Abstract
BackgroundAlthough a vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide. We reviewed the evidence for effectiveness of vector control methods in reducing its transmission.Methodology/Principal FindingsStudies of any design published since 1980 were included if they evaluated method(s) targeting Aedes aegypti or Ae. albopictus for at least 3 months. Primary outcome was dengue incidence. Following Cochrane and PRISMA Group guidelines, database searches yielded 960 reports, and 41 were eligible for inclusion, with 19 providing data for meta-analysis. Study duration ranged from 5 months to 10 years. Studies evaluating multiple tools/approaches (23 records) were more common than single methods, while environmental management was the most common method (19 studies). Only 9/41 reports were randomized controlled trials (RCTs). Two out of 19 studies evaluating dengue incidence were RCTs, and neither reported any statistically significant impact. No RCTs evaluated effectiveness of insecticide space-spraying (fogging) against dengue. Based on meta-analyses, house screening significantly reduced dengue risk, OR 0.22 (95% CI 0.05–0.93, p = 0.04), as did combining community-based environmental management and water container covers, OR 0.22 (95% CI 0.15–0.32, p<0.0001). Indoor residual spraying (IRS) did not impact significantly on infection risk (OR 0.67; 95% CI 0.22–2.11; p = 0.50). Skin repellents, insecticide-treated bed nets or traps had no effect (p>0.5), but insecticide aerosols (OR 2.03; 95% CI 1.44–2.86) and mosquito coils (OR 1.44; 95% CI 1.09–1.91) were associated with higher dengue risk (p = 0.01). Although 23/41 studies examined the impact of insecticide-based tools, only 9 evaluated the insecticide susceptibility status of the target vector population during the study.Conclusions/SignificanceThis review and meta-analysis demonstrate the remarkable paucity of reliable evidence for the effectiveness of any dengue vector control method. Standardised studies of higher quality to evaluate and compare methods must be prioritised to optimise cost-effective dengue prevention.
Highlights
Dengue is a viral infection transmitted between humans by Aedes mosquitoes
With dengue outbreaks occurring at increasing frequency and intensity, we undertook a systematic review and meta-analysis of the literature, to evaluate the evidence for effectiveness of vector control strategies currently available
There was limited evidence indicating that house screening and to a lesser extent, community-based environmental management with water container covers could reduce risk of dengue infection
Summary
With an estimated 390 million dengue infections occurring every year, and almost half the world’s population exposed to infection with dengue viruses, it is the most widespread mosquito-borne arboviral disease today, affecting 128 countries worldwide [1,2,3]. Until recent advances in vaccine development [16,17], and the approval and potential availability of the first product in 2016 [18], dengue has been unique among the major vector-borne diseases, in that prevention from infection could only be attempted by reducing or eliminating bites by infected vector mosquitoes [19, 20]. A vaccine could be available as early as 2016, vector control remains the primary approach used to prevent dengue, the most common and widespread arbovirus of humans worldwide.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
