Geographic and temporal distribution of primary and secondary dengue cases in Burkina Faso from 2023-2025: a hospital-based cross-sectional study

Background Dengue virus (DENV) is the main prevalent arbovirus in Burkina Faso, with significant morbidity and mortality. Discrimination between primary and secondary dengue infections is important for public health decision-making. This study aimed to characterize the spatiotemporal distribution of primary and secondary dengue infections, as well as pre-vaccination screening. Methods This study was conducted in 2023, 2024, and 2025 in Bobo-Dioulasso, Houndé, Ouagadougou, and Gaoua. Blood sample was collected from each suspected case. DENV detection was performed using a rapid diagnostic test, enzyme-linked immunosorbent assay (ELISA), and molecular techniques. Results In 2023, the primary and secondary infection rates were 75.40% (92/122) and 24.6% (30/122), respectively. In 2024, 77.17% (71/92) of primary infections and 22.83% (21/92) of secondary infections were reported. In 2025, primary and secondary infection accounted for 68.83% (53/77) and 31.17% (24/77), respectively. Across the 2023–2025 period, abdominal pain occurred in 7.87% (17/216) and persistent vomiting in 2,31% (5/216) of dengue primary infection cases, while 92.13% (199/216) showed no warning signs. Among patients with secondary dengue infection, abdominal pain was reported in 54.66% (41/75) and persistent vomiting in 29.33% (22/75), although 45.43% (34/75) presented without warning signs. In 2023, DENV-3 was the predominant serotype, accounting for 76.23% (93/122) of cases. In contrast, DENV-1 predominated in 2024 and 2025, representing 69.57% (66/92) and 71.42% (55/77) of cases, respectively. Conclusions Primary infection predominated in all years, with year-to-year variation in DENV serotype distribution, and warning signs were associated with secondary infection. Qdenga (TAK-003) vaccine may be a relevant option in the Burkina context