Abstract
BackgroundDengue fever is the most common and widespread mosquito-borne arboviral disease in the world. There is a compelling need for cost-effective approaches and practical tools that can reliably measure real-time dengue transmission dynamics that enable more accurate and useful predictions of incidence and outbreaks. Sensitive surveillance tools do not exist today, and only a small handful of new control strategies are available. Vector control remains at the forefront for combating dengue transmission. However, the effectiveness of many current vector control interventions is fraught with inherent weaknesses. No single vector control method is effective enough to control both vector populations and disease transmission. Evaluations of novel larval and adult control interventions are needed.Methods/designA cluster-randomized controlled trial will be carried out between 2017 and 2019 in urban community clusters in Khon Kaen and Roi Et cities, northeastern Thailand. The effectiveness of a pyriproxyfen/spinosad combination treatment of permanent water storage containers will be evaluated on epidemiological and entomological outcomes, including dengue incidence, number of female adult dengue vectors infected or not infected with dengue virus (DENV), human exposure to Aedes mosquito bites, and several other indices. These indices will also be used to develop predictive models for dengue transmission and impending outbreaks. Epidemiological and entomological data will be collected continuously for 2 years, with the intervention implemented after 1 year.DiscussionThe aims of the trial are to simultaneously evaluate the efficacy of an innovative dengue vector control intervention and developing predictive dengue models. Assessment of human exposure to mosquito bites by detecting antibodies generated against Aedes saliva proteins in human blood samples has, so far, not been applied in dengue epidemiological risk assessment and disease surveillance methodologies. Likewise, DENV detection in mosquitoes (adult and immature stages) has not been used in any practical way for routine disease surveillance strategies. The integration of multiple outcome measures will assist health authorities to better predict outbreaks for planning and applying focal and timely interventions. The trial outcomes will not only be important for Thailand, but also for the entire Southeast Asian region and further afield.Trial registrationISRCTN, ISRCTN73606171. Registered on 23 June 2017.
Highlights
Dengue fever is the most common and widespread mosquito-borne arboviral disease in the world
Assessment of human exposure to mosquito bites by detecting antibodies generated against Aedes saliva proteins in human blood samples has, so far, not been applied in dengue epidemiological risk assessment and disease surveillance methodologies
In view of the preceding discussion, this study aims to assess a specific vector control intervention and to contribute to the development of a practical early warning system that can more accurately predict changes in dengue transmission and impending outbreaks
Summary
Dengue fever is the most common and widespread mosquito-borne arboviral disease in the world. There is a compelling need for cost-effective approaches and practical tools that can reliably measure real-time dengue transmission dynamics that enable more accurate and useful predictions of incidence and outbreaks. Vector control remains at the forefront for combating dengue transmission. Dengue fever is the most common and widespread arboviral disease in the world, with an estimated four billion people in at least 128 countries at risk of infection [1]. There is currently no specific treatment for dengue and only recently has a vaccine been licensed, but it does not confer full protection for all virus serotypes [4]. Even with effective therapies and vaccines, vector control will likely remain important to curtail disease incidence and outbreaks. Infection of one of the four dengue virus serotypes (DENV1—4) typically confer lifelong protective homotypic (type-specific) immunity as well as production of more time-limited cross-reactive heterotypic neutralizing antibodies [6]; antibody-dependent enhancement may result in a second DENV serotype infection inducing a more severe clinical course [5]
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