In the last few decades, Dengue Hemorrhagic Fever (DHF) has become a significant global health problem. This disease, which is transmitted by the Aedes aegypti mosquito, causes thousands of deaths every year, with the impact mainly felt in tropical and subtropical regions throughout the world. However, new hope has emerged with innovative technology that promises to treat this disease, namely by using mosquitoes that have been modified with Wolbachia bacteria.
Wolbachia is a type of endosymbiotic bacteria that lives in the cells of its host organism. This bacteria is found in various insect species, including the Aedes aegypti mosquito which is responsible for the spread of the dengue virus. One of the unique properties of Wolbachia is its ability to change the population of its host mosquito by reducing the mosquito’s ability to transmit viruses.
When the Aedes aegypti mosquito contains Wolbachia, the bacteria interferes with the development of the virus in the mosquito’s body. As a result, mosquitoes infected with Wolbachia have a lower ability to spread the dengue virus to humans. In this way, the use of Wolbachia-infected mosquitoes can be an effective tool in controlling the spread of dengue fever.
The Indonesian Ministry of Health has implemented Wolbachia technology to reduce the spread of dengue fever in Indonesia. This technology has been successfully used in nine other countries such as Brazil, Australia, Vietnam and others.
Wolbachia technology is part of the National Dengue Control Strategy. As a pilot project in Indonesia, it has been implemented in five cities, including Yogyakarta, Semarang City, West Jakarta and Bandung.
Wolbachia can inhibit the transmission of the dengue virus by the Aedes aegypti mosquito, as well as control mosquito reproduction. Its effectiveness has been researched since 2011 by the World Mosquito Program (WMP) in Yogyakarta.
Trials in Yogyakarta City and Bantul Regency in 2022 succeeded in reducing dengue fever cases by up to 77% and reduced the proportion of hospital admissions by 86%.
The city of Yogyakarta is the first city in Indonesia to implement Wolbachia mosquito technology in controlling dengue fever. Since this program started in 2014, the number of dengue fever cases in Yogyakarta City has gradually decreased, and in 2023 it will record a record low of 67 cases.
Head of Disease Control Prevention and Health Data Management and Information Systems, Yogyakarta City Health Service, dr. Lana Unwanah explained that in 2016 the number of cases in Yogyakarta City was still very high, reaching more than 1,700 cases. In 2023 until last week it was recorded at only 67, the lowest in history in the city of Yogyakarta. Apart from well-known methods such as eradicating mosquitoes with 3M and jumantik, this reduction in cases cannot be separated from the intervention of the Wolbachia mosquito program which has been carried out since 2016 until now.
The implementation of this cutting-edge technology in the City of Yogyakarta is carried out by depositing buckets containing Aedes aegypti Wolbachia mosquito eggs in their natural habitat in the community, with support from the Health Service and various relevant stakeholders.
Along with the trend of decreasing case numbers and hospitalization rates, the need for physical intervention in the form of fumigation or fogging is decreasing. The use of local government budgets for handling dengue fever has also become more efficient so that it can be allocated for treating other diseases.
Looking back at the journey of research and implementation of Wolbachia mosquito technology, various important milestones have been recorded at each stage that has been passed. After going through a series of research processes, the first release of Aedes aegypti mosquito eggs containing Wolbachia was carried out for the first time in 2014 in four small villages in Sleman Regency and Sleman Regency. Thus, for almost 10 years some of the people of Yogyakarta have been living with Wolbachia mosquitoes.
Principal Researcher at WMP Yogyakarta, Prof. Adi Utarini, explained that the implementation of this technology in society was preceded by a risk analysis by a team of experts formed by Research, Technology and Higher Education to identify various potential impacts, with the conclusion that the risks from implementing this technology were very low or negligible. It is not implemented immediately, but there is an important process that is carried out beforehand. Everything is done carefully and accompanied by ethical clearance.
The WMP program in Yogyakarta itself ended in 2022, with results proving that this technology was effective in reducing 77% of Dengue cases and 86% of hospitalizations due to Dengue. Armed with these data, WMP then succeeded in obtaining recommendations from the World Health Organization and the Indonesian Academy of Sciences (AIPI), and will then be implemented in other cities in Indonesia. So that it can be widely implemented in various regions, the WMP team has developed a program implementation model in collaboration with the regional Health Service, including carrying out a series of training activities and providing a guidebook.
Even though the WMP program has shown very significant results, the public is still advised to continue implementing dengue prevention and control methods such as the 3M Plus movement and maintaining personal and environmental cleanliness.
