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Efficacy of Wolbachia-Infected Mosquito Deployments for the Control of Dengue
Open accessAbstract
BACKGROUNDAedes aegypti mosquitoes infected with the wMel strain of Wolbachia pipientis are less susceptible than wild-type A. aegypti to dengue virus infection. METHODSWe conducted a cluster-randomized trial involving releases of wMel-infected A. aegypti mosquitoes for the control of dengue in Yogyakarta, Indonesia.We randomly assigned 12 geographic clusters to receive deployments of wMel-infected A. aegypti (intervention clusters) and 12 clusters to receive no deployments (control clusters).All clusters practiced local mosquito-control measures as usual.A testnegative 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 testnegative controls.The primary end point was symptomatic VCD of any severity caused by any dengue virus serotype. RESULTSAfter successful introgression of wMel 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). CONCLUSIONSIntrogression of wMel into A. aegypti 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.govnumber, NCT03055585; Indonesia Registry number, INA-A7OB6TW.)
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Metadata
- Authors
- Utarini, A., Indriani, C., Ahmad, R. A., Tantowijoyo, W., Arguni, E., Ansari, M. R., Supriyati, E., Wardana, D. S., Meitika, Y., Ernesia, I., Nurhayati, I., Prabowo, E., Andari, B., Green, B. R., Hodgson, L., Cutcher, Z., Rancès, E., Ryan, P. A., O’Neill, S. L., Dufault, S. M., Tanamas, S. K., Jewell, N. P., Anders, K. L., & Simmons, C. P.
- Affiliations
- Universitas Gadjah Mada (ID)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2021-06-10
- Volume
- 384
- Issue
- 23
- Pages
- 2177-2186
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC8103655
- OpenAlex
- W3172070999
- Cited by
- 649
- References
- 33
- Citations by year
- 2026: 121 · 2025: 143 · 2024: 127 · 2023: 121 · 2022: 96 · 2021: 40
- FWCI
- 84.34
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- New England Journal of Medicine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Funders
- Wellcome Trust (212914)
- National Institute of Allergy and Infectious Diseases (R01AI148127)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Life Sciences › Agricultural and Biological Sciences › Insect Science › Insect symbiosis and bacterial influences
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Dengue and Mosquito Control Research
- Keywords
- Wolbachia, wMel strain, Aedes aegypti, dengue control, mosquito release, dengue virus, test-negative design, protective efficacy, dengue hospitalization, mosquito control, Yogyakarta, dengue serotypes, dengue surveillance, dengue prevention
- MeSH terms
- Mosquito Vectors, Adolescent, Adult, Aedes, Animals, Child, Child, Preschool, Communicable Disease Control, Dengue, Dengue Virus, Female, Humans, Indonesia, Male, Middle Aged, Incidence, Wolbachia, Young Adult
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