Centre for Strategic Studies, Fiocruz, Rio de Janeiro, Brazil.
World Mosquito Program, Fiocruz, Rio de Janeiro, Brazil.
F1000Res. 2019 Aug 1;8:1328. doi: 10.12688/f1000research.19859.2. eCollection 2019.
Rio de Janeiro and Niterói are neighbouring cities in southeastern Brazil which experience large dengue epidemics every 2 to 5 years, with >100,000 cases notified in epidemic years. Costs of vector control and direct and indirect costs due to the -borne diseases dengue, chikungunya and Zika were estimated to total $650 million USD in 2016, but traditional vector control strategies have not been effective in preventing mosquito-borne disease outbreaks. The method is a novel and self-sustaining approach for the biological control of -borne diseases, in which the transmission potential of mosquitoes is reduced by stably transfecting them with the bacterium ( Mel strain). This paper describes a study protocol for evaluating the effect of large-scale non-randomised releases of -infected mosquitoes on the incidence of dengue, Zika and chikungunya in the two cities of Niterói and Rio de Janeiro. This follows a lead-in period since 2014 involving intensive community engagement, regulatory and public approval, entomological surveys, and small-scale pilot releases. The releases during 2017-2019 covered a combined area of 170 km with a resident population of 1.2 million, across Niterói and Rio de Janeiro. Untreated areas with comparable historical dengue profiles and demographic characteristics have been identified as comparative control areas in each city. The proposed pragmatic epidemiological approach combines a controlled interrupted time series analysis of routinely notified suspected and laboratory-confirmed dengue and chikungunya cases, together with monitoring of -borne disease activity utilising outbreak signals routinely used in public health disease surveillance. If the current project is successful, this model for control of mosquito-borne disease through releases can be expanded nationally and regionally.
里约热内卢和尼泰罗伊是巴西东南部的两个相邻城市，每 2 至 5 年就会爆发大规模登革热疫情，在疫情年份报告的病例超过 10 万例。2016 年，用于病媒控制以及登革热、基孔肯雅热和寨卡病毒等蚊媒疾病造成的直接和间接成本估计总计 6.5 亿美元，但传统的病媒控制策略在预防蚊媒疾病爆发方面并不有效。释放沃尔巴克氏体（Wolbachia）方法是一种用于控制蚊媒疾病的新型可持续方法，通过稳定转染沃尔巴克氏体（Wolbachia）细菌（Mel 菌株）来降低蚊子的传播潜力。本文描述了一项评估在尼泰罗伊和里约热内卢两个城市大规模非随机释放感染沃尔巴克氏体的蚊子对登革热、寨卡和基孔肯雅热发病率影响的研究方案。该方案遵循 2014 年以来的一个导入期，包括密集的社区参与、监管和公众批准、昆虫学调查以及小规模试点释放。2017-2019 年的释放覆盖了尼泰罗伊和里约热内卢 170 公里的合并区域，居民人口为 120 万。每个城市都确定了具有可比历史登革热特征和人口统计学特征的未处理区域作为比较对照区域。拟议的实用流行病学方法结合了常规报告的疑似和实验室确诊的登革热和基孔肯雅热病例的对照中断时间序列分析，以及利用公共卫生疾病监测中常规使用的暴发信号监测蚊媒疾病活动。如果当前项目取得成功，这种通过释放沃尔巴克氏体控制蚊媒疾病的模式可以在全国和地区范围内推广。
