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Efficacy of Wolbachia-infected mosquito deployments for the control of dengue

BACKGROUND: Aedes aegypti mosquitoes infected with Wolbachia pipientis (wMel strain) have reduced potential to transmit dengue viruses. METHODS: We conducted a cluster randomised trial of deployments of wMel-infected Ae. aegypti for control of dengue in Yogyakarta City, Indonesia. Twenty-four geogra...

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Detalles Bibliográficos
Autores principales: Utarini, Adi, Indriani, Citra, Ahmad, Riris Andono, Tantowijoyo, Warsito, Arguni, Eggi, Ansari, M. Ridwan, Supriyati, Endah, Wardana, Dwi Satria, Metika, Yeti, Ernesia, Inggrid, Nurhayati, Indah, Prabowo, Equatori, Andari, Bekti, Green, Benjamin R., Hodgson, Lauren, Cutcher, Zoe, Rancès, Edwige, Ryan, Peter A., O’Neill, Scott L., Dufault, Suzanne M., Tanamas, Stephanie K., Jewell, Nicholas P., Anders, Katherine L., Simmons, Cameron P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Massachusetts Medical Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103655/
https://www.ncbi.nlm.nih.gov/pubmed/34107180
http://dx.doi.org/10.1056/NEJMoa2030243
Descripción
Sumario:BACKGROUND: Aedes aegypti mosquitoes infected with Wolbachia pipientis (wMel strain) have reduced potential to transmit dengue viruses. METHODS: We conducted a cluster randomised trial of deployments of wMel-infected Ae. aegypti for control of dengue in Yogyakarta City, Indonesia. Twenty-four geographic clusters were randomly allocated to receive wMel deployments as an adjunct to local mosquito control measures; or to continue with local mosquito control measures only. A test-negative design was used to measure efficacy. Study participants were persons 3–45 years old attending primary care clinics with acute undifferentiated fever. Laboratory testing identified virologically-confirmed dengue cases and test-negative controls. The primary endpoint was efficacy of wMel in reducing the incidence of symptomatic, virologically-confirmed dengue, caused by any dengue virus serotype. RESULTS: Following successful introgression of wMel in intervention clusters, 8144 participants were enrolled; 3721 from wMel-treated clusters and 4423 from untreated clusters. In the ITT analysis virologically-confirmed dengue occurred in 67 of 2905 (2.3%) participants in the wMel-treated and 318 of 3401 (9.4%) in the untreated arm (OR 0.23, 95% CI, 0.15 to 0.35; P=0.004): protective efficacy of 77.1% (95% CI, 65.3 to 84.9). Protective efficacy was similar for the four serotypes. Hospitalisation for virologically-confirmed dengue was less frequent for participants resident in the wMel-treated (13/2905, 2.8%) compared to the untreated arm (102/3401, 6.3%): protective efficacy 86.2% (95% CI, 66.2 to 94.3) CONCLUSIONS: wMel introgression into Ae. aegypti populations was efficacious in reducing the incidence of symptomatic dengue, and also led to fewer dengue hospitalisations. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT03055585 and INA-A7OB6TW