Dengue vector control in Malaysia: Are we moving in the right direction?

Dengue is a major public health problem across more than 123 countries. Vector control has been the hallmark of the dengue control programme in many countries in Southeast Asia since there are no anti-dengue drugs available, and the most recent dengue vaccine is partly efficacious. House-to-house larval surveys, source reduction, larviciding, fogging, ULV which have been carried out since the inception of the dengue control programme in the 1970s are no longer practicable and need to be augmented by more targeted but less ambitious outbreak responses that focus on a few tools that might justify expense of deployment. However, according to recent reports these tools have not really been evaluated for their effectiveness in dengue control. Novel techniques such the release of genetically modified mosquitoes (RIDL) and the use of the bacterium Wolbachia to control the populations of the Ae. aegypti are still under trial. In this review proactive methods to detect epidemics have been suggested. Tools based on adult mosquitoes is an important strategy for dengue vector surveillance and control. The outbreak response may be more efficient when timely vector control measures are implemented after the immediate detection of an infected mosquito.