ArticleEBioMedicine2026
Impact of Wolbachia-mediated incompatible and sterile insect techniques on dengue incidence: a large-scale cluster randomised controlled trial.
Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05505682 (Assessing the Efficacy of Male Wolbachia-infected Mosquito Deployments to Reduce Dengue Incidence in Singapore), which is not on this map. Not yet cited in PubMed.
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Assessing the Efficacy of Male Wolbachia-infected Mosquito Deployments to Reduce Dengue Incidence in Singapore: a Cluster Randomized Controlled Trial
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19 authors.
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Abstract
backgroundWild-type female Aedes aegypti which mate with Wolbachia-infected male Aedes aegypti (Wolbachia-Aedes) produce non-viable eggs due to cytoplasmic incompatibility. Sustained releases of Wolbachia-infected male Aedes aegypti can suppress wild-type mosquito populations, but robust evidence of its efficacy in reducing dengue incidence is needed.
methodsWe conducted a large-scale cluster-randomised controlled trial involving releases of male wAlbB-infected Ae. aegypti mosquitoes (wAlbB-SG) for dengue control in Singapore. Mosquitoes were irradiated to sterilise potential residual females. Fifteen clusters were randomised: 8 clusters received deployments of male wAlbB-SG infected Ae. aegypti (intervention clusters, n = 393,236) and 7 clusters received no deployments (control clusters, n = 331,192). All clusters practised baseline vector control measures. We assessed the protective efficacy of Wolbachia-Aedes to reduce dengue incidence using a differences-in-differences framework. The trial was registered with ClinicalTrials.gov (Identifier: NCT05505682) on 2022-08-18.
findingsIn the pre-intervention period, dengue incidence per 100,000 was similar across control (18.63) and intervention (18.14) arms. During the intervention period, reported dengue incidence was 11.31 and 36.57 cases per 100,000 residents in intervention and control arms, respectively. Six months after releases began, intervention clusters showed reductions in total dengue incidence, ranging from 27.6% (95% CI: -35.4% to 61.3%) to 83.8% (95% CI: 50.4%-94.7%). This protective effect varied across time, with some attenuation observed during the 2023 inter-epidemic period. We estimated that 2351 cases (95% CI: 1968-2735) were averted over the period of the trial, relative to 1037 dengue cases reported in the intervention arm. Reductions in epidemiologically-linked dengue incidence were greater, ranging from 60.9% (95% CI: 21.3%-80.6%) to 99.8% (95% CI: 99.2%-99.9%).
interpretationOur results demonstrate the high efficacy of Wolbachia-Aedes in reducing dengue incidence.
fundingMinistry of Finance, Singapore.
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