A Temperature-Dependent Multi-Serotype Model for Evaluating Dengue Vector Control Strategies in Thailand
Aekthong, S.; Suttirat, P.; Rueangkham, N.; Chadsuthi, S.; Bicout, D. J.; Haddawy, P.; Yin, M. S.; Lawpoolsri, S.; Modchang, C.
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Background: Dengue remains a major public health challenge in Thailand despite decades of vector control implementation. While mathematical models have explored dengue transmission dynamics, systematic evaluation of current control strategies under realistic operational conditions remains limited. Methods: We developed a temperature-dependent, multi-serotype dengue transmission model that explicitly incorporates three primary vector control strategies: reduction in mosquito biting rates through personal protection measures, further reduction in mosquito birth rates beyond current larval control efforts, and further increase in adult mosquito mortality beyond current adulticide application levels. Using Approximate Bayesian Computation with Sequential Monte Carlo (ABC-SMC), we fitted the model to dengue hemorrhagic fever (DHF) surveillance data from nine province-year combinations representing high (Rayong), moderate (Ratchaburi), and low (Phrae) transmission settings across three years (2006, 2015, and 2017). The model accounts for four dengue serotypes, temperature-dependent mosquito dynamics, and temporary cross-protective immunity between serotypes. Results: The model closely reproduced observed monthly DHF case counts across all nine province-year combinations. Estimated reporting proportions ranged from 1.4% to 16.7%, with the highest values occurring in high-transmission provinces during the 2015 outbreak year. When each strategy was independently intensified by 50% relative to fitted baseline levels, reducing mosquito biting rates and increasing adult mosquito mortality consistently produced greater reductions in transmission than reducing mosquito birth rates. In the highest-transmission scenario (Rayong, 2015), a 50% reduction in biting rate from the baseline level yielded a 96.4% reduction in cumulative infections (95% CrI: 95.4-97.3%), compared with 94.3% (95% CrI: 91.8-95.6%) for a 50% increase in adult mosquito mortality and 77.0% (95% CrI: 58.6-84.6%) for a 50% reduction in mosquito birth rate. Analysis of the time-varying reproduction number (R_t) confirmed that interventions targeting adult mosquito-human contact achieved the greatest sustained epidemic suppression, although the relative ranking between bite prevention and adulticide application varied by epidemiological setting. Conclusions: Under the uniform 50% intensification scenario tested, interventions that directly disrupt adult mosquito-human contact, whether through personal protection or adulticide application, substantially outperformed larval control in reducing dengue transmission across diverse Thai settings. These findings support prioritizing personal protection and adulticide application, while the generalizability of this ranking to other intensification levels and settings warrants further investigation.
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