Challenges and future perspective for dengue vector control in the Western Pacific Region.

Dengue remains a significant public health issue in the Western Pacific Region. In the absence of a vaccine, vector control is the mainstay for dengue prevention and control. In this paper we describe vector surveillance and vector control in the Western Pacific countries and areas. Vector surveillance and control strategies used by countries and areas of the Western Pacific Region vary. Vector control strategies include chemical, biological and environmental management that mainly target larval breeding sites. The use of insecticides targeting larvae and adult mosquitoes remains the mainstay of vector control programmes. Existing vector control tools have several limitations in terms of cost, delivery and long-term sustainability. However, there are several new innovative tools in the pipeline. These include Release of Insects Carrying a Dominant Lethal system and Wolbachia, an endosymbiotic bacterium, to inhibit dengue virus in the vector. In addition, the use of biological control such as larvivorous fish in combination with community participation has potential to be scaled up. Any vector control strategy should be selected based on evidence and appropriateness for the entomological and epidemiological setting and carried out in both inter-epidemic and epidemic periods. Community participation and interagency collaboration are required for effective and sustainable dengue prevention and control. Countries and areas are now moving towards integrated vector management.