Awareness and perception of Wolbachia-infected Aedes aegypti as a dengue control method among residents of Yogyakarta Municipality 10.55131/jphd/2022/200205

Main Article Content

Habibi Rohman Rosyad
Alan Frederick Geater
Citra Indriani
Riris Andono Ahmad


Dengue is an important communicable disease in Indonesia with an escalating annual incidence. Between 2016 and 2017, a new dengue control method using Wolbachia-infected Aedes aegypti was implemented in Yogyakarta Municipality. This study aimed to assess community awareness and perception about Wolbachia-infected Ae. aegypti release as a method of dengue control being implemented in their locality, and to identify the influencing factors.  A cross-sectional survey was conducted in 2019 among 484 households in Yogyakarta Municipality. Data were gathered using an electronic data collection tool through face-to-face interviews and direct observations under written informed consent. Weighted estimation and finite population correction were applied in the analysis. Approximately, 23.4% of respondents were aware of the recent Wolbachia-based mosquito control program. After being informed about the nature of the control program, 58% of respondents expressed some concern about the possible harmful effects of the release of infected mosquitoes. Concern over possible harmful effects was associated with older age (aOR=1.76, CI=1.04-2.99), a smaller family (aOR=1.86, CI=1.17-2.95), low income (aOR=1.63, CI=1.04-2.57), having an open vegetated area adjacent to the house (aOR=2.02, CI=1.16-3.51), not being aware (aOR=2.26, 95% CI=1.28-3.98) and having low knowledge (aOR=3.00, CI=1.38-6.53) of the Wolbachia-based mosquito control program, and perceiving a recent increase in the mosquito population (aOR=2.94, CI=1.43-6.03). In conclusion, awareness of the Wolbachia-based dengue control activities was low two years after it was implemented, and low knowledge had a strong association with concern over the possible harmful effects of the release of Wolbachia-infected mosquitoes. Long-term community engagement efforts should be made to maintain public awareness and understanding of the Wolbachia-based biocontrol method.


Download data is not yet available.

Article Details

How to Cite
Rosyad HR, Geater AF, Indriani C, Ahmad RA. Awareness and perception of Wolbachia-infected Aedes aegypti as a dengue control method among residents of Yogyakarta Municipality: 10.55131/jphd/2022/200205. JPHD [Internet]. 2022 May 3 [cited 2022 Aug. 10];20(2):54-71. Available from:
Original Articles
Author Biographies

Habibi Rohman Rosyad, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand

Alan Frederick Geater, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand

Citra Indriani, Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia

Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing,  Universitas Gadjah Mada, Indonesia

Riris Andono Ahmad, Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia

Center for Tropical Medicine,  Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia


World Health Organization. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. Rev. and expanded. ed. Organization WH, editor. New Delhi, India: World Health Organization Regional Office for South-East Asia; 2011.

World Health Organization. Global Strategy for Dengue Prevention and Control 2012-2020. Switzerland: World Health Organization; 2011.

Harapan H, Michie A, Mudatsir M, Sasmono RT, Imrie A. Epidemiology of dengue hemorrhagic fever in Indonesia: analysis of five decades data from the National Disease Surveillance. BMC Res Notes. 2019;350-5.

Rather IA, Parray HA, Lone JB, Paek WK, Lim J, Bajpai VK, et al. Prevention and control strategies to counter dengue virus infection. Front Cell Infect Microbiol. 2017;1-8.

O'Neill SL. The use of Wolbachia by the World Mosquito Program to interrupt transmission of Aedes aegypti transmitted viruses. Adv Exp Med Biol. 2018;355-60.

Ross PA, Callahan AG, Yang Q, Jasper M, Arif MAK, Afizah AN, et al. An elusive endosymbiont: Does Wolbachia occur naturally in Aedes aegypti? Ecol Evol. 2020;1581-91.

Jeyaprakash A, Hoy MA. Long PCR improves Wolbachia DNA amplification: wsp sequences found in 76% of sixty-three arthropod species. Insect Mol Biol. 2000;393-405.

Hilgenboecker K, Hammerstein P, Schlattmann P, Telschow A, Werren JH. How many species are infected with Wolbachia?--A statistical analysis of current data. FEMS Microbiol Lett. 2008;215-20.

McMeniman CJ, Lane RV, Cass BN, Fong AW, Sidhu M, Wang YF, et al. Stable introduction of a life-shortening Wolbachia infection into the mosquito Aedes aegypti. Science. 2009;141-4.

Turelli M. Cytoplasmic incompatibility in populations with overlapping generations. Evolution. 2010;232-41.

