The impact of large-scale deployment of Wolbachia mosquitoes on dengue and other Aedes-borne diseases in Rio de Janeiro and Niterói, Brazil: study protocol for a controlled interrupted time series analysis using routine disease surveillance data.
Background: Rio de Janeiro and Niterói are neighbouring cities in southeastern Brazil which experience large dengue epidemics every 2 to 5 years, with >100,000 cases notified in epidemic years. Costs of vector control and direct and indirect costs due to the Aedes-borne diseases dengue, chikungunya and Zika were estimated to total $650 million USD in 2016, but traditional vector control strategies have not been effective in preventing mosquito-borne disease outbreaks. The Wolbachia method is a novel and self-sustaining approach for the biological control of Aedes-borne diseases, in which the transmission potential of Aedes aegypti mosquitoes is reduced by stably transfecting them with the Wolbachia bacterium ( wMel strain). This paper describes a study protocol for evaluating the effect of large-scale non-randomised releases of Wolbachia--infected mosquitoes on the incidence of dengue, Zika and chikungunya in the two cities of Niterói and Rio de Janeiro. This follows a lead-in period since 2014 involving intensive community engagement, regulatory and public approval, entomological surveys, and small-scale pilot releases. Method: The Wolbachia releases during 2017-2019 covered a combined area of 170 km 2 with a resident population of 1.2 million, across Niterói and Rio de Janeiro. Untreated areas with comparable historical dengue profiles and demographic characteristics have been identified a priori as comparative control areas in each city. The proposed pragmatic epidemiological approach combines a controlled interrupted time series analysis of routinely notified suspected and laboratory-confirmed dengue and chikungunya cases, together with monitoring of Aedes-borne disease activity utilising outbreak signals routinely used in public health disease surveillance. Discussion: If the current project is successful, this model for control of mosquito-borne disease through Wolbachia releases can be expanded nationally and regionally.
['Durovni|Betina|B|', 'Saraceni|Valeria|V|0000-0001-7360-6490', 'Eppinghaus|Ana|A|', 'Riback|Thais I S|TIS|', 'Moreira|Luciano A|LA|', 'Jewell|Nicholas P|NP|', 'Dufault|Suzanne M|SM|0000-0002-6316-6548', "O'Neill|Scott L|SL|", 'Simmons|Cameron P|CP|', 'Tanamas|Stephanie K|SK|', 'Anders|Katherine L|KL|0000-0003-0485-5826']
D000330:Aedes D000818:Animals D061046:Biological Control Agents D001938:Brazil D065632:Chikungunya Fever D002947:Cities D003715:Dengue D003716:Dengue Virus D006801:Humans D015994:Incidence D065186:Interrupted Time Series Analysis D009032:Mosquito Control D000072138:Mosquito Vectors D020577:Wolbachia D000071244:Zika Virus D000071243:Zika Virus Infection
Wolbachia dengue Brazil controlled interrupted time series disease surveillance chikungunya Zika vector-borne disease