaccines and immunisation: Dengue: WHO; [Available from: https://www.who.int/news-room/questions-and-answers/item/dengue-vaccines Freddy A, Medina FV, Adams LE, Cardona J, Carrion J, Lamirande E, Luz N, Acosta, Carlos M De León-Rodríguez, Manuela Beltran, Demian Grau, Vanessa Rivera-Amill, Angel Balmaseda, Eva Harris, Madewell ZJ, Waterman SH (2024) Gabriela Paz-Bailey, Stephen Whitehead, Jorge L. Muñoz-Jordán. Comparison of the sensitivity and specificity of commercial anti-dengue virus IgG tests to identify persons eligible for dengue vaccination. Journal of Clinical Microbiology. ;62(10):16 Vasco Liberal RF, Zhang C, Pan C, Bonaparte M, Yin W, Zheng L, Viscardi V, Wu Y (2022) Yasemin Ataman-Önal, Stephen Savarino, Catherine Chena. Performance Evaluation of a Dengue IgG Rapid Diagnostic Test Designed to Determine Dengue Serostatus as Part of Prevaccination Screening. Bicrobiology Spectr 10(3):8 Tinto B, Kabore DPA, Kania D, Kagone TS, Kiba-Koumare A, Pinceloup L et al (2022) Serological Evidence of Zika Virus Circulation in Burkina Faso. Pathogens. ;11(7) Sawadogo S, Baguiya A, Yougbare F, Bicaba BW, Nebie K, Millogo T et al (2020) Seroprevalence and factors associated with IgG anti-DENV positivity in blood donors in Burkina Faso during the 2016 dengue outbreak and implications for blood supply. Transfus Med 30(1):37–45 Epelboin L, Hanf M, Dussart P, Ouar-Epelboin S, Djossou F, Nacher M et al (2012) Is dengue and malaria co-infection more severe than single infections? A retrospective matched-pair study in French Guiana. Malar J 11:142 Iftikhar M, Shah MM, Khan WM, Uddin Z, Saleem MN, Khan SJ (2024) Malaria and Dengue Co-infection: A Comprehensive Study in Peshawar. Pakistan Cureus 16(12):e76401 Zaki SA (2011) Malaria and dengue co-infection. Ann Indian Acad Neurol 14(2):141–142 Wiwanitkit V (2011) Concurrent malaria and dengue infection: a brief summary and comment. Asian Pac J Trop Biomed 1(4):326–327 Gebremariam TT, Schallig H, Kurmane ZM, Danquah JB (2023) Increasing prevalence of malaria and acute dengue virus coinfection in Africa: a meta-analysis and meta-regression of cross-sectional studies. Malar J 22(1):300 Badolo A, Sombié A, Yaméogo F, Wangrawa DW, Sanon A, Pignatelli PM et al (2022) First comprehensive analysis of Aedes aegypti bionomics during an arbovirus outbreak in west Africa: Dengue in Ouagadougou, Burkina Faso, 2016–2017. PLoS Negl Trop Dis 16(7):e0010059 Tam CC, O'Driscoll M, Taurel AF, Nealon J, Hadinegoro SR (2018) Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. PLoS Negl Trop Dis 12(11):e0006932 Were F (2012) The dengue situation in Africa. Paediatr Int Child Health 32(Suppl 1s1):18–21 Doum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T et al (2020) Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int J Environ Res Public Health. ;17(23) Elaagip A, Alsedig K, Altahir O, Ageep T, Ahmed A, Siam HA et al (2020) Seroprevalence and associated risk factors of Dengue fever in Kassala state, eastern Sudan. PLoS Negl Trop Dis 14(12):e0008918 Eldigail MH, Abubaker HA, Khalid FA, Abdallah TM, Adam IA, Adam GK et al (2020) Recent transmission of dengue virus and associated risk Facors among residents of Kassala state, eastern Sudan. BMC Public Health 20(1):530 Braga C, Luna CF, Martelli CM, de Souza WV, Cordeiro MT, Alexander N et al (2010) Seroprevalence and risk factors for dengue infection in socio-economically distinct areas of Recife, Brazil. Acta Trop 113(3):234–240 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8740684","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583023638,"identity":"6e428ea1-fd20-4c6c-8708-c0cd11d06c16","order_by":0,"name":"Siaka 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sites\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-8740684/v1/f0d425214c83dcfece2541d6.png"},{"id":101634397,"identity":"1ebb5fab-cd20-405f-8e53-13cfef5bd04e","added_by":"auto","created_at":"2026-02-02 06:11:14","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":499312,"visible":true,"origin":"","legend":"\u003cp\u003eDiagram of participants recruitment\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-8740684/v1/7fffec6f47c5d89260fd07d2.png"},{"id":101753880,"identity":"47b3635f-507b-474f-af6c-a75281584eb5","added_by":"auto","created_at":"2026-02-03 10:41:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2469130,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8740684/v1/5528f507-228d-4391-a725-43df7e8e6d9f.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eSeroprevalence of dengue virus infection and associated risk factors in a malaria-endemic country : a community-based cross-sectional survey in Burkina Faso\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":" What is already known on the topic","content":"\u003cul\u003e\n \u003cli\u003eDengue fever is an emerging and increasingly recognised public health problem in Africa, but its true burden remains underestimated due to limited surveillance and widespread under-reporting;\u003c/li\u003e\n \u003cli\u003ePopulation-based dengue seroprevalence data are scarce in Burkina Faso and across most African countries, limiting accurate assessment of transmission intensity, population immunity, and eligibility for dengue vaccination according to WHO recommendations.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eWhat this study adds\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThis study provides the first nationally representative estimates of dengue virus seroprevalence in Burkina Faso and regional settings based on a community-based seroepidemiological survey;\u003c/li\u003e\n \u003cli\u003eIt identifies key demographic and socioeconomic factors associated with dengue seropositivity, highlighting population groups and settings at increased risk of dengue infection.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eHow this study might affect research, practice or policy\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThe findings offer essential evidence to inform national dengue surveillance, vector control strategies, and considerations for targeted dengue vaccination in line with WHO recommendations.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eBakground and rationale\u003c/h2\u003e \u003cp\u003eDengue fever is a neglected tropical disease caused by four antigenically distinct dengue virus serotypes (DENV-1 to DENV-4), infection with which does not confer cross-protective immunity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The virus is transmitted primarily by \u003cem\u003eAedes aegypti\u003c/em\u003e, a mosquito highly adapted to urban environments, and secondarily by \u003cem\u003eAedes albopictus\u003c/em\u003e [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Over recent decades, dengue incidence has increased substantially worldwide, although the true burden remains underestimated due to under-reporting and misclassification. Current estimates suggest approximately 390\u0026nbsp;million dengue infections occur annually, with nearly 4\u0026nbsp;billion people at risk globally [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn Africa, dengue transmission is increasingly recognised but remains poorly characterised [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Burkina Faso is among the African countries reporting dengue outbreaks, with documented epidemics in 1925, 2016, and 2017, the latter resulting in over 15,000 suspected cases and multiple deaths [\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Despite these outbreaks, dengue surveillance in Burkina Faso relies largely on facility-based reporting, which fails to capture community infections and may substantially underestimate population-level transmission [\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the absence of specific antiviral treatment, dengue prevention depends on vector control measures and, in high-transmission settings, vaccination. The World Health Organization (WHO) recommends dengue vaccination in populations with high transmission intensity (seroprevalence\u0026thinsp;\u0026ge;\u0026thinsp;60%) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], underscoring the need for population-based seroepidemiological data to guide policy decisions. However, such data remain scarce in Burkina Faso and most African countries. Nationally representative seroprevalence estimates are therefore essential to assess transmission intensity, population immunity, and priority groups for targeted interventions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eThe objectives of this study were to estimate the national seroprevalence of dengue virus infection and to identify demographic and socioeconomic factors associated with dengue seropositivity in Burkina Faso. The findings were expected to inform national dengue control strategies, including the potential implementation of targeted vaccination programmes.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eWe conducted a national, community-based cross-sectional seroepidemiological survey to estimate the seroprevalence of dengue virus infection and to identify associated demographic and socioeconomic risk in the general population of Burkina Faso.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSetting and Coverage\u003c/h3\u003e\n\u003cp\u003eThe study was conducted in all the 13 adminsitrative regions of Burkina Faso ensuring nationwide geographic coverage. Both urban and rural areas were included to capture heterogeneity in dengue transmission related to population density, environmental conditions, and access to infrastructure. The country administrative regions included Boucle du Mouhoun, Cascades, Centre, Cente-East, Centre-North, Centre-West, Centre-South, East, Haut-Bassin, North, Plateau-Central, Sahel and South-West regions (Fig.\u0026nbsp;1). They representes geaographical divisions with different climatic, socio-economic and cultural characteristics. Burkina Faso has a tropical climate with a long dry season from November to May and a short rainy season from June to October. The country is divided into three climate zones. The humid zone, located in the south part, receives the highest rainfall (1,000\u0026ndash;1,300 mm over at least five months) and has dense vegetation such as savannahs and forests, with humidity rising from about 23% in the dry season to 75% in the wet season. The intermediate zone, located in the central part, experiences moderate rainfall (600\u0026ndash;1,000 mm over three to four months), supports tiger bush and savannah vegetation, and has higher wet-season humidity of up to 85%. The dry zone, located in the north part, receives the least rainfall (400\u0026ndash;600 mm over three to four months), has sparse thorny shrub vegetation and few trees, and is mainly suitable for cereal cultivation.\u003c/p\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe target population consisted of individuals aged 5 years and above whore are permanent residents of selected households in Burkina Faso.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEligibility\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eInclusion criteria\u003c/h2\u003e \u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eResidence in the selected household for at least six months prior to the survey\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eAbility and willingness to provide informed consent (or parental consent for minors)\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eExlucion criteria\u003c/h3\u003e\n\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eIndividuals with medical conditions contraindicating blood collection\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSevere illness requiring urgent medical care\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSampling Design\u003c/h2\u003e \u003cp\u003eA multistage stratified cluster sampling design was used to obtain a representative sample of the national population while maintaining operational feasibility. The country was first stratified by region. A two-stage cluster sampling approach was then applied. In the first stage, enumeration areas in rural and urban zones were selected using simple random sampling within each stratum based on the most recent census data. In the second stage, households were selected by systematic random sampling from a complete household listing. Within each selected household, all eligible household members were invited.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eOutcomes measures\u003c/h2\u003e \u003cp\u003eThe primary outcome was dengue virus seropositivity, defined as the presence of anti-dengue IgG antibodies. The secondary outcomes included region-specific, urban-rural and climate zones seroprevalence estimates and identification of factors associated with dengue seropositivity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003eQuestionnaires administration\u003c/h2\u003e \u003cp\u003eTrained field workers administered a standardized, pre-tested questionnaire through face-to-face interviews. Data were collected electronically using KoboCollect platform, intalled on electronic tablets.\u003c/p\u003e \u003cp\u003eThe household questionnaire captured information on household conditions and socioeconomic characteristics : housing features (wall, ceiling, and floor type); main sources of water, fuel, and energy; household assets (livestock including cattle, donkeys, horses, goats, fowl, pigs, sheep and household goods such as radios, televisions, telephones, refrigerators, bicycles, motorcycles, tricycles, carts, cars, trucks, and canoes). The individual questionnaire captured demographic data, including age, sex, marital status, professional occupation, and education level. History of febrile illness was self-reported and current body temperature was measured with an axillary thermometer.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eBiological sample collection\u003c/h2\u003e \u003cp\u003eA venous blood (5 mL) was collected from each participant under aseptic conditions. For young children, finger-prick samples were used. Serum samples were processed and stored following standard biosafety protocols.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLaboratory methods\u003c/h2\u003e \u003cp\u003eSerum samples were tested for anti-dengue virus IgG antibodies using the CTK Onsite Dengue IgG Rapid Test (R0065C) following the manufacturer instructions. This test developed by CTK Biotech (inc., USA) has a reported sensitivity of 95% and specificity of 82%[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. To perform the test, 5\u0026micro;L of blood were placed into the designated well of the test cassette. Then one drop of the buffer solution was added to the buffer well. The result was obtained in 20\u0026ndash;25 minutes. The test was considered valid if the Control Line (C) was visible. Invalid tests were repeated using a new kit. The test was interpreted as positive when the IgG Line (G) appeared on a valid test.