Seroprevalence of 17 pathogens from an integrated national serosurvey in Niue

Integrated serosurveillance (ISS), using multiplex bead assays to measure antibodies to multiple pathogens, can provide insights into population immunity and pathogen exposure. We estimated seroprevalence for neglected tropical diseases (NTDs), arboviruses, vaccine-preventable diseases, and enteric protozoa in Niue through a cross-sectional survey embedded within a World Health Organization (WHO) STEPwise survey from 24 February to 4 April 2025. Dried blood spots from participants aged ≥ 3 years were tested for 26 pathogen-specific antibodies. Among 750 participants (median age 37 years; range 3–93; 53% female), NTD seroprevalence was low (0% for yaws [among 165 participants aged ≤ 14 years] to 2.7% for cysticercosis). Arbovirus seroprevalence ranged from 3.1% (Zika) to 35.1% (dengue serotype 4). Dengue seropositivity increased with age ( p < 0.05). Measles and rubella seroprevalence exceeded 98%, while diphtheria and tetanus seropositivity was lower in older age groups ( p ≤ 0.03). Cryptosporidium seroprevalence (68.7%) increased with age ( p < 0.001), while Giardia seroprevalence was low (4.1%). Findings demonstrate the utility of ISS to generate policy-relevant surveillance data, although interpretation is limited by the cross-sectional design and non-probability sampling.