"Wolbachia", the Key to Yogyakarta's Victory Against DHF

The "Wolbachia" bacteria is a weapon against the malignancy of the dengue hemorrhagic fever virus. The city of Yogyakarta is a witness.

The following article was translated using both Microsoft Azure Open AI and Google Translation AI. The original article can be found in "Wolbachia", Kunci Kemenangan Yogyakarta Melawan DBD

FAKHRI FADLURROHMAN

A teenager is taking care of their parents who are being treated at the RSUD Cibinong Hospital in Bogor Regency, on Saturday (3/6/2023). The patient is undergoing treatment due to dengue hemorrhagic fever (DHF).

Still fresh in Totok Pratopo's memory are the dark times before 2018. During that time, every year before the rainy season, the residents of his village in Jetisharjo, Cokrodiningratan District, Yogyakarta City, were always worried. This was because dengue fever was lurking. However, with the help of the government and community efforts, the number of cases has significantly reduced in recent years.

Not only does the disease cause suffering for the residents, it also brings grief by claiming lives. In 2016, two residents in the village died from dengue fever. "In 2017, an 8-year-old child died," said a community leader in Jetisharjo, on Wednesday (22/11/2023).

The village on the outskirts of Kali Code which divides the center of Yogyakarta city is densely populated. Apart from that, the condition of some villages tends to be slum and there are lots of puddles when it rains. This combination provides an ideal environment for the development of the Aedes aegypti mosquito, which carries the dengue virus.

However, starting in 2018, Totok, who also served as the head of the neighborhood association in that village, felt a real difference, which was the disappearance of dengue fever cases. In fact, throughout the Cokrodiningratan sub-district, there were only two cases this year. "This is truly relieving for us as a community," he said.

Also read: Wolbachia, a new weapon amidst the widespread spread of dengue fever

KOMPAS/FERGANATA INDRA RIATMOKO

A densely populated residential area on the edge of the Kali Code river in Yogyakarta can be seen from the air on Thursday (15/3/2018).

This of course didn't come suddenly. This condition occurred thanks to the application ofWolbachia mosquito technology developed by the World Mosquito Program (WMP) Yogyakarta in collaboration with the Center for Tropical Medicine, Gadjah Mada University (UGM), Monash University Australia, and the Tahija Foundation. The research began in 2011.

The testimony from Totok was delivered during a technology-related discussion at the UGM Central Building in Yogyakarta, Indonesia. Also in attendance as speakers were Chief Researcher WMP Yogyakarta Adi Utarini, Director of UGM Tropical Medicine Center Riris Andono Ahmad, and Head of Disease Prevention, Control, and Data Management for the Yogyakarta Health Department Lana Unwanah.

Prevent development

This technology in principle utilizes natural insect bacteria called Wolbachia to prevent the development of the dengue virus in the body of the Aedes aegypti mosquito. How it works is that bacteria are inserted into the eggs of the Aedes aegypti mosquito so that when they hatch, the mosquito will carry the bacteria.

If a male mosquito that has been infected with Wolbachia mates with a female mosquito that is not infected with Wolbachia, the eggs will not hatch. If a female mosquito with Wolbachia mates with a male that does not have Wolbachia or one that has Wolbachia, then all of her eggs will contain Wolbachia /i>.

REUTERS/JOSUE DECAVELE

The Aedes aegypti mosquito

If it bites a human, Aedes aegypti containing Wolbachia will not transmit the dengue virus. Wolbachia will continue to live and be passed down in the mosquito's body to subsequent generations. This means that, gradually, the population of Aedes aegypti in nature will be dominated by mosquitoes which no longer pose a danger to humans.

The program to release mosquitoes carryingWolbachiawas carried out in stages in 2016-2017 in randomly selected parts of Yogyakarta, including Jetisharjo. After being proven effective, mosquito release was carried out in all areas of the city in 2020.

Also read: Wolbachia Technology Promises for Dengue Control

The impact is being felt now. Based on the data from the Yogyakarta City Health Office, in 2016, the number of dengue fever (DBD) cases in the capital of the Special Region of Yogyakarta (DIY) reached 1,705 with a mortality rate of 0.4 percent. Meanwhile, in 2017, there were 414 cases with a mortality rate of 0.5 percent.

According to Lana Unwanah, this year until mid-November, there were "only" 67 cases of Dengue Fever with no deaths. "This is the lowest in the history of Yogyakarta. It is also the lowest number compared to all five districts in DIY," she said.

