Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue

Abstract Background Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial–temporal impact of W...

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Main Authors: Jo Yi Chow, Lin Geng, Somya Bansal, Borame Sue Lee Dickens, Lee Ching Ng, Ary Anthony Hoffmann, Jue Tao Lim
Format: Article
Language:English
Published: BMC 2024-08-01
Series:BMC Medical Research Methodology
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Online Access:https://doi.org/10.1186/s12874-024-02291-6
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author Jo Yi Chow
Lin Geng
Somya Bansal
Borame Sue Lee Dickens
Lee Ching Ng
Ary Anthony Hoffmann
Jue Tao Lim
author_facet Jo Yi Chow
Lin Geng
Somya Bansal
Borame Sue Lee Dickens
Lee Ching Ng
Ary Anthony Hoffmann
Jue Tao Lim
author_sort Jo Yi Chow
collection DOAJ
description Abstract Background Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial–temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method’s validity. Methods A systematic search for Wolbachia intervention data was conducted via PubMed. Efficacy was reassessed using commonly-used quasi-experimental approaches coupled with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods’ ability to reproduce true intervention efficacies (IE). Results Wolbachia interventions in Singapore, Malaysia, and Brazil were associated to significant decreases in dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests. Conclusions Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.
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spelling doaj-art-0ddf6f33e8074ca8ae48b4aaab4ff0e42025-08-20T02:17:56ZengBMCBMC Medical Research Methodology1471-22882024-08-0124111110.1186/s12874-024-02291-6Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengueJo Yi Chow0Lin Geng1Somya Bansal2Borame Sue Lee Dickens3Lee Ching Ng4Ary Anthony Hoffmann5Jue Tao Lim6Lee Kong Chian School of Medicine, Nanyang Technological UniversityLee Kong Chian School of Medicine, Nanyang Technological UniversitySaw Swee Hock School of Public Health, National University of SingaporeSaw Swee Hock School of Public Health, National University of SingaporeNational Environment AgencyPest and Environmental Research Group, Bio21 Institute, University of MelbourneLee Kong Chian School of Medicine, Nanyang Technological UniversityAbstract Background Wolbachia symbiosis in Aedes aegypti is an emerging biocontrol measure against dengue. However, assessing its real-world efficacy is challenging due to the non-randomised, field-based nature of most intervention studies. This research re-evaluates the spatial–temporal impact of Wolbachia interventions on dengue incidence using a large battery of quasi-experimental methods and assesses each method’s validity. Methods A systematic search for Wolbachia intervention data was conducted via PubMed. Efficacy was reassessed using commonly-used quasi-experimental approaches coupled with extensive robustness checks, including geospatial placebo tests and a simulation study. Intervention efficacies across multiple study sites were computed using high-resolution aggregations to examine heterogeneities across sites and study periods. We further designed a stochastic simulation framework to assess the methods’ ability to reproduce true intervention efficacies (IE). Results Wolbachia interventions in Singapore, Malaysia, and Brazil were associated to significant decreases in dengue incidence, with reductions ranging from 48.17% to 69.19%. IEs varied with location and duration. Malaysia showed increasing efficacy over time, while Brazil exhibited initial success with subsequent decline, hinting at operational challenges. Singapore's strategy was highly effective despite partial saturation. Simulations identified Synthetic Control Methods (SCM) and its variant, count Synthetic Control Method (cSCM), as superior in precision, with the smallest percentage errors in efficacy estimation. These methods also demonstrated robustness in placebo tests. Conclusions Wolbachia interventions exhibit consistent protective effects against dengue. SCM and cSCM provided the most precise and robust estimates of IEs, validated across simulated and real-world settings.https://doi.org/10.1186/s12874-024-02291-6WolbachiaDengueNon-randomisedQuasi-experimentSynthetic control
spellingShingle Jo Yi Chow
Lin Geng
Somya Bansal
Borame Sue Lee Dickens
Lee Ching Ng
Ary Anthony Hoffmann
Jue Tao Lim
Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
BMC Medical Research Methodology
Wolbachia
Dengue
Non-randomised
Quasi-experiment
Synthetic control
title Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
title_full Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
title_fullStr Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
title_full_unstemmed Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
title_short Evaluating quasi-experimental approaches for estimating epidemiological efficacy of non-randomised field trials: applications in Wolbachia interventions for dengue
title_sort evaluating quasi experimental approaches for estimating epidemiological efficacy of non randomised field trials applications in wolbachia interventions for dengue
topic Wolbachia
Dengue
Non-randomised
Quasi-experiment
Synthetic control
url https://doi.org/10.1186/s12874-024-02291-6
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