沃尔巴克氏体介导的不育与昆虫不育技术对抑制新加坡埃及伊蚊成虫种群的有效性:一项合成控制研究

IF 24.1 1区 医学 Q1 ENVIRONMENTAL SCIENCES Lancet Planetary Health Pub Date : 2024-09-01 DOI:10.1016/S2542-5196(24)00169-4
Somya Bansal MSc , Jue Tao Lim PhD , Chee-Seng Chong PhD , Borame Dickens PhD , Youming Ng BSc , Lu Deng BSc , Caleb Lee MSc , Li Yun Tan BSc , Evdoxia G Kakani PhD , Yanni Yoong BSc , David Du Yu PhD , Grace Chain BSc , Pei Ma MSc , Shuzhen Sim PhD , Lee Ching Ng PhD , Cheong Huat Tan PhD
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引用次数: 0

摘要

背景不相容昆虫技术(IIT)与昆虫不育技术(SIT)相结合,通过释放受沃尔巴乔病毒感染的不育雄蚊,是一种很有前景的伊蚊传播疾病控制手段。然而,有关 IIT-SIT 对蚊子数量的抑制效果的实际证据,大多仍局限于半农村的小村庄和郊区的短时间试验。然而,大部分伊蚊传播的疾病都发生在人口稠密的城市和高层建筑中,这就限制了之前的研究对这些疾病负担重的环境的适用性。在这项合成对照研究中,我们针对新加坡(一个赤道城市州)高层公共住宅区的埃及伊蚊进行了一次大规模的现场 IIT-SIT 试验。我们从一个由 57 990 个独特蚊虫诱捕器组成的大型全国性监测系统中收集了常规数据,并结合一组高维度的人为和环境混杂因素,以确定蚊虫数量及其主要驱动因素。选定四个乡镇作为干预组(截至 2022 年,人口规模约为 607 872 人),在研究期间进行 ITT 与 SIT 相结合的干预。乡镇每周两次释放 wAlbB-SG 雄性埃及疟蚊。对流行病学周(EWs)的数据进行了评估,这提供了记录的沃尔巴克氏体释放时间表和蚊子数量数据的最精细的时间分辨率。然后,我们制定了一个新的合成控制框架,以考虑在各试验区采用干预措施的非随机和交错设置,从而确定 IIT-SIT 对雌性埃及伊蚊种群的直接抑制效果、非释放区的溢出效应以及干预措施对白纹伊蚊等其他蚊子种群的影响。此外,我们重新计算了日历时间、干预后时间以及多个地点的效果,以研究 IIT-SIT 效果的异质性。研究结果在 2018 年 EW27 至 2022 年 EW26 期间,在 117 个区进行了沃尔巴克氏体释放,其中 97 个区有足够的诱捕器数据,这些数据是在 2019 年 EW8 至 2022 年 EW26 期间收集的。我们发现,基于沃尔巴克氏体的 IIT-SIT 在释放 3 个月后可将野生型雌性埃及蝇的数量平均减少 62-01%(95% CI 60-68 至 63-26),在释放 6 个月后减少 78-40%(77-56 至 79-18),在释放至少 18 个月后减少 91-32%(90-95 至 91-66)。我们还发现了一个较小但不可忽略的溢出抑制效应,该效应随着时间的推移逐渐增强(在相邻的非干预区,平均溢出干预效果为 61-02% [95% CI 57-89 至 63-72])。尽管在释放沃尔巴克氏体后,四个干预乡镇的白纹伊蚊数量没有发生一致的变化,但所有释放区对白纹伊蚊数量的平均干预效果为-25-80%(95% CI -30-93至-21-05),其中两个乡镇的白纹伊蚊数量有所增加。这些干预措施在不同地理环境中的效果应在今后的工作中进行评估。资金来源新加坡财政部、可持续发展与环境部、国家环境局和国家机器人计划。
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Effectiveness of Wolbachia-mediated sterility coupled with sterile insect technique to suppress adult Aedes aegypti populations in Singapore: a synthetic control study

