Optimal control approaches for combining medicines and mosquito control in tackling dengue

Dengue is a debilitating and devastating viral infection spread by mosquito vectors, and over half the world’s population currently live at risk of dengue (and other flavivirus) infections. Here, we use an integrated epidemiological and vector ecology framework to predict optimal approaches for tackling dengue. Our aim is to investigate how vector control and/or vaccination strategies can be best combined and implemented for dengue disease control on small networks, and whether these optimal strategies differ under different circumstances. We show that a combination of vaccination programmes and the release of genetically modified self-limiting mosquitoes (comparable to sterile insect approaches) is always considered the most beneficial strategy for reducing the number of infected individuals, owing to both methods having differing impacts on the underlying disease dynamics. Additionally, depending on the impact of human movement on the disease dynamics, the optimal way to combat the spread of dengue is to focus prevention efforts on large population centres. Using mathematical frameworks, such as optimal control, are essential in developing predictive management and mitigation strategies for dengue disease control.