The Past, Present, and Future of Dengue Vector Control: A Systematic Review and Meta-Analysis

Abstract

Dengue is one of the most pressing public health threats today, with half of the world’s population currently at risk of infection. The only form of prevention or treatment for dengue involves suppressing its transmission vector, Aedes aegypti and albopictus mosquitoes. This study reviews the effectiveness of the standard vector control measures, biological and chemical control, and is the first to review the next generation of control programs, Sterile Insect Technique (SIT) and Wolbachia-based strategies. I systematically searched PubMed, ISI Web of Science, ScienceDirect, Scopus, and the WHO Dengue Bulletin for vector control programs involving biological, chemical, SIT, or Wolbachia-based interventions. 52 studies conducting 55 dengue vector control interventions were identified. Entomological index data and basic characteristics were pulled from each study, and relative effectiveness was measured using risk ratios (RR). Biological control measures showed partial effectiveness, with RR values ranging from 0.18-0.28. Chemical control measures were not effective, with RR values ranging from 0.23-0.35. Wolbachia-based measures showed a potential for high efficacy, as its RR based on the Infection Index, a metric created and described by this thesis, was 0.05. Meta-analysis was not conducted for SIT, but the reported metrics indicate the potential for efficacy at large scales. The results of this meta-analysis suggest that SIT and Wolbachia-based control measures may be effective for widespread dengue vector control. There is little evidence that either biological or chemical control interventions are effective in the long-term, but each can play a role in dengue management in local contexts. This thesis also highlights a number of important evidence gaps and other systemic issues with dengue control studies that must be addressed by future research.