# Seroprevalence and preventive practices of dengue and chikungunya among school children in Bangkok: Gaps in prevention and vaccination strategies

## TL;DR

This study finds that many school children in Bangkok have been exposed to dengue and some to chikungunya, but preventive measures like repellent use and larval control are lacking.

## Contribution

The study provides new seroprevalence data for dengue and chikungunya among Bangkok school children and identifies gaps in preventive practices.

## Key findings

- Dengue seroprevalence was 28.1% among children aged 10–15 in Bangkok.
- Only 14.8% of participants consistently used mosquito repellent.
- Chikungunya seroprevalence was 6.3%, indicating an emerging trend.

## Abstract

Dengue and chikungunya, both transmitted by Aedes mosquitoes, continue to pose significant public health concerns in Thailand, particularly during the rainy season. Despite ongoing vector control efforts, the incidence of infection remains high, with an increasing trend observed in chikungunya. This underscores the need for additional control measures, including vaccination, to reduce disease burden and morbidity. This study aims to assess the seroprevalence of dengue and chikungunya infections among children aged 10–15 years in Bangkok and to evaluate the knowledge, attitudes, and practices (KAP) related to mosquito-borne disease prevention.

A cross-sectional descriptive study was conducted across 12 schools in Bangkok. Children aged 10–15 years were included. Seroprevalence was determined using rapid diagnostic tests (Abbott DENGUE IgG/IgM and Citest Chikungunya IgG/IgM) based on the immunochromatography technique, using fingertip blood samples. Parents completed KAP questionnaires, including factors influencing vaccination decisions.

From June to August 2024, 937 participants were enrolled, with a mean (SD) age of 11 (1.6) years; 67% were aged 10–12 years, and 33% were aged 13–15 years. The seroprevalence of dengue was 28.1% (95% CI 25.2-31.0), while that of chikungunya was 6.3% (95% CI 4.7-7.9). KAP assessments revealed a high level of awareness regarding symptoms and transmission; however, notable deficiencies in preventive behaviors were identified. Only 14.8% of respondents reported consistent use of mosquito repellent, and 17.5% routinely inspected and removed mosquito larvae from their homes.

The substantial seroprevalence of dengue and the emerging trend of chikungunya among children in Bangkok highlights the urgent need to enhance community education and strengthen vector control interventions. Expanding dengue vaccination coverage and raising awareness about chikungunya prevention, including consideration for future vaccine implementation, are essential to mitigating future outbreaks and reducing the disease burden.

Thai Clinical Trials under the number TCTR20240404002 (https://www.thaiclinicaltrials.org/show/TCTR20240404002).

Mosquito-borne diseases, including dengue and chikungunya, are significant health problems in Southeast Asia. In our study, we evaluate the seroprevalence of these diseases using rapid blood tests in school-based settings among children in Bangkok. The seroprevalence data highlight the risk of exposure, particularly among children, and can guide preventive practices, including vaccination. Despite the widespread recognition of these diseases, preventive practices remain limited. Therefore, implementing effective preventive measures and vaccination strategies could significantly reduce the severity of infections and improve public health outcomes.