KOMPAS/HERU SRI KUMORO

Officers carry out fogging or fumigation at a housing complex in the Serpong area, South Tangerang, Monday (21/8/2023).

However, previously, Yogyakarta had always recorded the highest number of dengue fever cases in all of the Special Region of Yogyakarta. In fact, cases in Yogyakarta often fell into the high category nationally.

Thanks to the drastic drop in cases, Lana said, her party was also able to reduce the budget. The biggest budget in dealing with dengue fever is funding fogging or fumigation to eradicate mosquitoes in residential areas.

In 2016, the Yogyakarta Health Office carried out 200 fumigation events due to the high number of cases. In 2017, more than 50 times of fogging were also recorded. "However, this year until mid-November there have only been nine fogging events," said Lana.

In fact, the Yogyakarta Health Office has allocated a budget of IDR 246 million for 125 times of fogging this year. Lana also said that her party had diverted around IDR 200 million from the budget for the need to control other diseases, namely tuberculosis.

Polemics

However, recently a polemic has emerged regarding thisWolbachiamosquito. The narrative that is developing generally states that these mosquitoes can bring potential danger to humans in the future.

Answering that, Adi Utarini explained that this technology research was carried out using the method with the highest validity, namely cluster randomized controlled trial. Research was also carried out in stages with strict scientific discipline over 12 years.

The release ofWolbachiamosquitoes began on a small scale in two hamlets in Sleman Regency and two hamlets in Bantul Regency, both in the DIY region, in 2014. The results of the research were then assessed for risks by an independent team formed Ministry of Research, Technology and Higher Education in 2016. The team consists of 24 people from a cross-section of expertise.

The team focuses on four main aspects, namely the risk to public health, vectors or mosquitoes, environmental concerns, and socio-humaniora. As a result, the team declares that the risk associated with this technology is very low, and within the next 30 years, the likelihood of an increase in danger can be disregarded.

KOMPAS/BAHANA PATRIA GUPTA

Jentik Surveillance Officer (Jumantik) personnel checked the water at a resident's house in Banyu Urip Village, Surabaya City, East Java on Friday (17/6/2022).

Based on the results of the risk assessment, a large-scale study was conducted in Yogyakarta City in 2016-2017. After proving to be effective, the research results were then submitted to the World Health Organization (WHO) which then provided recommendations in 2021.

"We also received a recommendation from the Indonesian Academy of Sciences (AIPI)," said Utarini.

He said, Wolbachia is not a modified or genetically engineered bacterium, but a natural bacterium. The research results also show that this bacteria cannot be transferred to other insects or humans. "This bacteria can only live in insect cells," he said.

Also read: ”Wolbachia” Technology Is Not the Result of Genetic Engineering

KOMPAS/MOHAMAD FINAL DAENG

Director of the Tropical Medicine Center at UGM, Riris Andono Ahmad, placed her hand on a box containing Aedes aegypti mosquitoes that have been infected with the Wolbachia bacteria at the UGM Center Building in Yogyakarta on Wednesday (22/11/2023).

Riris Andono Ahmad even proved to himself that mosquito bites are not dangerous. During a discussion at UGM, he brought a box containing 1,200 mosquitoes carryingWolbachia, then attached his arm to the box covered in mosquito netting.

Not long after, the mosquitoes swarmed around her arms to suck her blood. The activity of "feeding" these mosquitoes has become a routine for Riris and the technology researchers since 2011.

Riris also considers the current polemic to be a normal occurrence in any introduction of new technology. She cites the similar situation that occurred during the introduction of the Covid-19 vaccine during the previous pandemic. "This is indeed part of the dynamic of introducing new technology," she said.

Also read: "Wolbachia" Sued Again

This bacteria can only live in insect cells

KOMPAS/FERGANATA INDRA RIATMOKO

Vehicles pass by at sunset at the intersection of Tugu, Yogyakarta on Tuesday (19/9/2023).

Regarding the selection of Yogyakarta as the program location, Riris mentioned that one of the reasons is due to the dense population and high number of dengue fever cases in the city. The program can run effectively, both in terms of success and cost, in a city with such conditions.

Apart from that, other prerequisites were also met, namely ease of logistics, infrastructure and location close to the research center at UGM. Currently, the population of Aedes aegypti hasWolbachiastable at 80 percent in Yogyakarta. "The main key to the success of the program is being able to invite people to have this program," he said.

For Totok and other residents of Yogyakarta who have experienced it, this technology is indeed something to be grateful for. At least one major concern during the rainy season has now been eliminated.