Reduced dengue incidence following deployments ofWolbachia -infectedAedes aegyptiin Yogyakarta, Indonesia: a quasi-experimental trial using controlled interrupted time series analysis

Gates Open Research

article

Citra Indriani¹  Warsito Tantowijoyo¹  Edwige Rancès³  Bekti Andari¹  Equatori Prabowo¹  Dedik Yusdi¹  Muhammad Ridwan Ansari¹  Dwi Satria Wardana¹  Endah Supriyati¹  Indah Nurhayati¹  Inggrid Ernesia¹  Sigit Setyawan¹  Iva Fitriana¹  Eggi Arguni¹  Yudiria Amelia⁵  Riris Andono Ahmad¹  Nicholas P. Jewell⁶  Suzanne M. Dufault⁶  Peter A. Ryan³  Benjamin R. Green³  Thomas F. McAdam³  Scott L. O'Neill³  Stephanie K. Tanamas³  Cameron P. Simmons³  Katherine L. Anders³  Adi Utarini¹ 

[1] Centre of Tropical Medicine, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada;Department of Epidemiology Biostatistics and Public Health, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada;Institute of Vector Borne Disease, Monash University;Department of Paediatrics, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada;Yogyakarta City Health Office;Division of Epidemiology and Biostatistics, School of Public Health, University of California;Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine;Oxford University Clinical Research Unit, Hospital for Tropical Diseases;Department of Health Policy and Management, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada

关键词: Wolbachia;    Aedes aegypti;    dengue;    vector-borne disease;    mosquito release;    quasi-experimental study;    interrupted time series analysis;    Indonesia;    World Mosquito Program;   

DOI  :  10.12688/gatesopenres.13122.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: Ae. aegypti mosquitoes stably transfected with the intracellular bacterium Wolbachia pipientis (wMel strain) have been deployed for biocontrol of dengue and related arboviral diseases in multiple countries. Field releases in northern Australia have previously demonstrated near elimination of local dengue transmission from Wolbachia-treated communities, and pilot studies in Indonesia have demonstrated the feasibility and acceptability of the method. We conducted a quasi-experimental trial to evaluate the impact of scaled Wolbachia releases on dengue incidence in an endemic setting in Indonesia. Methods: In Yogyakarta City, Indonesia, following extensive community engagement, wMel Wolbachia-carrying mosquitoes were released every two weeks for 13–15 rounds over seven months in 2016–17, in a contiguous 5 km2 area (population 65,000). A 3 km2 area (population 34,000) on the opposite side of the city was selected a priori as an untreated control area. Passive surveillance data on notified hospitalised dengue patients was used to evaluate the epidemiological impact of Wolbachia deployments, using controlled interrupted time-series analysis. Results: Rapid and sustained introgression of wMel Wolbachia into local Ae. aegypti populations was achieved. Thirty-four dengue cases were notified from the intervention area and 53 from the control area (incidence 26 vs 79 per 100,000 person-years) during 24 months following Wolbachia deployment. This corresponded in the regression model to a 73% reduction in dengue incidence (95% confidence interval 49%,86%) associated with the Wolbachia intervention. Exploratory analysis including 6 months additional post-intervention observations showed a small strengthening of this effect (30 vs 115 per 100,000 person-years; 76% reduction in incidence, 95%CI 60%,86%). Conclusions: We demonstrate a significant reduction in dengue incidence following successful introgression of Wolbachia into local Ae. aegypti populations in an endemic setting in Indonesia. These findings are consistent with previous field trials in northern Australia, and support the effectiveness of this novel approach for dengue control.

【 授权许可】

CC BY