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应对登革热全球威胁的新解决方案:沃尔巴克氏体干预措施的机遇

New solutions against the dengue global threat: opportunities for Wolbachia interventions.

作者信息

Paz-Bailey Gabriela, Jernigan Daniel B, Laserson Kayla, Zielinski-Gutierrez Emily, Petersen Lyle

机构信息

US Centers for Disease Control and Prevention, Atlanta, GA.

US Centers for Disease Control and Prevention, Atlanta, GA.

出版信息

Int J Infect Dis. 2025 Aug;157:107923. doi: 10.1016/j.ijid.2025.107923. Epub 2025 May 5.

Abstract

Reliance on traditional vector control methods, such as insecticides and "clean up" source reduction efforts for reducing mosquito breeding sites, has proven increasingly ineffective and costly in the battle against dengue. The Wolbachia-based mosquito replacement strategy, which replaces wild mosquitoes with mosquitoes trans-infected with Wolbachia bacteria, preventing up to 77% dengue transmission, represents an advancement in prevention. Integrating this approach into current routine dengue control efforts could reduce dengue incidence. However, challenges such as implementation costs, the need for country ownership, alignment of released mosquitoes with local mosquito populations, increased education and sensitization for government authorities and the public on the benefits of Wolbachia, identifying international funding partners, and recognizing areas where the strategy may be less effective due to environmental or socio-political factors must be addressed. Furthermore, Wolbachia replacement must focus in areas with high population density and high dengue incidence because it is not feasible to cover all endemic areas. Establishing robust surveillance systems to monitor efficacy against different dengue serotypes is also critical. Despite these challenges, the Wolbachia strategy is the one of the most promising developments in dengue prevention to date. By complementing this approach with effective vaccines, we have the unprecedented opportunity to significantly reduce dengue.

摘要

在抗击登革热的斗争中,依靠传统的病媒控制方法,如使用杀虫剂和开展“清理”源头减少工作以减少蚊子繁殖地,已被证明越来越无效且成本高昂。基于沃尔巴克氏体的蚊子替代策略,即用感染了沃尔巴克氏体细菌的蚊子替代野生蚊子,可防止高达77%的登革热传播,这是预防方面的一项进步。将这种方法纳入当前的常规登革热控制工作中可以降低登革热发病率。然而,必须应对一些挑战,如实施成本、国家自主的必要性、释放的蚊子与当地蚊子种群的匹配、提高政府当局和公众对沃尔巴克氏体益处的认识、确定国际资金合作伙伴,以及认识到由于环境或社会政治因素该策略可能效果较差的地区。此外,沃尔巴克氏体替代必须集中在人口密度高和登革热发病率高的地区,因为覆盖所有流行地区是不可行的。建立强大的监测系统以监测针对不同登革热血清型的效果也至关重要。尽管存在这些挑战,但沃尔巴克氏体策略是迄今为止登革热预防领域最有前景的进展之一。通过用有效的疫苗补充这种方法,我们有前所未有的机会大幅减少登革热。

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