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Assessing the Relationship between Vector Indices and Dengue Transmission: A Systematic Review of the Evidence

Bowman, Leigh, Runge-Ranzinger, Silvia and McCall, Philip ORCID: (2014) 'Assessing the Relationship between Vector Indices and Dengue Transmission: A Systematic Review of the Evidence'. PLoS Neglected Tropical Diseases, Vol 8, Issue 5, e2848.

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Despite doubts about methods used and the association between vector density and dengue transmission, routine sampling of mosquito vector populations is common in dengue-endemic countries worldwide. This study examined the evidence from published studies for the existence of any quantitative relationship between vector indices and dengue cases.

Methodology/Principal Findings

From a total of 1205 papers identified in database searches following Cochrane and PRISMA Group guidelines, 18 were included for review. Eligibility criteria included 3-month study duration and dengue case confirmation by WHO case definition and/or serology.
A range of designs were seen, particularly in spatial sampling and analyses, and all but 3 were classed as weak study designs. Eleven of eighteen studies generated Stegomyia indices from combined larval and pupal data. Adult vector data were reported in only three studies. Of thirteen studies that investigated associations between vector indices and dengue cases, 4 reported positive correlations, 4 found no correlation and 5 reported ambiguous or inconclusive associations. Six out of 7 studies that measured Breteau Indices reported dengue transmission at levels below the currently accepted threshold of 5.


There was little evidence of quantifiable associations between vector indices and dengue transmission that could reliably be used for outbreak prediction. This review highlighted the need for standardized sampling protocols that adequately consider dengue spatial heterogeneity. Recommendations for more appropriately designed studies include: standardized study design to elucidate the relationship between vector abundance and dengue transmission; adult mosquito sampling should be routine; single values of Breteau or other indices are not reliable universal dengue transmission thresholds; better knowledge of vector ecology is required.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 650 Insect vectors
WC Communicable Diseases > WC 20 Research (General)
WC Communicable Diseases > Virus Diseases > Infectious Mononucleosis. Arbovirus Infections > WC 528 Dengue
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI):
Depositing User: Samantha Sheldrake
Date Deposited: 15 May 2014 12:25
Last Modified: 06 Feb 2018 13:07


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