@article{fdi:010093862,
  title = {{K}nowledge, attitude and practice ({KAP}) and risk factors on dengue fever among children in {B}razil, {F}ortaleza : a cross-sectional study},
  author = {{Z}hang, {Y}. and {Z}ahreddine, {M}. and {A}breu, {K}. and {A}zevedo {D}antas, {M}. and {C}harland, {K}. and {P}ierce, {L}. and {R}idde, {V}al{\'e}ry and {Z}inszer, {K}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {D}engue fever is a mosquito-borne viral disease that is associated with four serotypes of the dengue virus. {C}hildren are vulnerable to infection with the dengue virus, particularly those who have been previously infected with a different dengue serotype. {S}ufficient knowledge, positive attitudes, and proper practices ({KAP}) are essential for dengue prevention and control. {T}his 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 {B}razil. {M}ethodology/{P}rincipal findings : {T}his analysis was based on a cross-sectional study from {F}ortaleza, {B}razil between {N}ovember 2019, and {F}ebruary 2020. {T}here were 392 households and 483 participant children who provided a sample of sufficient quality for serological analysis. {T}he 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. {T}he main outcome is dengue immunoglobulin {G}({I}g{G}) antibodies, collected using dried blood spots and assessed with {P}anbio {D}engue {I}g{G} indirect {ELISA} (enzyme-linked immunosorbent assays) test commercial kits. {T}he estimated crude dengue seroprevalence among participating children (n = 483) was 25%. {F}ive percent of households (n = 20) achieved a score over 75% for {KAP}, sixty-nine percent of households (n = 271) scored between 50% and 75%, and twenty-six percent of households (n = 101) scored lower than 50%. {E}ach {KAP} domain was significantly and positively associated with the others. {T}he mean percentage scores for the three domains are 74%, 63%, and 39% respectively. {W}e found high household {KAP} scores were associated with an increased adjusted relative risk (a{RR}) of seropositivity (a{RR}: 2.11, 95% {CI}: 1.11-4.01, p = 0.023). {H}ousehold adult respondents' education level of elementary school or higher was negatively associated with children's risk of being seropositive (a{RR}: 0.65, 95% {CI}: 0.48-0.87, p = 0.005). {T}he risk of seropositivity in older children (6-12 years old) was over 6 times that of younger children (2-5 years old) (a{RR}: 6.08, 95% {CI}: 3.47-10.64, p<0.001). {C}hildren living in households with sealed water tanks or no water storage had a lower risk of being seropositive (a{RR}: 0.73, 95% {CI}: 0.54-0.98, p = 0.035). {C}onclusions/{S}ignificance : {O}ur results provide insight into the prevalence of dengue seropositivity in {F}ortaleza, {B}razil in children, and certain demographic and socioeconomic characteristics associated with children's risk of being seropositive. {T}hey also suggest that {KAP} may not identify those more at-risk for dengue, although understanding and enhancing households' {KAP} is crucial for effective community dengue control and prevention initiatives.},
  keywords = {{BRESIL} ; {FORTALEZA}},
  booktitle = {},
  journal = {{P}lo{S} {N}eglected {T}ropical {D}iseases},
  volume = {17},
  numero = {9},
  pages = {e0011110 [16 ]},
  ISSN = {1935-2735},
  year = {2023},
  DOI = {10.1371/journal.pntd.0011110},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093862},
}