Invited Speaker Australian Society for Microbiology Annual Scientific Meeting 2021

Efficacy of Wolbachia-infected mosquito deployments for the control of dengue (#106)

Cam Simmons 1
  1. Monash University, AUSTRALIA, Australia

Dengue causes a considerable health and economic burden for ~40 percent of the world’s population. Aedes aegypti mosquitoes infected with Wolbachia (wMel strain) bacteria have reduced potential to transmit dengue viruses. In this presentation data from the AWED trial (Applying Wolbachia to Eliminate Dengue), a cluster randomised trial of wMel-infected mosquito deployments in Yogyakarta, Indonesia will be presented. A 26 km2 urban area was subdivided into 24 contiguous clusters, allocated randomly 1:1 to receive Wolbachia deployments or no intervention. Routine vector control activities continued in both study arms. A test-negative design was used to measure efficacy. Patients aged 3–45 years presenting to 18 primary care clinics with 1–4 days of undifferentiated fever were enrolled, and were later classified as virologically-confirmed dengue (VCD) cases or arbovirus-negative controls on the basis of laboratory diagnostic testing. The primary endpoint was efficacy in reducing VCD caused by any DENV serotype; secondary endpoints to be reported here were efficacy against individual DENV serotypes, and against chikungunya. The intention-to-treat (ITT) analysis compared the odds of residence in a  Wolbachia-treated area between VCD cases and test-negative controls. A per-protocol analysis accounted for mosquito and human mobility using measured Wolbachia prevalence in participants’ cluster of residence, and in locations visited during 10 days prior to illness onset. In March 2020 the AWED trial was terminated early due to the COVID-19 pandemic. In total 8144 participants were enrolled from Jan 2018 – Mar 2020, including 385 VCD cases and 5921 test-negative controls, meeting a priori power requirements. The efficacy of Wolbachia deployments in preventing VCD cases was 77.1% (95%CI, 65.3, 84.9) in the ITT analysis of the primary endpoint. Efficacy data for additional predefined primary and secondary endpoints, plus a snapshot of global progress, will be presented.