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSamples size calculation\u003c/h2\u003e \u003cp\u003eThe sample size was calculated using standard formulas for prevalence estimation in complex survey design, assuming : an expected dengue seroprevalence of 50%, a 95% confidence level, a margin of error of 5%, a design effect of 2 and anticipated non-response rate of 20%. This was expected to yield a final sample size of approximately 5,255 participants nationwide, allowing precise national and regional estimates.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eStatistical methods\u003c/h2\u003e \u003cp\u003eData analysis accounted for the complex survey design inclusinf clustering, stratification and sampling weights. Descriptive statistics summarized demographic and socioeconomic characteristics in frequency and mean for categorial and numerical variables respectively. Principal Component Analysis (PCA) was used to classify socioeconomic status (SES) into three categories (poor, intermediate and rich classes) based on possession of goods and house features. Variance estimations accounted for sampling weight and confidence level of 95%. In a bivariate analysis, associations between sociodemographic characteristics and DENV seropositivity were evaluated using Chi-square test adjusted on design-effect. Multivariate logistic regression model was used to assess independent associations between dengue seropositivity and potential risk factors. The Akaike Information Criterion (AIC) was used to selecting the final parcimonuous model. Resultas were presented with adjusted odds ratios and 95% Confidence intervals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003eThe project protocol was approved by the National Ethic Committee before the implementation of project-related activities (Approval Letter No. 2020-9-195, dated September 2, 2020). The study was authorized by the administrative, health, and security authorities in each region. Prior to any data collection, household heads and participants consented. Confidentiality was maintained through assignment of unique identifier to each participant. Participants with acute illness were referred to the closest health facility for provision of appropriate healthcares.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003ePatient and Public involvement\u003c/h2\u003e \u003cp\u003eStudy participants or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eA total of 6,006 residents from 1,601 households were recruited across the 13 administrative regions of Burkina Faso, including 3,001 individuals from rural areas and 3,005 from urban areas (Fig.\u0026nbsp;2). Of these, 481 individuals were excluded due to refusal to participate (380), blood collection failure (60), severe illness at the time of survey (25), and missing individual-level data (16). The final analytical sample therefore comprised 5,525 participants, with an almost equal distribution between rural (2,751 participants) and urban (2,774 participants) areas. All regions were represented, with larger contributions from the South-West, Cascades, Centre-East and Centre-North regions.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003ePopulation characteristics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e describes the demographic and socioeconomic characteristics overall and by residence area. Females represented a higher proportion of participants than males, particularly in urban areas. The population was predominantly young, with participants aged 5\u0026ndash;24 years accounting for more than half of the sample. Marked differences were observed between rural and urban areas for education level and socioeconomic status. Urban residents were more likely to have secondary or tertiary education, whereas rural residents were more frequently classified as having no formal education. Socioeconomic status also differed substantially by residence, with higher proportions of poor households in urban areas and higher proportions of rich households in rural areas. Marital status was fairly balanced, though a slight majority of participants were single, especially in urban areas.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eOverall seroprevalence\u003c/h2\u003e \u003cp\u003eThe overall dengue IgG seroprevalence was 45% (95% CI 42\u0026ndash;48). Seroprevalence was consistently higher in urban areas (52%) than in rural areas (26%) across all regions (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). At the regional level, the highest seroprevalence was observed in the Centre (62%), Centre-North (48%), Centre-West (49%) and North (47%) regions, while the lowest were reported in the East (12%) and Cascades (18%) regions. An exception to the typical pattern was observed in the South-West, where rural prevalence (42%) slightly exceeded urban prevalence (37%). According to climate zones (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), overall seroprevalence was highest in the intermediate climate area (55%), followed by the dry (37%) and humid (30%) areas. In all climate zones, seroprevalence was higher in urban than in rural areas. The largest urban\u0026ndash;rural difference was observed in the dry and intermediate zones.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eSeroprevalence according to demographic and socioeconomic characteristics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the distribution of DENV IgG seropositivity according to demographic and socioeconomic factors, stratified by rural and urban residence. A consistent pattern emerges showing higher seropositivity in urban areas compared with rural areas across nearly all sociodemographic categories. Regarding sex, seropositivity was similar between females and males in both settings, although prevalence was markedly higher in urban areas for both sexes. Overall, females showed slightly higher seropositivity than males. A strong age-related increase in seropositivity was observed. In both rural and urban settings, DENV IgG prevalence increased progressively with age, from the lowest levels among children aged 5\u0026ndash;14 years to the highest levels among adults aged 55 years and older. Urban residents consistently exhibited substantially higher prevalence than rural residents within each age group. With respect to education level, seropositivity varied across categories. Individuals with no education had relatively high prevalence in both rural and urban areas. In urban settings, very high seropositivity was observed among those with tertiary education, although confidence intervals were wide, likely reflecting small sample sizes. Overall, seropositivity tended to be higher among individuals with higher educational attainment in urban areas. Married individuals had higher seropositivity than single individuals in both rural and urban settings, again with urban residents showing substantially higher prevalence overall. Socioeconomic status showed mixed patterns. In urban areas, individuals with poor socioeconomic status had the highest seropositivity, while in rural areas differences between socioeconomic groups were less pronounced. Overall, dengue exposure appeared to be more strongly associated with urban residence and age than with socioeconomic status alone.