Is dengue vector control deficient in effectiveness or evidence?: systematic review and meta-analysis
Author(s)
Bowman, Leigh R
Donegan, Sarah
McCall, Philip J
Type
Journal Article
Abstract
Background
Although a vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide. We reviewed the evidence for effectiveness of vector control methods in reducing its transmission.
Methodology/Principal Findings
Studies of any design published since 1980 were included if they evaluated method(s) targeting Aedes aegypti or Ae. albopictus for at least 3 months. Primary outcome was dengue incidence. Following Cochrane and PRISMA Group guidelines, database searches yielded 960 reports, and 41 were eligible for inclusion, with 19 providing data for meta-analysis. Study duration ranged from 5 months to 10 years. Studies evaluating multiple tools/approaches (23 records) were more common than single methods, while environmental management was the most common method (19 studies). Only 9/41 reports were randomized controlled trials (RCTs). Two out of 19 studies evaluating dengue incidence were RCTs, and neither reported any statistically significant impact. No RCTs evaluated effectiveness of insecticide space-spraying (fogging) against dengue. Based on meta-analyses, house screening significantly reduced dengue risk, OR 0.22 (95% CI 0.05–0.93, p = 0.04), as did combining community-based environmental management and water container covers, OR 0.22 (95% CI 0.15–0.32, p<0.0001). Indoor residual spraying (IRS) did not impact significantly on infection risk (OR 0.67; 95% CI 0.22–2.11; p = 0.50). Skin repellents, insecticide-treated bed nets or traps had no effect (p>0.5), but insecticide aerosols (OR 2.03; 95% CI 1.44–2.86) and mosquito coils (OR 1.44; 95% CI 1.09–1.91) were associated with higher dengue risk (p = 0.01). Although 23/41 studies examined the impact of insecticide-based tools, only 9 evaluated the insecticide susceptibility status of the target vector population during the study.
Conclusions/Significance
This review and meta-analysis demonstrate the remarkable paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardised studies of higher quality to evaluate and compare methods must be prioritised to optimise cost-effective dengue prevention.
Although a vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide. We reviewed the evidence for effectiveness of vector control methods in reducing its transmission.
Methodology/Principal Findings
Studies of any design published since 1980 were included if they evaluated method(s) targeting Aedes aegypti or Ae. albopictus for at least 3 months. Primary outcome was dengue incidence. Following Cochrane and PRISMA Group guidelines, database searches yielded 960 reports, and 41 were eligible for inclusion, with 19 providing data for meta-analysis. Study duration ranged from 5 months to 10 years. Studies evaluating multiple tools/approaches (23 records) were more common than single methods, while environmental management was the most common method (19 studies). Only 9/41 reports were randomized controlled trials (RCTs). Two out of 19 studies evaluating dengue incidence were RCTs, and neither reported any statistically significant impact. No RCTs evaluated effectiveness of insecticide space-spraying (fogging) against dengue. Based on meta-analyses, house screening significantly reduced dengue risk, OR 0.22 (95% CI 0.05–0.93, p = 0.04), as did combining community-based environmental management and water container covers, OR 0.22 (95% CI 0.15–0.32, p<0.0001). Indoor residual spraying (IRS) did not impact significantly on infection risk (OR 0.67; 95% CI 0.22–2.11; p = 0.50). Skin repellents, insecticide-treated bed nets or traps had no effect (p>0.5), but insecticide aerosols (OR 2.03; 95% CI 1.44–2.86) and mosquito coils (OR 1.44; 95% CI 1.09–1.91) were associated with higher dengue risk (p = 0.01). Although 23/41 studies examined the impact of insecticide-based tools, only 9 evaluated the insecticide susceptibility status of the target vector population during the study.
Conclusions/Significance
This review and meta-analysis demonstrate the remarkable paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardised studies of higher quality to evaluate and compare methods must be prioritised to optimise cost-effective dengue prevention.
Date Issued
2016-03-01
Date Acceptance
2016-02-24
Citation
PLoS Neglected Tropical Diseases, 2016, 10 (3), pp.1-24
ISSN
1935-2727
Publisher
Public Library of Science
Start Page
1
End Page
24
Journal / Book Title
PLoS Neglected Tropical Diseases
Volume
10
Issue
3
Copyright Statement
© 2016 Bowman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000373272500066&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Parasitology
Tropical Medicine
INSECTICIDE-TREATED CURTAINS
COMMUNITY-BASED CONTROL
AEDES-AEGYPTI
INFECTIOUS-DISEASES
VIRUS TRANSMISSION
CHARTERS TOWERS
BORNE DISEASES
HUMAN MOVEMENT
OUTBREAKS
EPIDEMIC
Publication Status
Published
Article Number
ARTN e0004551
Date Publish Online
2017-03-17