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Estimating the effect of the wMel release programme on the incidence of dengue and chikungunya in Rio de Janeiro, Brazil: a spatiotemporal modelling study - 27/10/22

Doi : 10.1016/S1473-3099(22)00436-4 
Gabriel Ribeiro dos Santos, MSc a, Betina Durovni, MD b, c, Valeria Saraceni, MD PhD d, Thais Irene Souza Riback, PhD c, Sofia B Pinto, PhD c, Katherine L Anders, PhD e, Luciano A Moreira, PhD c, f, , Henrik Salje, PhD a, ,
a Pathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, UK 
b Centre for Strategic Studies, Fiocruz, Rio de Janeiro, Brazil 
c World Mosquito Program, Fiocruz, Rio de Janeiro, Brazil 
d City Health Secretariat, Rio de Janeiro, Brazil 
e World Mosquito Program, Institute of Vector-Borne Disease, Monash University, Melbourne, VIC, Australia 
f Instituto Rene Rachou, Fiocruz, Belo Horizonte, Brazil 

* Correspondence to: Dr Henrik Salje, Department of Genetics, University of Cambridge, Cambridge CB2 3EH, UK Department of Genetics University of Cambridge Cambridge CB2 3EH UK

Summary

Background

Introgression of genetic material from species of the insect bacteria Wolbachia into populations of Aedes aegypti mosquitoes has been shown in randomised and non-randomised trials to reduce the incidence of dengue; however, evidence for the real-world effectiveness of large-scale deployments of Wolbachia-infected mosquitoes for arboviral disease control in endemic settings is still scarce. A large Wolbachia (wMel strain) release programme was implemented in 2017 in Rio de Janeiro, Brazil. We aimed to assess the effect of this programme on the incidence of dengue and chikungunya in the city.

Methods

67 million wMel-infected mosquitoes were released across 28 489 locations over an area of 86·8 km2 in Rio de Janeiro between Aug 29, 2017 and Dec 27, 2019. Following releases, mosquitoes were trapped and the presence of wMel was recorded. In this spatiotemporal modelling study, we assessed the effect of the release programme on the incidence of dengue and chikungunya. We used spatiotemporally explicit mathematical models applied to geocoded dengue cases (N=283 270) from 2010 to 2019 and chikungunya cases (N=57 705) from 2016 to 2019.

Findings

On average, 32% of mosquitoes collected from the release zones between 1 month and 29 months after the initial release tested positive for wMel. Reduced wMel introgression occurred in locations and seasonal periods in which cases of dengue and chikungunya were historically high, with a decrease to 25% of mosquitoes testing positive for wMel during months in which disease incidence was at its highest. Despite incomplete introgression, we found that the releases were associated with a 38% (95% CI 32–44) reduction in the incidence of dengue and a 10% (4–16) reduction in the incidence of chikungunya.

Interpretation

Stable establishment of wMel in the geographically diverse, urban setting of Rio de Janeiro seems to be more complicated than has been observed elsewhere. However, even intermediate levels of wMel seem to reduce the incidence of disease caused by two arboviruses. These findings will help to guide future release programmes.

Funding

Bill & Melinda Gates Foundation and the European Research Council.

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© 2022  The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 22 - N° 11

P. 1587-1595 - novembre 2022 Retour au numéro
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