Background

Incompatible insect technique (IIT) coupled with sterile insect technique (SIT) via the release of sterile male Wolbachia-infected mosquitoes is a promising tool for Aedes-borne disease control. Yet, real-world evidence on the suppressive effectiveness of IIT-SIT on mosquito abundance remains mostly limited to small semi-rural village and suburban localities over short trial durations. However, a large proportion of Aedes-borne diseases occur in dense, urban, and high-rise locations, limiting the applicability of previous studies for these settings with high disease burden. The sustainability and use of this technology over multiple years is also unknown.

Methods

In this synthetic control study, we conducted a large-scale, field trial of IIT-SIT targeting Aedes aegypti among high-rise public housing estates in Singapore, an equatorial city state. Routinely collected data from a large, nationwide surveillance system of 57 990 unique mosquito traps, combined with a high-dimensional set of anthropogenic and environmental confounders were collected to ascertain mosquito abundance and its key drivers. Four townships were selected as the intervention groups (approximate population size of 607 872 residents as of 2022), wherein interventions that combined ITT with SIT over the course of the study period were conducted. Townships were subject to releases of wAlbB-SG male A aegypti mosquitoes twice a week. Data were assessed over the course of epidemiological weeks (EWs), which provide the finest temporal resolution of recorded Wolbachia release schedule and mosquito abundance data. A novel synthetic control framework was then developed to account for the non-randomised and staggered adoption setting of the intervention across trial sectors to identify the direct suppressive effectiveness of IIT-SIT on female A aegypti populations, the spillover effects in non-release areas, and the effect of the intervention on other mosquito populations such as Aedes albopictus. Furthermore, we recalculated effectiveness in terms of calendar time, time since intervention, and over multiple sites to examine heterogeneities in IIT-SIT effectiveness.

Findings

Between EW27 2018 and EW26 2022, Wolbachia releases were conducted across 117 sectors, of which 97 had sufficient trap data, which were collected between EW8 2019 and EW26 2022. We found that Wolbachia-based IIT-SIT reduced wild-type female A aegypti populations by a mean of 62·01% (95% CI 60·68 to 63·26) by 3 months, 78·40% (77·56 to 79·18) by 6 months, and 91·32% (90·95 to 91·66) by at least 18 months of releases. We also found a smaller but non-negligible spillover suppression effect that gradually increased over time (mean spillover intervention effectiveness 61·02% [95% CI 57·89 to 63·72] in adjacent, non-intervention sectors). Although no consistent change in A albopictus populations was seen across the four intervention townships after Wolbachia releases, the average intervention effectiveness on the A albopictus population across all release sectors was –25·80% (95% CI –30·93 to –21·05), which was driven by increases in two towns.

Interpretation

Our results demonstrate the potential of IIT-SIT for strengthening long-term, large-scale vector control in tropical cities, where dengue burden is the greatest. The effect of these interventions in different geographical settings should be assessed in future work.

Funding

Singapore's Ministry of Finance, Ministry of Sustainability and the Environment, National Environment Agency, and National Robotics Program.

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来源期刊
CiteScore
28.40
自引率
2.30%
发文量
272
审稿时长
8 weeks
期刊介绍: The Lancet Planetary Health is a gold Open Access journal dedicated to investigating and addressing the multifaceted determinants of healthy human civilizations and their impact on natural systems. Positioned as a key player in sustainable development, the journal covers a broad, interdisciplinary scope, encompassing areas such as poverty, nutrition, gender equity, water and sanitation, energy, economic growth, industrialization, inequality, urbanization, human consumption and production, climate change, ocean health, land use, peace, and justice. With a commitment to publishing high-quality research, comment, and correspondence, it aims to be the leading journal for sustainable development in the face of unprecedented dangers and threats.
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