Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.
BMC Med Res Methodol. 2024 Aug 6;24(1):170. doi: 10.1186/s12874-024-02291-6.
Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial-temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method's validity.
A systematic search for Wolbachia intervention data was conducted via PUBMED. Efficacy was reassessed using commonly-used quasi-experimental approaches with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods' ability to estimate intervention efficacies (IE).
Wolbachia interventions in Singapore, Malaysia, and Brazil significantly decreased dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests.
Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.
埃及伊蚊中的共生菌沃尔巴克氏体是一种新兴的登革热生物控制措施。然而，由于大多数干预研究都是基于非随机的现场性质，因此评估其实际效果具有挑战性。本研究使用大量准实验方法重新评估了沃尔巴克氏体干预对登革热发病率的时空影响，并评估了每种方法的有效性。
通过 PUBMED 进行了沃尔巴克氏体干预数据的系统搜索。使用常用的准实验方法进行了功效重新评估，并进行了广泛的稳健性检查，包括地理空间安慰剂测试和模拟研究。使用高分辨率聚合来计算多个研究地点的干预效果，以检查地点和研究期间的异质性。我们还设计了一个随机模拟框架来评估方法估计干预效果（IE）的能力。
新加坡、马来西亚和巴西的沃尔巴克氏体干预显著降低了登革热发病率，降幅从 48.17%到 69.19%不等。IE 随地点和时间而变化。马来西亚的疗效随着时间的推移而增加，而巴西则在最初取得成功后随后下降，暗示存在操作上的挑战。新加坡的策略尽管存在部分饱和，但仍然非常有效。模拟确定了综合控制方法（SCM）及其变体，计数综合控制方法（cSCM）在精度方面具有优势，IE 估计的百分比误差最小。这些方法在安慰剂测试中也表现出稳健性。
沃尔巴克氏体干预对登革热具有一致的保护作用。SCM 和 cSCM 提供了最准确和最稳健的 IE 估计值，在模拟和实际环境中都得到了验证。