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eRisk factors associated to DENV IgG seropositivity\u003c/h2\u003e \u003cp\u003eIn bivariate analysis (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e), DENV IgG seropositivity was significantly associated with place of residence, ecological zone, age group, education level, marital status, and socioeconomic status (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Seropositivity increased progressively with age. The average age was 37 years [95CI:35\u0026ndash;39] in seropositive individuals compared to 22 years [95CI:21\u0026ndash;23] for seronegative individuals. Sex was not associated with seropositivity (p\u0026thinsp;=\u0026thinsp;0.093).\u003c/p\u003e \u003cp\u003eAfter adjustment in multivariate logistic regression (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), urban residence remained significantly associated with DENV IgG seropositivity (adjusted OR [aOR] 2.2, 95% CI 1.6\u0026ndash;3.2). Age showed a strong independent association, with increasing odds from 25 years onwards and the highest odds among participants aged\u0026thinsp;\u0026ge;\u0026thinsp;55 years (aOR 11.8, 95% CI 6.3\u0026ndash;22.3). Secondary education remained associated with higher odds of seropositivity, while higher socioeconomic status was associated with lower odds. Sex and marital status were not associated after adjustment (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the final parsimonious model (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), urban residence, age, education level, and socioeconomic status remained independently associated with DENV IgG seropositivity. A clear age-related gradient was observed, and intermediate and high socioeconomic status were associated with reduced odds of seropositivity.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of the study population\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRural area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUrban area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFreq (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFreq (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFreq (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55[53\u0026ndash;58]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61[57\u0026ndash;64]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59[56\u0026ndash;62]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45[42\u0026ndash;47]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39[36\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41[37\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge groups (in years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38[35\u0026ndash;40]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27[\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30[27\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18[\u003cspan additionalcitationids=\"CR17 CR18 CR19\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24[\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25 CR26 CR27\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23[\u003cspan additionalcitationids=\"CR21 CR22 CR23 CR24\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e 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class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13[\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13[\u003cspan additionalcitationids=\"CR11 CR12 CR13 CR14\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12[\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9[\u003cspan additionalcitationids=\"CR9 CR10\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10[\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10[\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11[\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12[\u003cspan additionalcitationids=\"CR11 CR12 CR13 CR14\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11[\u003cspan additionalcitationids=\"CR11 CR12 CR13\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55[53\u0026ndash;58]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29[26\u0026ndash;33]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36[34\u0026ndash;39]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34[32\u0026ndash;37]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30[26\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31[29\u0026ndash;34]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9[\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33[30\u0026ndash;37]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27[\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.3[0.1-1]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8[\u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6[\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46[43\u0026ndash;49]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55[51\u0026ndash;59]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52[49\u0026ndash;56]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54[51\u0026ndash;57]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46[42\u0026ndash;50]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48[44\u0026ndash;51]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83[81\u0026ndash;86]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62[59\u0026ndash;64]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32[30\u0026ndash;35]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16[\u003cspan additionalcitationids=\"CR14 CR15 CR16 CR17\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20[\u003cspan additionalcitationids=\"CR19 CR20 CR21\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65[62\u0026ndash;67]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18[\u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDengue seroprevalence by region, climate zones and residence area\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLocalities\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eRural area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eUrban area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRDT+\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRDT +\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eRDT +\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoucle Mouhoun\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16[\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e56[49\u0026ndash;62]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e450\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e31[27\u0026ndash;35]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCascades\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9[\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10 CR11\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19[\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e18[\u003cspan