Enhancing public health strategies for dengue control: insights and recommendations for comprehensive management in tropical regions
Authors: Man Sun, Huan Zhou
Journal: The Lancet Microbe (2024)

We read with interest the Article published in The Lancet Microbe by Jue Tao Lim and colleagues.1Lim JT Bansal S Chong CS et al.Efficacy of Wolbachia-mediated sterility to reduce the incidence of dengue: a synthetic control study in Singapore.Lancet Microbe. 2024; 5: e422-e432Summary Full Text Full Text PDF PubMed Scopus (0) Google Scholar The authors used the synthetic control method to conduct extensive field trials in various urban settings across Singapore, demonstrating that releasing Wolbachia-infected male Aedes aegypti mosquitoes substantially reduces the incidence of dengue fever. The acceleration of globalisation because of increased human activity and trade has facilitated the spread of dengue fever, making implementation of urgent intervention measures crucial. In this paper, we suggest future research directions and public health management strategies to address this issue. The study by Lim and colleagues was conducted in towns across Singapore, which has uniform geographical and climatic conditions. Therefore, caution is advised when generalising these results to other tropical regions with diverse climates, environments, and socioeconomic conditions.2Adnan RA Ramli MF Othman HF Asha'ri ZH Ismail SNS Samsudin S The impact of sociological and environmental factors for dengue infection in Kuala Lumpur, Malaysia.Acta Trop. 2021; 216105834Crossref PubMed Scopus (6) Google Scholar Moreover, resistance to mosquito release programmes and misunderstandings in some cultural and community contexts highlight the need for government and community organisations to improve education and boost public cooperation and acceptance.3Liew C Soh LT Chen I Ng LC Public sentiments towards the use of Wolbachia-Aedes technology in Singapore.BMC Public Health. 2021; 21: 1417Crossref PubMed Scopus (0) Google Scholar Additionally, the widespread release of Wolbachia-infected mosquitoes could disrupt local ecological balances, thereby warranting further research to ensure the safety and feasibility of its broad application. We propose using multivariable regression analysis to investigate the factors affecting dengue incidence in tropical regions. The analysis should focus on the effect of socioeconomic factors, such as population density, urbanisation, and public health infrastructure, as well as health education and behavioural factors, including disease control measures implemented by health authorities, public awareness, and the adoption of mosquito prevention strategies, on dengue incidence.4Zellweger RM Cano J Mangeas M et al.Socioeconomic and environmental determinants of dengue transmission in an urban setting: an ecological study in Nouméa, New Caledonia.PLoS Negl Trop Dis. 2017; 11e0005471Crossref Scopus (66) Google Scholar Future approaches should include implementing detailed strategies aimed at achieving more comprehensive disease prevention and control. Establishing public health management strategies for mitigating the incidence of dengue fever in tropical regions are essential. We advocate for a three-tier public health management system to address this issue. The primary level involves the formulation of health policies, disease monitoring, and resource coordination by the government. At the secondary level, regional departments implement control measures such as vaccination and disease surveillance, guided by national strategies. The third level focuses on community workers promoting prevention activities and monitoring local disease incidence, ensuring a coherent and effective response to public health challenges. We appreciate that the authors focused on dengue control in the tropics, a public health challenge that will require concerted efforts in the future. We declare no competing interests. Efficacy of Wolbachia-mediated sterility to reduce the incidence of dengue: a synthetic control study in SingaporeOur results demonstrated the potential of Wolbachia-mediated incompatible insect technique for strengthening dengue control in tropical cities, where dengue burden is the greatest. Full-Text PDF Open Access