Enterovirus 71 seropositivity among children and adolescents in Bangladesh

Objectives

The world has witnessed an increase in non-polio enterovirus infections. This study assessed the seroprevalence of enterovirus 71 (EV71) neutralizing antibodies (NAbs) and explored associated risk factors among children and adolescents in Bangladesh.

Methods

Between March 2019 and March 2020, a cross-sectional survey was conducted in one urban and one rural district of Bangladesh. A total of 1207 children aged 0-17 years were enrolled, including 607 from urban and 600 from rural areas. Serum samples were tested using a cytopathic effect-based microneutralization assay to measure EV71 NAb titers. Demographic and socio-epidemiological data were also collected through structured interviews.

Results

Overall, 817 (67.7%) were seropositive for EV71, with 68.3% in urban and 31.7% in rural areas. Age-specific seroprevalence in urban vs rural settings was: <6 months, 96.0% vs 38.9%; 6-71 months, 90.3% vs 35.1%; 6-11 years, 92.7% vs 80.4%; 12-17 years, 100% vs 77.6%. In urban areas, having an indoor toilet was linked to lower seropositivity (P = 0.03). In rural areas, older age, lower parental education, and parental unemployment were significant factors.

Conclusions

The high EV71 seroprevalence in Bangladeshi children indicates widespread exposure. Further research on non-polio enterovirus, including EV71, is needed to inform surveillance, prevention, and potential vaccine strategies.