Efficacy of Wolbachia-Infected Mosquito Deployments for the Control of Dengue

Authors: Adi Utarini, Citra Indriani, Riris Andono Ahmad, Warsito Tantowijoyo, Eggi Arguni, Muhammad Ridwan Ansari, Endah Supriyati, Dwi Satria Wardana, Yeti Meitika, Inggrid Ernesia, Indah Nurhayati, Equatori Prabowo, Bekti Andari, Benjamin R. Green, Lauren Hodgson, Zoe Cutcher, Edwige Rancès, Peter A. Ryan, Scott L. O’Neill, Suzanne M. Dufault, Stephanie K. Tanamas, Nicholas P. Jewell, Katherine L. Anders, Cameron P. Simmons - New England Journal of Medicine, NEJM 2021 cited by 630

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.).