Journal Article 2 Mentions
Efficacy of Wolbachia-Infected Mosquito Deployments for the Control of Dengue
Adi Utarini2021
Citra IndrianiRiris Andono Ahmad
Top 1% · 99th Percentile
654 citations · Public Health, Environmental and Occupational Health
Open AccessWorld Mosquito Programme

TLDR

Releasing special mosquitoes that can't spread dengue as easily led to far fewer people getting sick and needing hospital care in a city in Indonesia.

Summary

1 Study Aim

The study set out to test whether releasing Aedes aegypti mosquitoes infected with the wMel strain of Wolbachia (a type of bacteria that makes mosquitoes less able to spread dengue virus) could lower the number of people getting sick with dengue in a real-world city setting. The researchers wanted to see if this method would work better than standard mosquito control practices and if it would reduce cases across all types of dengue virus. The study wanted to find out if releasing bacteria-infected mosquitoes could stop people from getting dengue.

2 Study Design

Researchers conducted a cluster-randomized trial in Yogyakarta, Indonesia, dividing the city into 24 areas (clusters). Twelve clusters received releases of wMel-infected Aedes aegypti mosquitoes, while the other twelve did not. All areas continued their usual mosquito control activities. People aged 3 to 45 years with recent fever who visited local clinics were enrolled and tested for dengue. The main outcome was the number of symptomatic, lab-confirmed dengue cases. The study used a test-negative design, comparing those who tested positive for dengue to those who did not. The trial included over 8,000 participants and lasted more than two years. The researchers compared neighborhoods with and without special mosquito releases to see if fewer people got dengue.

3 Findings

The study found that areas where wMel-infected mosquitoes were released had a 77% lower rate of symptomatic, lab-confirmed dengue compared to areas without releases. Hospitalizations for dengue were also much lower (an 86% reduction) in the intervention areas. The protective effect was seen against all four types of dengue virus. The results suggest that releasing Wolbachia-infected mosquitoes is a highly effective way to reduce dengue cases and hospitalizations in urban settings. The authors recommend considering this approach as a new tool for dengue control, especially in places where traditional methods have not worked well. Fewer people got sick and needed hospital care in areas with the special mosquitoes, showing this method works well to fight dengue.

Abstract

BACKGROUND: to dengue virus infection. METHODS: (intervention clusters) and 12 clusters to receive no deployments (control clusters). All clusters practiced local mosquito-control measures as usual. A test-negative design was used to assess the efficacy of the intervention. Patients with acute undifferentiated fever who presented to local primary care clinics and were 3 to 45 years of age were recruited. Laboratory testing was used to identify participants who had virologically confirmed dengue (VCD) and those who were test-negative controls. The primary end point was symptomatic VCD of any severity caused by any dengue virus serotype. RESULTS: Mel into the intervention clusters, 8144 participants were enrolled; 3721 lived in intervention clusters, and 4423 lived in control clusters. In the intention-to-treat analysis, VCD occurred in 67 of 2905 participants (2.3%) in the intervention clusters and in 318 of 3401 (9.4%) in the control clusters (aggregate odds ratio for VCD, 0.23; 95% confidence interval [CI], 0.15 to 0.35; P = 0.004). The protective efficacy of the intervention was 77.1% (95% CI, 65.3 to 84.9) and was similar against the four dengue virus serotypes. The incidence of hospitalization for VCD was lower among participants who lived in intervention clusters (13 of 2905 participants [0.4%]) than among those who lived in control clusters (102 of 3401 [3.0%]) (protective efficacy, 86.2%; 95% CI, 66.2 to 94.3). CONCLUSIONS: populations was effective in reducing the incidence of symptomatic dengue and resulted in fewer hospitalizations for dengue among the participants. (Funded by the Tahija Foundation and others; AWED ClinicalTrials.gov number, NCT03055585; Indonesia Registry number, INA-A7OB6TW.).

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