Effectiveness of Vector Control Approaches in Mitigating Dengue Epidemics: A Systematic Review and Meta-Analysis

Abstract

Background: Dengue remains one of the most significant mosquito-borne viral diseases worldwide, imposing a major public health and economic burden in tropical and subtropical regions. In the absence of universally effective vaccines or antivirals, vector control remains the cornerstone of dengue prevention. However, evidence on the comparative effectiveness of various control interventions remains fragmented.

Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) were searched for studies published between January 2000 and June 2025. Eligible studies included randomized controlled trials, quasi-experimental, and observational studies evaluating vector control interventions—chemical, biological, environmental, or integrated approaches—with dengue incidence or entomological indices as outcomes. Data were pooled using a random-effects model, and heterogeneity was assessed using the I² statistic.

Results: Of 4,256 identified records, 68 studies from 24 countries met inclusion criteria. Pooled analysis demonstrated that Integrated Vector Management (IVM) reduced dengue incidence by 42% (RR = 0.58; 95% CI: 0.46-0.74) compared with no intervention. Larval source reduction combined with community participation achieved a 37% risk reduction (RR = 0.63; 95% CI: 0.49-0.81), while chemical control alone showed modest short-term impact (RR = 0.78; 95% CI: 0.62-0.98). Biological controls, including Bacillus thuringiensis israelensis (Bti) and Wolbachia-infected mosquitoes, achieved a 51% reduction in the Breteau Index (95% CI: 41-61%). Publication bias was minimal, and sensitivity analyses confirmed the robustness of findings.

Conclusion: Integrated, community-based, and biologically oriented vector control interventions demonstrate the highest and most sustainable impact on dengue prevention. Reliance on chemical control alone is inadequate for long-term reduction of transmission. National dengue programs should adopt Integrated Vector Management aligned with WHO’s Global Vector Control Response (GVCR) 2017-2030, emphasizing intersectoral collaboration, community engagement, and resistance management to achieve sustained control of dengue epidemics.