Kitrayapong P, Baimai V, O'Neill SL. Field prevalence of Wolbachia in the mosquito vector Aedes albopictus. Am J Trop Med Hyg. 2002;108-11.

Hu Y, Xi Z, Liu X, Wang J, Guo Y, Ren D, et al. Identification and molecular characterization of Wolbachia strains in natural populations of Aedes albopictus in China. Parasit Vectors. 2020;28-41.

Goindin D, Cannet A, Delannay C, Ramdini C, Gustave J, Atyame C, et al. Screening of natural Wolbachia infection in Aedes aegypti, Aedes taeniorhynchus and Culex quinquefasciatus from Guadeloupe (French West Indies). Acta Trop. 2018;314-7.

Kulkarni A, Yu W, Jiang J, Sanchez C, Karna AK, Martinez KJL, et al. Wolbachia pipientis occurs in Aedes aegypti populations in New Mexico and Florida, USA. Ecol Evol. 2019;6148-56.

Carvajal TM, Hashimoto K, Harnandika RK, Amalin DM, Watanabe K. Detection of Wolbachia in field-collected Aedes aegypti mosquitoes in metropolitan Manila, Philippines. Parasit Vectors. 2019;361-9.

Balaji S, Jayachandran S, Prabagaran SR. Evidence for the natural occurrence of Wolbachia in Aedes aegypti mosquitoes. FEMS Microbiol Lett. 2019.

Hoffmann AA, Montgomery BL, Popovici J, Iturbe-Ormaetxe I, Johnson PH, Muzzi F, et al. Successful establishment of Wolbachia in Aedes populations to suppress dengue transmission. Nature. 2011;454-7.

Nazni WA, Hoffmann AA, NoorAfizah A, Cheong YL, Mancini MV, Golding N, et al. Establishment of Wolbachia strain wAlbB in Malaysian populations of Aedes aegypti for dengue control. Curr Biol. 2019;1-8.

Pacidonio EC, Caragata EP, Alves DM, Marques JT, Moreira LA. The impact of Wolbachia infection on the rate of vertical transmission of dengue virus in Brazilian Aedes aegypti. Parasit Vectors. 2017;296.

Mains JW, Kelly PH, Dobson KL, Petrie WD, Dobson SL. Localized control of Aedes aegypti (Diptera: Culicidae) in Miami, FL, via inundative releases of Wolbachia-infected male mosquitoes. J Med Entomol. 2019;1296-303.

Kittayapong P, Ninphanomchai S, Limohpasmanee W, Chansang C, Chansang U, Mongkalangoon P. Combined sterile insect technique and incompatible insect technique: The first proof-of-concept to suppress Aedes aegypti vector populations in semi-rural settings in Thailand. PLoS Negl Trop Dis. 2019;e0007771.

Crawford JE, Clarke DW, Criswell V, Desnoyer M, Cornel D, Deegan B, et al. Efficient production of male Wolbachia-infected Aedes aegypti mosquitoes enables large-scale suppression of wild populations. Nat Biotechnol. 2020;482-92.

Ching NL, Christina L, Ramona G, Seng CC, Huat TC, Grace Y, et al. How safe is Wolbachia for Aedes control? ENB Quarterly. 2017:8-16.

Tantowijoyo W, Andari B, Arguni E, Budiwati N, Nurhayati I, Fitriana I, et al. Stable establishment of wMel Wolbachia in Aedes aegypti populations in Yogyakarta, Indonesia. PLoS Negl Trop Dis. 2020;e0008157.

Ryan PA, Turley AP, Wilson G, Hurst TP, Retzki K, Brown-Kenyon J, et al. Establishment of wMel Wolbachia in Aedes aegypti mosquitoes and reduction of local dengue transmission in Cairns and surrounding locations in northern Queensland, Australia. Gates Open Res. 2019;1-32.

McNaughton D, Duong TT. Designing a community engagement framework for a new dengue control method: a case study from central Vietnam. PLoS Negl Trop Dis. 2014;e2794.

Pinto SB, Riback TIS, Sylvestre G, Costa G, Peixoto J, Dias FBS, et al. Effectiveness of Wolbachia-infected mosquito deployments in reducing the incidence of dengue and other Aedes-borne diseases in Niteroi, Brazil: A quasi-experimental study. PLoS Negl Trop Dis. 2021;e0009556.

Hoffmann AA, Iturbe-Ormaetxe I, Callahan AG, Phillips BL, Billington K, Axford JK, et al. Stability of the wMel Wolbachia infection following invasion into Aedes aegypti populations. PLoS Negl Trop Dis. 2014;e3115.

