Dengue is an emerging infectious disease of global significance. Although this virus has been reported for a long time, its significance within the burden of diseases in West Africa is not obvious, especially in Burkina Faso. Our objective was to evaluate flavivirus presence in Ouagadougou (Burkina Faso) and the link between anti-flavivirus antibody seroprevalence and urbanization modes. A population-based cross-sectional survey was conducted and 3015 children were enrolled from Ouagadougou districts with different types and degrees of urbanization (with/without equipment and high/low building density). Flavivirus (FLAV) IgM MAC-ELISA and FLAV indirect IgG ELISA were performed. Associations between FLAV IgG presence (sign of past infection) and various independent variables were assessed using the chi-square test and a multivariate logistic regression analysis. The apparent prevalence of past flavivirus infections among the enrolled children was 22.7% (95% CI: 22.4–26.7) (n = 685). Eleven children (0.4%; 95% CI: 0.61–2.14) were positive for FLAV IgM, indicating active transmission. Factors associated with flavivirus infection were identified among the enrolled children (age, sex), householders (educational level, asset index) and in the environment (building density, water access, waste management and house appearance); however, they showed great variability according to the city districts. The water access modality did not significantly influence FLAV IgG positivity. Conversely, apparently good practices of waste management had unexpected consequences (increased risk related to municipal dumpsters). Given the scale of ongoing urbanization and the spread of arboviral diseases, close collaboration between health and city stakeholders is needed.
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