Impact of Wolbachia-infected Aedes aegypti on dengue incidence in endemic regions: a systematic review and meta-analysis

Zainal H.M.; Guimarães R.S.; Al Owesie A.; Ribeiro L.S.; Roman-Pimentel A.; Sharma T.; de Godoy V.N.; Mendes R.B. · Transactions of the Royal Society of Tropical Medicine and Hygiene (2026) · DOI: 10.1093/trstmh/trag063

Resumen

Dengue remains a major public health challenge in endemic regions, and conventional vector-control strategies have shown limited long-term effectiveness. The release of Wolbachia-infected Aedes aegypti mosquitoes has emerged as a novel biocontrol strategy to reduce dengue transmission. We conducted a systematic review and meta-analysis to evaluate the effectiveness of Wolbachia deployments in reducing dengue incidence. We searched PubMed, Embase, and the Cochrane Library until 30 April 2025 for randomized controlled trials and quasi-experimental studies conducted in dengue-endemic settings. Population-level effectiveness was assessed using pooled incidence rate ratios (IRRs), and individual-level protective efficacy using pooled odds ratios (ORs). Random-effects meta-analysis with restricted maximum likelihood with Hartung–Knapp adjustment was applied. Subgroup analyses examined geographic region and deployment coverage. Nine studies involving >8 million individuals were included. Wolbachia deployment was associated with a substantial reduction in dengue incidence (pooled IRR 0.15, 95% CI 0.05–0.39), corresponding to an estimated 85% reduction. Full-area deployments demonstrated greater reductions (IRR 0.046, 95% CI 0.038–0.055) than partial-area deployments (IRR 0.22, 95% CI 0.07–0.74). Exploratory individual-level analyses yielded a pooled OR of 0.29 (95% CI 0.01–8.41) with substantial heterogeneity (I² = 86.5%). © The Author(s) 2026. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

Instituciones: Universidad Peruana de Ciencias Aplicadas