The impact of large-scale deployment of Wolbachia mosquitoes on dengue and other -borne diseases in Rio Aedes de Janeiro and Niterói, Brazil: study protocol for a controlled interrupted time series analysis using routine disease

Rio de Janeiro and Niterói are neighbouring cities in Background: southeastern Brazil which experience large dengue epidemics every 2 to 5 years, with >100,000 cases notified in epidemic years. Costs of vector control and direct and indirect costs due to the -borne diseases Aedes dengue, chikungunya and Zika were estimated to total $650 million USD in 2016, but traditional vector control strategies have not been effective in preventing mosquito-borne disease outbreaks. The method is a Wolbachia novel and self-sustaining approach for the biological control of -borne Aedes diseases, in which the transmission potential of mosquitoes Aedes aegypti is reduced by stably transfecting them with the bacterium ( Mel Wolbachia w strain). This paper describes a study protocol for evaluating the effect of large-scale non-randomised releases of -infected mosquitoes Wolbachia­ on the incidence of dengue, Zika and chikungunya in the two cities of Niterói and Rio de Janeiro. This follows a lead-in period since 2014 1,2 3 4 2