additionalcitationids=\"CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32[25\u0026ndash;40]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e67[61\u0026ndash;73]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e62[57\u0026ndash;68]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre-East\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25[20\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e31[25\u0026ndash;38]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e434\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e26[22\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre-North\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34[28\u0026ndash;41]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e67[61\u0026ndash;73]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e449\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e48[43\u0026ndash;52]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre-West\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33[27\u0026ndash;39]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e52[45\u0026ndash;58]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e49[43\u0026ndash;54]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCentre-South\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31[25\u0026ndash;37]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e48[42\u0026ndash;55]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e43[38\u0026ndash;48]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11[\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13[\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e12[\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaut-Bassins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24[\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e 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class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e66[60\u0026ndash;72]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e47[42\u0026ndash;52]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlateau-Central\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e 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align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e47[40\u0026ndash;53]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e27[22\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth-West\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42[36\u0026ndash;49]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e37[31\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e41[36\u0026ndash;45]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClimate zones\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDry zone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e672\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23[\u003cspan additionalcitationids=\"CR21 CR22 CR23 CR24 CR25 CR26 CR27\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e663\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e63[50\u0026ndash;67]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e555\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1,335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e37[34\u0026ndash;40]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate zone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1,165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28[34\u0026thinsp;\u0026minus;\u0026thinsp;32]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1,206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e64[58\u0026ndash;69]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2,371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e55[51\u0026ndash;60]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHumid zone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e914\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23[\u003cspan additionalcitationids=\"CR22 CR23 CR24 CR25\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e31[27\u0026ndash;36]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e539\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1,819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e30[26\u0026ndash;32]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e657\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2,751\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26[\u003cspan additionalcitationids=\"CR24 CR25 CR26 CR27\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1,253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2,774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e52[49\u0026ndash;56]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1,910\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5,525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e45[42\u0026ndash;48]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDengue seroprevalence by demographic and socioeconomic factors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRural area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUrban area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePrev (%) [95%CI]\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25[\u003cspan additionalcitationids=\"CR23 CR24 CR25 CR26 CR27 CR28\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53[49\u0026ndash;58]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47[43\u0026ndash;50]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26[\u003cspan additionalcitationids=\"CR23 CR24 CR25 CR26 CR27 CR28 CR29\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51[48\u0026ndash;57]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43[39\u0026ndash;48]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge groups (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10[\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28[22\u0026ndash;35]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22[\u003cspan additionalcitationids=\"CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17[\u003cspan additionalcitationids=\"CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42[34\u0026ndash;50]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37[31\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23[\u003cspan additionalcitationids=\"CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67[57\u0026ndash;75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57[49\u0026ndash;64]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39[32\u0026ndash;47]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65[54\u0026ndash;74]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58[50\u0026ndash;65]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51[42\u0026ndash;60]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76[64\u0026ndash;84]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69[61\u0026ndash;77]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57[49\u0026ndash;65]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79[71\u0026ndash;86]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74[67\u0026ndash;80]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32[29\u0026ndash;36]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56[50\u0026ndash;63]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47[42\u0026ndash;50]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16[\u003cspan additionalcitationids=\"CR14 CR15 CR16 CR17 CR18 CR19\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39[32\u0026ndash;46]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32[27\u0026ndash;37]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20[\u003cspan additionalcitationids=\"CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56[49\u0026ndash;63]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53[46\u0026ndash;59]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3[0.3\u0026ndash;23]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75[62\u0026ndash;85]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74[61\u0026ndash;84]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21[\u003cspan additionalcitationids=\"CR18 CR19 CR20 CR21 CR22 CR23 