Serostudies are needed to answer generalizable questions on disease risk. However, recruitment is usually biased by age or location. We present a nationally-representative study for dengue from 70 communities in Bangladesh. We collected data on risk factors, trapped mosquitoes and tested serum for IgG. Out of 5,866 individuals, 24% had evidence of historic infection, ranging from 3% in the north to >80% in Dhaka. Being male (aOR:1.8, [95%CI:1.5-2.0]) and recent travel (aOR:1.3, [1.1-1.8]) were linked to seropositivity. Using catalytic models, we estimate that 40 million [34.3-47.2] people have been infected with 2.4 million ([1.3-4.5]) annual infections. Had we visited only 20 communities, seropositivity estimates would have ranged from 13% to 37%, highlighting the lack of representativeness generated by small numbers of communities. Our findings have implications for both the design of serosurveys and tackling dengue in Bangladesh.
All data generated or analysed during this study are included in the manuscript and supporting files with the exception of precise coordinate information of households.
- Henrik Salje
- Emily Gurley
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Human subjects: This study was approved by the icddr,b ethical review board. (protocol number PR-14058). The U.S. Centers for Disease Control and Prevention relied on icddr,b's ethical review board approval. All adult participants provided written, informed consent after receiving detailed explanation of the study and procedures. Parents/guardians of all child participants were asked to provide written, informed consent on their behalf.
- Ben Cooper, Mahidol Oxford Tropical Medicine Research Unit, Thailand
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