Cross-sectional study on the association between seroprevalence among children and their parents’ knowledge, attitudes, and practices in a dengue-endemic city in Bangladesh
Claudia Ximena Robayo Gonzalez, Bouchra Nasri, Marie-Catherine Gagnon-Dufresne, Avijit Saha, Laura Pierce, Mushfiqur Rahman, John Barnard Mackfield, Yang Zhang, Mrittika Barua, Md. Mizanur Rahman, Malay Kanti Mridha, Valéry Ridde, Kate ZinszerIntroduction
Bangladesh is experiencing a drastic increase in dengue infections since 2019, with a record number of cases exceeding 300,000 in 2023 and 102,082 cases in 2025. Control of dengue, spread by Aedes mosquitoes, requires an in-depth understanding of knowledge, attitudes, and practices (KAP) regarding prevention strategies and their association with the risk of infection. This association has been rarely examined in adults and even more rarely in relation to the risk of infection in children. This study aimed to investigate the association between parents’ knowledge, attitudes, and practices (KAP) and children’s dengue seropositivity in Dhaka, Bangladesh.
Methodology
A cross-sectional study was conducted in four neighborhoods of Dhaka in November and December 2023. A total of 297 parents and 412 children aged 2–12 years participated in the study. Parents completed a questionnaire that collected data on their previous dengue experiences, sociodemographic characteristics, social capital, and knowledge, attitudes, and practices (KAP) related to dengue. Children’s capillary blood samples were collected via finger prick and tested for IgM and IgG dengue antibodies. The relative risk (RR) of dengue seropositivity was estimated using a modified Poisson regression model with robust error variance.
Results
The median ages of the parents and children were 32.5 and 6.7 years, respectively. The adjusted seroprevalence of dengue for both IgM and IgG in children was 14.0% (95% CI 10% -19%). Parents’ KAP scores were classified as intermediate knowledge of the disease in 60.3% of participants; 64.3% reported positive attitudes towards dengue control and prevention actions; and 62.0% had a high score for dengue prevention practices. A higher parent attitude score was associated with lower child seropositivity (aRR 0.77, 95% CI 0.60-0.99).
Conclusions
These findings provide preliminary insight into the factors associated with dengue seropositivity in children in Dhaka, offering additional information about parents’ attitudes towards dengue risk and prevention and the relationship with child’s seropositivity. This information can guide public health interventions, such as dengue control campaigns. A more in-depth exploration of the context will help to understand the cultural and social factors that shape KAP in Dhaka.