CR24\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43[38\u0026ndash;50]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39[34\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38[34\u0026ndash;42]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68[62\u0026ndash;73]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60[55\u0026ndash;64]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24[14\u0026ndash;40]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55[51\u0026ndash;59]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55[51\u0026ndash;59]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23[\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24 CR25 CR26\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39[32\u0026ndash;47]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32[28\u0026ndash;37]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27[\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32[24\u0026ndash;41]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27[\u003cspan additionalcitationids=\"CR25 CR26 CR27 CR28 CR29\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate associations with DENV IgG seropositivity\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eSeropositivty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCoreected Chi2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNegative (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePositive (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e8.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eurban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEcological Zone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emoderate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehumid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e3.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge groups (in years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e31.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e12.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enot married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e23.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e9.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable analysis of factors associated with DENV IgG seropositivity\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eUnivariate analysis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eMultivariate analysis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eFinal Multivariate model\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIC95%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eORaj\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eIC95%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eORaj\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eIC95%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of Residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eurban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[2.6\u0026ndash;3.9]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[1.6\u0026ndash;3.2]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0,001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.4\u0026ndash;2.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEcological Zone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emoderate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[1.7\u0026ndash;2.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.8\u0026ndash;1.3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.918\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ehumid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.6\u0026ndash;0.9]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.2\u0026ndash;0.4]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.7\u0026ndash;1.1]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.7\u0026ndash;1.2]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.614\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (in years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[1.4-3.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.8\u0026ndash;2.4]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.9\u0026ndash;2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[3.1-7.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[2.0\u0026ndash;7.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2.2\u0026ndash;5.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[3.2\u0026ndash;7.3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[2.8\u0026ndash;10.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3.2\u0026ndash;8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[5.1\u0026ndash;12.8]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[4.4\u0026ndash;17.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.3\u0026ndash;15.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[6.6\u0026ndash;15.3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[6.3\u0026ndash;22.3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7.4\u0026ndash;20.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eprimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.4\u0026ndash;0.7]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.7\u0026ndash;1.9]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.512\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.9\u0026ndash;1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.9\u0026ndash;1.7]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[1.1\u0026ndash;2.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.2\u0026ndash;2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[1.7-6.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.9\u0026ndash;4.2]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1,2\u0026ndash;4,8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003enot married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[1.8-3.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.7\u0026ndash;1.4]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.864\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003epoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eintermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.230.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.4\u0026ndash;0.9]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.4\u0026ndash;0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003erich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e[0.2\u0026ndash;0.4]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e[0.4\u0026ndash;0.8]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.4\u0026ndash;0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussions","content":"\u003cp\u003eThis study aimed to to provide estimates of dengue virus exposure and to identify key demographic and socioeconomic factors associated DENV IgG seropositivity using the CTK Onsite Dengue IgG Rapid Test, a tool suitable for detecting probable dengue cases.