Viruses transmitted by Aedes mosquitoes, such as dengue, Zika, and chikungunya, have expanding ranges and seem unabated by current vector control programs. Effective control of these pathogens likely requires integrated approaches. We evaluated dengue management options in an endemic setting that combine novel vector control and vaccination using an agent-based model for Yucatán, Mexico, fit to 37 y of data. Our intervention models are informed by targeted indoor residual spraying (TIRS) experiments; trial outcomes and World Health Organization (WHO) testing guidance for the only licensed dengue vaccine, CYD-TDV; and preliminary results for in-development vaccines. We evaluated several implementation options, including varying coverage levels; staggered introductions; and a one-time, large-scale vaccination campaign. We found that CYD-TDV and TIRS interfere: while the combination outperforms either alone, performance is lower than estimated from their separate benefits. The conventional model hypothesized for in-development vaccines, however, performs synergistically with TIRS, amplifying effectiveness well beyond their independent impacts. If the preliminary performance by either of the in-development vaccines is upheld, a one-time, large-scale campaign followed by routine vaccination alongside aggressive new vector control could enable short-term elimination, with nearly all cases avoided for a decade despite continuous dengue reintroductions. If elimination is impracticable due to resource limitations, less ambitious implementations of this combination still produce amplified, longer-lasting effectiveness over single-approach interventions.

中文翻译：

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通过综合干预措施设计有效控制登革热。

由伊蚊传播的病毒，如登革热、寨卡病毒和基孔肯雅热，其范围不断扩大，而且目前的病媒控制计划似乎并未减弱这种病毒。有效控制这些病原体可能需要综合方法。我们使用墨西哥尤卡坦州基于代理的模型评估了登革热流行环境下的登革热管理方案，该方案结合了新型病媒控制和疫苗接种，符合 37 年的数据。我们的干预模型以有针对性的室内滞留喷洒（TIRS）实验为基础；唯一获得许可的登革热疫苗 CYD-TDV 的试验结果和世界卫生组织 (WHO) 测试指南；以及正在开发的疫苗的初步结果。我们评估了几种实施方案，包括不同的覆盖水平；交错介绍；以及一次性大规模疫苗接种活动。我们发现 CYD-TDV 和 TIRS 会产生干扰：虽然组合的性能优于单独的任何一个，但性能低于根据其单独的优势估计的性能。然而，针对正在开发的疫苗假设的传统模型与 TIRS 具有协同作用，其有效性远远超出了它们的独立影响。如果任何一种正在开发的疫苗的初步性能得到维持，那么一次性的大规模运动，然后是常规疫苗接种以及积极的新病媒控制，可能会在短期内消除，尽管连续十年内几乎所有病例都可以避免登革热重新引入。如果由于资源限制而无法消除，那么与单一方法干预措施相比，不太雄心勃勃的组合实施仍会产生更大、更持久的效果。