A cross-sectional study on knowledge, attitude and practice (KAP) and risk factors for dengue seropositivity among children in Fortaleza, Brazil.

Background Dengue fever is a mosquito-borne viral disease that is associated with four serotypes of the dengue virus. Children are vulnerable to infection with the dengue virus and the risk of severe dengue disease is the highest among infants and children, particularly those who have been previously infected with a different dengue serotype. Sufficient knowledge, positive attitudes, and proper practices (KAP) are essential for dengue prevention and control. This study aims to estimate the dengue seropositivity for study participants and to examine the association between households’ dengue-related knowledge, attitudes, and practices (KAP), and children’s risk of dengue seropositivity, while accounting for socioeconomic and demographic differences in Brazil. Methodology/Principal Findings This analysis was based on a cross-sectional study from Fortaleza, Brazil between November 2019, and February 2020. There were 392 households and 483 participant children who provided a sample of sufficient quality for serological analysis. The main exposure was a household’s dengue-related knowledge, attitudes, and practices, assessed through a questionnaire to construct a composite KAP score categorized into three levels: low, moderate and high. The main outcome is dengue immunoglobulin G(IgG) antibodies, collected using dried blood spots and assessed with Panbio Dengue IgG indirect ELISA (enzyme-linked immunosorbent assays) test commercial kits. The estimated crude dengue seroprevalence among participating children (n=483) was 25.1%. 5% (n=20) of households achieved a score of over 75% for KAP, while most households achieved between 50% and 75% of the total scores (n=271, 69%), and 101 households scored . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 20, 2023. ; https://doi.org/10.1101/2023.01.19.23284811 doi: medRxiv preprint

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