\u003c/p\u003e \u003cp\u003eOverall seroprevalence was high (45%), with substantial heterogeneity across regions, climate zones, and areas of residence. These findings indicate that dengue fever has emerged as a major public health concern in the country, alongside malaria, consistent with evidence from multiple previous studies [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Dengue infection may contribute significantly to the onset, the persistence and the severity of fever in patients suffering from other infectious diseases, mainly malaria [\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Previous study reported a high prevalence of malaria-dengue coinfection across African regions ranging from 16 per 1000 febrile cases (95% CI 6\u0026ndash;45) in West Africa to 47 (95% CI 22\u0026ndash;98) in Central Africa, with a marked increase over time from 0.9% during 2008\u0026ndash;2013 to 5.5% during 2018\u0026ndash;2021 [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In the absence of specific antiviral treatment for dengue, such coinfections are likely to complicate patient management. These findings underscore the importance for healthcare professionals to consider both malaria and dengue in the differential diagnosis of febrile illness. They also highlight the need for policymakers to strengthen health system capacity through training and provision of diagnostic tools. Following the 2017 outbreak, Burkina Faso adopted national guidelines for dengue case management; however, wider dissemination and comprehensive training of health workers remain necessary. Community sensitisation on dengue prevention, symptoms, and its potential coexistence with malaria is also essential.\u003c/p\u003e \u003cp\u003eThe results indicate that nearly half of the population in Burkina Faso has been exposed to the dengue virus. The estimated overall seroprevalence remains below the WHO threshold of 60% defining an high transmission intensity [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], suggesting moderate dengue transmission nationwide. Consequently, Burkina Faso does not currently meet WHO eligibility criteria for dengue vaccine introduction for the whole population. However, urban populations in the Centre, Centre-North, and North regions experienced high dengue transmission, suggesting that these areas may be suitable candidates for targeted dengue vaccination programmes. These programmes could also integrate adults in urban zones. In paralell, strengthening vector control interventions, including environmental sanitation, reduction of mosquito breeding sites around households, appropriate insecticide use, and installation of protective screens, remains a priority for the entire country.\u003c/p\u003e \u003cp\u003eUrban residence was associated with DENV IgG seropositivity. Higher seroprevalence in urban compared with rural areas across most regions and climate zones suggests that urban environments play a central role in sustaining dengue transmission. This finding is consistent with the ecology of Aedes vectors, which thrive in densely populated settings with abundant artificial breeding sites [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Poor wastewater management, accumulation of water containers, and household gardening practices most occurring in uarban settings, may favour mosquito proliferation and increase human\u0026ndash;vector contact\u003c/p\u003e \u003cp\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, some studies have reported homogeneous dengue exposure across rural and urban settings, suggesting that dengue transmission may no longer be exclusively urban [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Further research is needed to clarify these patterns in different ecological contexts.\u003c/p\u003e \u003cp\u003eSeropositivity increased steadly, showing a stron dose-response relationship and remaining the strongest independent predictor of dengue exposure, in line with previous studies [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR28 CR29\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. This pattern is indicative of cumulative lifetime exposure and supports the presence of long-standing endemic transmission rather than sporadic outbreaks. Higher exposure among adults may reflect increased outdoor activities, occupational exposure, mobility, and travel to dengue-endemic areas. Adults may spend more time in environments where mosquitoes are prevalent, such as gardens, markets, or construction sites. Ongoing urbanisation, climate change, and changes in mosquito populations may further amplify adult exposure, particularly in urban settings.\u003c/p\u003e \u003cp\u003eEducation level and socioeconomic status were independently associated with seropositivity. Higher education was associated with increased odds of dengue exposure, while intermediate and high socioeconomic status appeared protective. These associations may reflect complex interactions between mobility, housing quality, living environments, and access to vector control measures, although residual confounding cannot be excluded.\u003c/p\u003e \u003cp\u003eThis study has some limitations. First, the cross-sectional design precludes causal inference between identified risk factors and dengue seropositivity. Second, sampling was restricted to regional capital cities, which may limit representativeness at sub-regional level. Third, the use of anti-dengue IgG antibodies reflects past exposure and does not capture recent or acute infections. Consequently, infections detectable by IgM antibodies and/or NS1 antigen may have been missed, potentially leading to an underestimation of the true seroprevalence. Finally, cross-reactivity with other flaviviruses cannot be completely excluded, although available evidence suggests that such cross-reactivity is uncommon [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This study provides nationally representative estimates of dengue virus seroprevalence in Burkina Faso, offering a comprehensive assessment of population-level exposure in a malaria-endemic setting. The community-based design allows detection of asymptomatic and past infections that are typically missed by routine facility-based surveillance systems. In addition, the study identifies demographic and socioeconomic factors associated with dengue seropositivity, thereby generating robust evidence to support evidence-based dengue surveillance, vector control, and vaccination strategies.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis nationwide study demonstrates substantial exposure to dengue virus in Burkina Faso, with nearly half of the population showing evidence of past infection. Dengue transmission remains of moderate intensity but is widespread, with marked variation by region, climate zone, age, and place of residence. Urban residence and increasing age were the strongest independent predictors of DENV IgG seropositivity, highlighting the central role of urban environments and cumulative exposure in sustaining dengue transmission. Although current seroprevalence levels do not meet World Health Organization criteria for dengue vaccine introduction, the high burden of exposure underscores dengue as an important public health concern alongside malaria. Adults residing in urban areas most affected may need dengue vaccine as supplementary strategy. Strengthening integrated surveillance, improving diagnostic capacity, expanding health worker training, and reinforcing vector control interventions (particularly in urban settings) are essential. Targeted community sensitisation and sustained implementation of national dengue management guidelines will be critical to reducing dengue-related morbidity and improving febrile illness management in Burkina Faso.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eData sharing\u003c/h2\u003e \u003cp\u003eTechnical appendix, statistical codes and dataset are available upon reasonable request.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSupplementary and data raw\u003c/strong\u003e \u003cp\u003eThe supplementary and data raw are placed alongside this article.