Does ignoring transmission dynamics lead to underestimation of the impact of interventions against mosquito-borne disease?
Does ignoring transmission dynamics lead to underestimation of the impact of interventions against mosquito-borne disease?
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DOI：
10.1136/bmjgh-2023-012169
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发表时间：
2023-08
影响因子：
8.1
通讯作者：
Perkins, T Alex
中科院分区：
文献类型：
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作者：
Cavany, Sean;Huber, John H;Wieler, Annaliese;Tran, Quan Minh;Alkuzweny, Manar;Elliott, Margaret;Espana, Guido;Moore, Sean M;Perkins, T Alex
迫切需要新的病媒控制技术来对抗蚊媒疾病，其采用取决于大规模集群随机试验（CRT）的疗效估计。释放沃尔巴克氏体感染的蚊子是遏制登革热病毒（DENV）传播的一种有希望的策略，最近的CRT报告说，释放这些蚊子后，登革热发病率显著降低。然而，这些试验可能受到多种偏倚来源的影响。我们使用数学模型的DENV传播在CRT的沃尔巴克氏体感染的蚊子，探索三个这样的偏见：人类运动，蚊子运动和试验臂之间的耦合传播动力学。我们发现，未能考虑到这些偏见将导致低估的功效，而这种低估的大部分是由于迄今未被认识到的偏见所造成的传输耦合。总的来说，我们的研究结果表明，感染沃尔巴克氏体的蚊子可能比最近的CRT建议更有希望。通过强调的重要性，占武器之间的传输耦合，这需要一个数学模型，我们强调的关键作用，模型可以发挥解释和推断的结果，从试验的病媒控制干预措施。
New vector-control technologies to fight mosquito-borne diseases are urgently needed, the adoption of which depends on efficacy estimates from large-scale cluster-randomised trials (CRTs). The release of Wolbachia-infected mosquitoes is one promising strategy to curb dengue virus (DENV) transmission, and a recent CRT reported impressive reductions in dengue incidence following the release of these mosquitoes. Such trials can be affected by multiple sources of bias, however. We used mathematical models of DENV transmission during a CRT of Wolbachia-infected mosquitoes to explore three such biases: human movement, mosquito movement and coupled transmission dynamics between trial arms. We show that failure to account for each of these biases would lead to underestimated efficacy, and that the majority of this underestimation is due to a heretofore unrecognised bias caused by transmission coupling. Taken together, our findings suggest that Wolbachia-infected mosquitoes could be even more promising than the recent CRT suggested. By emphasising the importance of accounting for transmission coupling between arms, which requires a mathematical model, we highlight the key role that models can play in interpreting and extrapolating the results from trials of vector control interventions.