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Buhler, Claudia; Winkler, Volker; Runge-Ranzinger, Silvia; Boyce, Ross und Horstick, Olaf (2019): Environmental methods for dengue vector control - A systematic review and meta-analysis.
In: PLOS Neglected Tropical Diseases 13(7), e0007420 [PDF, 1MB]

Abstract

Background Vector control remains the primary method to prevent dengue infections. Environmental interventions represent sustainable and safe methods as there are limited risks of environmental contamination and toxicity. The objective of this study is to perform a systematic review and meta-analysis of the effectiveness of the following environmental methods for dengue vector control. Methodology/Principal findings Following the PRISMA guidelines, a systematic literature search was conducted using the databases PubMed, EMBASE, LILACS, the Cochrane Library and Google Scholar. Quality assessment was done using the CONSORT 2010 checklist. For the meta-analysis the difference-in-differences (DID) and the difference-of-endlines (DOE) were calculated according to the Schmidt-Hunter method for the Breteau index (BI) and the pupae per person index (PPI). Nineteen studies were eligible for the systematic review, sixteen contributed data to the meta-analysis. The following methods were evaluated: (a) container covers with and without insecticides, (b) waste management and clean-up campaigns, and (c) elimination of breeding sites by rendering potential mosquito breeding sites unusable or by eliminating them. Study quality was highest for container covers with insecticides, followed by waste management without direct garbage collection and elimination of breeding places. Both, systematic review and meta-analysis, showed a weak effect of the interventions on larval populations, with no obvious differences between the results of each individual method. For the meta-analysis, both, container covers without insecticides (BI: DID -7.9, DOE -5) and waste management with direct garbage collection (BI: DID -8.83, DOE -6.2) achieved the strongest reductions for the BI, whereas for the PPI results were almost opposite, with container covers with insecticides (PPI: DID -0.83, DOE 0.09) and elimination of breeding places (PPI: DID -0.95, DOE -0.83) showing the strongest effects. Conclusions Each of the investigated environmental methods showed some effectiveness in reducing larval and pupal densities of Aedes sp. mosquitoes. However, there is a need for more comparable high-quality studies at an adequate standard to strengthen this evidence. Author summary Dengue is an emerging mosquito-borne viral disease, which is transmitted through the bite of Aedes sp. mosquitoes. The dengue virus causes 390 million infections and 96 million cases every year, and represents a major public health problem in the tropics and subtropics. Although a dengue vaccine was licensed in late 2015, it does not represent a general solution due to significant imperfections. Vector control remains still the primary method to prevent dengue infections. Environmental interventions to control dengue vectors represent sustainable and safe methods as there are limited risks of environmental contamination and toxicity. We provide a systematic review and meta-analysis of the effectiveness of the following environmental methods for dengue vector control: container covers with and without insecticides, waste management with and without direct garbage collection, elimination of breeding places. Both, systematic review and meta-analysis, showed a weak effect of the interventions on larval Aedes sp. populations, with no obvious differences between the results of each individual method. However, there is a need for more comparable high-quality studies at an adequate standard to strengthen this evidence.

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