Public Perception of Wolbachia-based Dengue Control in High-incidence Countries: A Scoping Review

Aim and background:Dengue, a major public health issue in tropical and subtropical regions, is primarily transmitted by Aedes aegypti. Despite conventional vector control efforts, challenges such as insecticide resistance and operational constraints persist. The Wolbachia method, which reduces dengue transmission by infecting mosquitoes with a natural bacterium, has demonstrated promising results. However, its effective implementation requires public acceptance, shaped by sociocultural and ethical considerations, and community engagement. This scoping review aimed to map and analyze public perceptions of Wolbachia-infected mosquitoes as a dengue control strategy in high-incidence countries, focusing on identifying barriers, facilitators, and knowledge gaps influencing its adoption. Materials and methods: A systematic search was conducted in four databases (PubMed, Scopus, Embase, and Virtual Health Library) to identify studies exploring public perceptions of Wolbachia-based strategies in high-dengue-incidence countries. Eligible studies, published without time restrictions, were selected and reviewed independently by two researchers following Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analyses extension for Scoping Reviews guidelines. Data were extracted on study characteristics, methodologies, findings, and conclusions. Results: Thirteen studies, published between 2012 and 2024, were included, with most conducted in Asia (69%). Acceptance of Wolbachia interventions ranged from 67 to 97%, improving after targeted educational campaigns. Key barriers included insufficient knowledge, mistrust in authorities, and misconceptions about genetic modifications. Facilitators included community participation and transparent communication. Proposed strategies emphasized culturally adapted educational programs, use of social media, and involvement of local leaders in planning and implementation. Conclusion: Public perceptions of Wolbachia-based dengue control interventions vary widely, but are pivotal to their success. Overcoming barriers through tailored communication, education, and active community engagement can enhance acceptance and ensure sustainable implementation of this innovative strategy. Clinical significance: Public acceptance of Wolbachia-based dengue control strategies relies on education, community engagement, and transparent communication. Overcoming barriers enhances the effectiveness and sustainability of these interventions.