| Abstrak/Abstract |
Background:
Aedes aegypti mosquitoes infected with the Wolbachia pipientis (wMel strain) have reduced potential to transmit dengue viruses.
Methods:
We conducted a randomised trial to assess the efficacy of deployments of Wolbachia (wMel strain)-infected Ae. aegypti to reduce the incidence of virologically-confirmed dengue (VCD) cases in Yogyakarta City, Indonesia. Twenty-four geographic clusters were randomly allocated to one of two study arms; one arm received wMel deployments as an adjunct to local dengue control measures, the untreated arm continued with local dengue control measures only. A test-negative design was used to measure efficacy. Study participants were aged 3-45 years old presenting with acute undifferentiated fever at any of 18 primary care clinics between January 2018 and March 2020. Laboratory testing identified VCD cases and test-negative controls. The intention-to-treat (ITT) analysis compared the odds of residence in a wMel-treated cluster between VCD cases and test-negative controls.
Results:
Following successful introgression of wMel in intervention clusters, a total of 8144 participants were enrolled; 3721 from wMel-treated clusters and 4423 from untreated clusters. There were 385 VCD cases and 5921 test-negative controls amongst 6306 participants in the analysis set. wMel deployments were associated with a 77.1% (95% CI, 65.3, 84.9) reduction in VCD case incidence in the ITT analysis. Protective efficacy was similar for the four serotypes. Efficacy against hospitalisation for VCD was 86.2% (66.2, 94.3).
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