Mapping the Timing and Deployment Strategies of Wolbachia-Based Interventions for Dengue Prevention and Outbreak Response: A Scoping Review

Abstract

Introduction: Dengue remains a major global public health challenge, particularly in tropical and subtropical regions where Aedes aegypti transmission persists despite conventional vector-control strategies. Wolbachia-based interventions show promise for reducing dengue transmission however, less is known about how deployment timing, release strategy, scale, and establishment influence their role in dengue prevention and outbreak response. Objective: This scoping review aimed to map evidence on the timing and deployment of Wolbachia-based interventions and their relationship to establishment, dengue outcomes, and implementation feasibility.

Method: A PRISMA-guided scoping review was conducted using PubMed, MEDLINE and Web of Science with screening managed in Rayyan. Searches identified 657 imported records, including 477 from the initial search and 180 from an amended keyword search. After duplicate removal, 92 additional records from the amended search required screening. Title, abstract, and full-text screening were conducted using inclusion criteria requiring Wolbachia relevance, dengue transmission relevance, and a temporal or deployment-related component. Forty-eight studies were included. Data was extracted on study design, location, Wolbachia strain, release method, frequency, duration, timing, establishment, dengue outcomes, spillover, sustainability, and limitations.

Results: Wolbachia interventions were most commonly implemented as pre-emptive, population-level strategies rather than rapid emergency outbreak responses. Field studies reported repeated releases over weeks to months using adult mosquitoes, egg-based containers, vehicle-based releases, or community-assisted approaches. Dengue reductions were generally reported after stable Wolbachia establishment. Modelling studies suggested that establishment before transmission peaks or epidemic surges may improve outbreak prevention, while entomological studies highlighted seasonality, mosquito abundance, and vector survival as timing considerations.

Conclusion: Current evidence suggests Wolbachia-based interventions are best positioned as preventative dengue-control strategies requiring timely deployment and sustained establishment before major transmission periods. Further systematic review is warranted to determine which deployment characteristics are most strongly associated with successful establishment and dengue reduction.

Keywords: Wolbachia, dengue, deployment, transmission, outbreak