Risk Assessment on the Release of Wolbachia -Infected Aedes aegypti in Yogyakarta, Indonesia.

Simple Summary: Globally, the number of dengue cases reported to the WHO increased over 8-fold over the last 2 decades, from 505,430 cases in 2000 to over 2.4 million in 2010 to 5.2 million in 2019. Reported deaths between the years 2000 and 2015 increased from 960 to 4032, affecting mostly younger age groups. The latest data in November 2021 recorded that the cumulative number of dengue cases in Indonesia was 40,759 cases (incidence rate (IR) 14.76/100,000 population) and 402 deaths (l (CFR) 0.99%). Wolbachia-infected Aedes aegypti has been hailed as a new technology that can solve dengue fever disease. Infected females are unable to transmit the dengue virus and are reproductively incompatible with uninfected males. The aim of this study is to conduct risk assessment on the release of Wolbachia-infected Aedes aegypti in Yogyakarta, Indonesia. The assessment of the risks associated with the release of Wolbachia-infected Ae. aegypti used methodology developed by the Commonwealth Scientific Industrial Research Organization (CSIRO), Australia. In this paper, the Bayesian belief network (BBN) was used as the analysis method, and combined with the discussion results and analysis data of the local expert group, the risk assessment of the release of Wolbachia-infected Ae. aegypti was carried out. The results showed that the release of Wolbachia-infected Ae. aegypti led to negligible risk (0.0088). Wolbachia-infected Aedes aegypti is the latest technology that was developed to eliminate dengue fever. The Ministry of Research and Technology of the Republic of Indonesia (Kemenristekdikti) established an expert group to identify future potential risks that may occur over a period of 30 years associated with the release of Wolbachia-infected Ae. aegypti. The risk assessment consisted of identifying different hazards that may have impacts on humans and the environment. From the consensus among the experts, there were 56 hazards identified and categorized into 4 components, namely, ecological matters, efficacy in mosquito management, economic and sociocultural issues, and public health standards. There were 19 hazards in the ecological group. The overall likelihood in the ecology of the mosquito is very low (0.05), with moderate consequence (0.74), which resulted in negligible risk. For the efficacy in mosquito management group, there were 12 hazards that resulted in very low likelihood (0.11) with high consequence (0.85). The overall risk for mosquito management efficacy was very low (0.09). There were 14 hazards identified in the public health standard with very low likelihood (0.07), moderate consequence (0.50) and negligible risk (0.04). Lastly, 13 hazards were identified in the economic and sociocultural group with low likelihood (0.01) but of moderate consequence (0.5), which resulted in a very low risk (0.09). The risk severity level of the four components leading to the endpoint risk of "cause more harm" due to releasing Wolbachia-infected Ae. aegypti is negligible (0.01). [ABSTRACT FROM AUTHOR]