Utarini A, Indriani C, Ahmad RA, Tantowijoyo W, Arguni E, Ansari MR, et al. Efficacy of Wolbachia-Infected Mosquito Deployments for the Control of Dengue. N Engl J Med. 2021;2177-86.

Popovici J, Moreira LA, Poinsignon A, Iturbe-Ormaetxe I, McNaughton D, O'Neill SL. Assessing key safety concerns of a Wolbachia-based strategy to control dengue transmission by Aedes mosquitoes. Mem Inst Oswaldo Cruz. 2010;957-64.

Moreira LA, Saig E, Turley AP, Ribeiro JM, O'Neill SL, McGraw EA. Human probing behavior of Aedes aegypti when infected with a life-shortening strain of Wolbachia. PLoS Negl Trop Dis. 2009;e568.

Liew C, Soh LT, Chen I, Ng LC. Public sentiments towards the use of Wolbachia-Aedes technology in Singapore. BMC Public Health. 2021;1417.

Adalja A, Sell TK, McGinty M, Boddie C. Genetically modified (GM) mosquito use to reduce mosquito-transmitted disease in the US: A community opinion survey. PLoS Curr. 2016.

Anders KL, Indriani C, Ahmad RA, Tantowijoyo W, Arguni E, Andari B, et al. The AWED trial (Applying Wolbachia to Eliminate Dengue) to assess the efficacy of Wolbachia-infected mosquito deployments to reduce dengue incidence in Yogyakarta, Indonesia: study protocol for a cluster randomised controlled trial. Trials. 2018;302-17.

Indriani C, Tantowijoyo W, Rances E, Andari B, Prabowo E, Yusdi D, et al. Reduced dengue incidence following deployments of Wolbachia-infected Aedes aegypti in Yogyakarta, Indonesia: a quasi-experimental trial using controlled interrupted time series analysis. Gates Open Res. 2020;50-65.

Statistics of Yogyakarta Municipality. Yogyakarta Municipality in Figures 2018. In: Municipality B-SoY, editor. Yogyakarta: BPS-Statistics of Yogyakarta Municipality 2018.

R Core Team. R: A language and environtment for statistical computing. 3.6.3 ed: R Foundation for Statistical Computing; 2020.

Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G, editors. Open data kit: tools to build information services for developing regions. the 4th ACM/IEEE International Conference on Information and Communication Technologies and Development; 2010; London, United Kingdom: Association for Computing Machinery.

Textor J, van der Zander B, Gilthorpe MS, Liskiewicz M, Ellison GT. Robust causal inference using directed acyclic graphs: the R package 'dagitty'. Int J Epidemiol. 2016;1887-94.

Lumley T. Survey: Analysis of Complex Survey Samples. R package version 3.35-1 ed2019.

Zaki R, Roffeei SN, Hii YL, Yahya A, Appannan M, Said MA, et al. Public perception and attitude towards dengue prevention activity and response to dengue early warning in Malaysia. PLoS One. 2019;e0212497.

Jeelani S, Sabesan S, Subramanian S. Community knowledge, awareness and preventive practices regarding dengue fever in Puducherry - South India. Public Health. 2015;790-6.

Saied KG, Al-Taiar A, Altaire A, Alqadsi A, Alariqi EF, Hassaan M. Knowledge, attitude and preventive practices regarding dengue fever in rural areas of Yemen. Int Health. 2015;420-5.

Ariffin F, Ramli AS, Naim N, Selamat MI, Syed-Jamal SJ. Recognizing life-threatening features of dengue in children and health seeking behavior in dengue emergency amongst parents and carers: A cross-sectional study in Gombak District, Malaysia. Med J Malaysia. 2014;210-5.

Elsinga J, Schmidt M, Lizarazo EF, Vincenti-Gonzalez MF, Velasco-Salas ZI, Arias L, et al. Knowledge, attitudes, and preventive practices regarding dengue in Maracay, Venezuela. Am J Trop Med Hyg. 2018;195-203.

Sow S, de Vlas SJ, Mbaye A, Polman K, Gryseels B. Low awareness of intestinal schistosomiasis in northern Senegal after 7 years of health education as part of intense control and research activities. Trop Med Int Health. 2003;744-9.

Dulai J, Salway T, Thomson K, Haag D, Lachowsky N, Grace D, et al. Awareness of and intention to use an online sexually transmitted and blood-borne infection testing service among gay and bisexual men in British Columbia, two years after implementation. Can J Public Health. 2021;78-88.