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e \u003cp\u003e Ethical clearance was obtained from the \u0026ldquo;Comit\u0026eacute; Ethique pour la Recherche en Sant\u0026eacute; (CERS)\u0026rdquo; before implementing the protocol-related activities. This committee belongs to the Burkina Faso Ministry of Health. All participants provided signed informed consent before any individual data was collected. The study adhered to the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis work was funded by the World Bank Group under Grant No. GFF N\u0026deg;TF A7763-BF. The Burkina Faso Ministry of Health also contributed to the implementation of the project activities.\u003c/p\u003e\u003ch2\u003eAuthor Contributions\u003c/h2\u003e \u003cp\u003eSD made substantial contributions to the study's design, coordination of fieldwork, data analysis, and interpretation, as well as manuscript preparation. AG contributed to the design, project oversight, and substantive manuscript revision. RK, GWN, KY, FT, WB and SRI were responsible for data acquisition, supervision of fieldwork activities, and ensuring high-quality data collection. GSS, NO, HS, SS, HS, SM, MO, CWT, HJT and AO supervised blood sample collection, assisted with sample processing and storage, and provided laboratory results. MWG provided significant advices for the project design and implementation. AGo developed the electronic data collection tool used in the study. TIT and LBS provided technical assistance and contributed to the manuscript substantial revision. All authors revised the manuscript, approved the final submitted version, and agreed to be personally accountable for their respective contributions.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003e We extend our gratitude to World Bank Group, Burkina Faso Ministry of Health and its related institutions, national project partners, research group, regional administrative and security authorities, and project participants for their strong commitment in ensuring the success of this project. We also express our gratitude to CDC Dengue Branch for providing support on dengue diagnostic practices and the references of appropriate reagents.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTinto B, Kania D, Samdapawinde Kagone T, Dicko A, Traore I, de Rekeneire N et al (2022) [Dengue virus circulation in West Africa: An emerging public health issue]. Med Sci (Paris) 38(2):152\u0026ndash;158\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL et al (2013) The global distribution and burden of dengue. Nature 496(7446):504\u0026ndash;507\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG et al (2012) Refining the global spatial limits of dengue virus transmission by evidence-based consensus. 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PLoS Negl Trop Dis 16(7):e0010059\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTam CC, O'Driscoll M, Taurel AF, Nealon J, Hadinegoro SR (2018) Geographic variation in dengue seroprevalence and force of infection in the urban paediatric population of Indonesia. PLoS Negl Trop Dis 12(11):e0006932\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWere F (2012) The dengue situation in Africa. Paediatr Int Child Health 32(Suppl 1s1):18\u0026ndash;21\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDoum D, Overgaard HJ, Mayxay M, Suttiprapa S, Saichua P, Ekalaksananan T et al (2020) Dengue Seroprevalence and Seroconversion in Urban and Rural Populations in Northeastern Thailand and Southern Laos. Int J Environ Res Public Health. ;17(23)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElaagip A, Alsedig K, Altahir O, Ageep T, Ahmed A, Siam HA et al (2020) Seroprevalence and associated risk factors of Dengue fever in Kassala state, eastern Sudan. PLoS Negl Trop Dis 14(12):e0008918\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEldigail MH, Abubaker HA, Khalid FA, Abdallah TM, Adam IA, Adam GK et al (2020) Recent transmission of dengue virus and associated risk Facors among residents of Kassala state, eastern Sudan. BMC Public Health 20(1):530\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraga C, Luna CF, Martelli CM, de Souza WV, Cordeiro MT, Alexander N et al (2010) Seroprevalence and risk factors for dengue infection in socio-economically distinct areas of Recife, Brazil. Acta Trop 113(3):234\u0026ndash;240\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Centre National de Recherche et de Formation sur le Paludisme","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"seroprevalence, dengue virus, cross-sectional survey, risk factors","lastPublishedDoi":"10.21203/rs.3.rs-8740684/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8740684/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEpidemiological data on dengue remain limited in west African settings. To support policymakers with robust evidence on the burden of dengue, this study was conducted to estimate the seroprevalence of dengue infection and to identify its potential risk factors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a nationwide, community-based cross-sectional survey in May 2022 in all the Burkina Faso 13 regions, including both urban and rural areas. A multistage stratified cluster sampling design was used to select participants aged\u0026thinsp;\u0026ge;\u0026thinsp;5 years. Data were collected through standardized questionnaires and blood samples. Anti-dengue IgG antibodies were detected using a rapid diagnostic test. Weighted analyses accounted for the complex survey design, and multivariate logistic regression identified factors associated with dengue seropositivity.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOverall DENV IgG seroprevalence was 45% (95% CI: 42\u0026ndash;48) and was consistently higher in urban areas (52%) than in rural areas (26%). Seroprevalence varied geographically, ranging from 12% in the East region to 62% in the Centre region, and was highest in moderate climate zones (55%). In multivariable analysis, urban residence was significantly associated with seropositivity (aOR 2.0, 95% CI: 1.4\u0026ndash;2.8). Increasing age showed a strong association, with the highest odds among participants aged\u0026thinsp;\u0026ge;\u0026thinsp;55 years (aOR 12.1, 95% CI: 7.4\u0026ndash;20.1).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eFindings indicate moderate-intensity dengue transmission in Burkina Faso, suggesting that the country is not currently eligible for WHO dengue vaccine implementation. On the other hand, adults population residing in urban areas may need dengue vaccination programmes.\u003c/p\u003e","manuscriptTitle":"Seroprevalence of dengue virus infection and associated risk factors in a malaria-endemic country : a community-based cross-sectional survey in Burkina Faso","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 06:09:20","doi":"10.21203/rs.3.rs-8740684/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"85fa6548-a43e-4be2-b03b-3ad33fc489b8","owner":[],"postedDate":"February 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":62028563,"name":"Epidemiology"}],"tags":[],"updatedAt":"2026-02-02T06:09:20+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-02 06:09:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8740684","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8740684","identity":"rs-8740684","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}