1. Introduction
Malaria is a febrile illness caused by several species of
Plasmodium protozoan parasites and transmitted by the bite of an infected female
Anopheles (An.) mosquito [
1]. Falciparum malaria is a leading cause of death globally and the most lethal of the five known species of
Plasmodium that can infect humans [
2]. Current efforts to control malaria typically focus on strengthening surveillance, administering seasonal malaria chemoprophylaxis, or reducing mosquito populations, through means such as distributing insecticide-treated bed nets, implementing larval control, and conducting indoor residual spraying [
3]. Due to increasing insecticide resistance, the impact of climate change, and other environmental factors on mosquito breeding and feeding behavior, more sustainable and effective mitigation strategies will be needed.
Wolbachia pipientis is a Gram-negative, intracellular endosymbiotic bacterium that naturally infects over 75% of all arthropods [
4,
5], including mosquitoes that spread human diseases. Transinfection of
Aedes spp. mosquitoes is shown to be effective at controlling dengue fever, chikungunya, and Zika virus transmission. Recently, evidence has suggested that similar approaches can control the spread of
P. falciparum malaria [
6,
7,
8].
Mathematical models have been a great tool to understand infectious disease dynamics and predict mitigation efforts, as they provide an analytical framework to describe and characterize the complex interactions between counterparts in systems. We aim to use our modeling tool to characterize the establishment of
Wolbachia among the mosquito population as mosquito controls and inform various aspects of designing an effective
Wolbachia release trial.
Wolbachia has been used as both a
population suppression strategy and
population replacement strategy (
Table 1), and our modeling work focuses on scenarios related to the population replacement strategy.
The population suppression strategy involves releasing infected males only. The
Wolbachia-induced cytoplasmic incompatibility (CI) phenomenon provides an alternative approach similar to adulticide. The sustainability issue and the accidental release of infected females may undermine the process [
9,
10].
The population replacement strategy involves releasing both male and female infected mosquitoes into the field [
11,
12]. Infecting
Anopheles mosquitoes with
wMelPop and
wAlbB strains of
Wolbachia show a reduction in
P. falciparum sporozoite and oocyst levels in specific species (
Table 2) [
7], and
Wolbachia-infected
Anopheles mosquitoes are less effective in transmitting the parasite. These antipathogenic traits can be passed to offspring since
Wolbachia exhibits high rates of maternal transmission in both
Aedes and
Anopheles spp. mosquitoes [
4,
6,
13]. This leads to a population replacement strategy, where instead of removing the wild mosquitoes, the goal is to infect mosquitoes with
Wolbachia and replace the wild mosquito population with the infected ones that can no longer transmit the malaria parasite. Field studies show that the population replacement strategy can be a more sustainable approach [
14,
15]. For our modeling study, we base our parameterizations on the
wAlbB strain, which exhibits perfect maternal transmission in
An. stephensi [
6,
13].
The existing mathematical models for studying the
Wolbachia infection in mosquitoes primarily focus on arboviruses spread by
Aedes spp. mosquitoes. Xue et al. [
22] compared the impact of infecting
Aedes aegypti and
Aedes albopictus mosquitoes with
wAlbB and
wMel in reducing the transmission of dengue, chikungunya, and Zika viruses. This study analyzed a system of seven ordinary differential equations (ODEs) that accounted for the reduced fitness of
Wolbachia-infected mosquitoes, reduced transmissibility of infected mosquitoes, and behavior changes of infected humans caused by disease. This model was based on previous studies that modeled the potential of establishing
Wolbachia in wild
Aedes mosquitoes [
23,
24,
25] and incorporated a series of two-sex compartmental models for
Wolbachia transmission in
Aedes mosquitoes. These models quantify the effectiveness of different approaches to ensure the sustained transmission of
Wolbachia within wild
Aedes mosquitoes.
Our current modeling work is motivated by Qu et al. [
23] but with several key differences. We subdivide the mosquito aquatic stage into the egg and larval/pupae stages to emphasize the potential impact of the environment. We also eliminate the impregnated mosquito compartments by assuming the impregnation time is relatively short compared to the lifespan of mosquitoes. Similar to previous studies, we identify a threshold condition for
Wolbachia replacement, which requires a minimum infection of 34% to be achieved among mosquitoes. In addition, we consider the impact of incorporating malaria-specific interventions before
Wolbachia releases to accelerate establishing
Wolbachia infection among mosquitoes. Lastly, we study how the seasonal variation in the environment may impact the deployment of the
Wolbachia population. Based on the remote sensing data from Grand Anse, Haiti, our model suggests that releasing infection right before the dry season is more efficient.
After defining our compartmental ODE model (
Section 2.1), we analyze the model by introducing the next-generation numbers,
and
, for the uninfected and infected mosquito populations (
Section 2.2.1). We derive the reproductive number,
, for the spread of
Wolbachia in the mosquito population and illustrate how
can be interpreted in terms of the next-generation numbers (
Section 2.2.2). We then compare different release scenarios and investigate the effect of concurrent malaria vector control interventions and the impact of seasonality (
Section 3).
3. Results
Our numerical simulations aimed to provide qualitative insights for designing optimal release strategies to establish a stable Wolbachia infection in mosquito populations. We compared prerelease larvicide and thermal fogging, releasing multiple batches of Wolbachia mosquitoes, and the time of year for the release.
3.1. Sensitivity Analysis
We quantified the significance of the parameters in the model predictions using a local sensitivity analysis. This helped us better understand our model when parameters were changed.
We used the normalized relative sensitivity index of a quantity of interest (QOI), , with respect to a parameter of interest (POI), p, defined as . This index measured the percentage change in the QOI given the percentage change in the input POI. In other words, if parameter p changed by , then q would change by . The sign determined the decreasing or increasing behavior of the quantity. We evaluated the index at the baseline parameter values to obtain the local sensitivity index.
We considered three different QOIs concerning the establishment of
Wolbachia infection: the reproductive number
; the threshold of infection in females, which corresponded to the unstable equilibrium indicated in the bifurcation diagram of
Figure 2; and the establishment time, measured as the time to achieve
infection for a particular release setting of interest (
Figure 3, with prerelease mitigation and released in five batches).
The sensitivity indices were ranked by magnitude (importance) for the QOI = threshold case in
Table 4. Following this criterion, the maternal transmission rate
was the most sensitive parameter among all the selected POIs. In addition, the egg-laying rates (
and
) and the adult mosquito lifespans of females (
and
) also had a significant sensitivity with respect to the QOIs. That is, the parameters related to the reproduction and CI of mosquitoes were critical to both the threshold and the speed of establishing a sustained
Wolbachia infection.
Conversely, parameters involved in the survival of eggs, such as the egg lifespans ( and ) and their hatching rate , were less sensitive in the three QOIs studied. Furthermore, due to the assumption , the adult male lifespans ( and ) did not represent an impact in and the threshold condition. Instead, they played a relevant role in the time to establish a sustained infection once infection exceeded the threshold.
We also simultaneously perturbed all the adult death rates , , , and . This simulated a change in the global environment that affected both infected and uninfected mosquitoes. As indicated by the column, this change did not have a significant impact on and the threshold. This can be understood by checking the individual sensitivity indices for and , the perturbation of which gave the same amount of change in opposite directions. Thus, the simultaneous change neutralized the impact and did not affect the competition outcome. Meanwhile, the change did delay the establishment process, as the infected cohort () had a larger impact on the establishment time.
3.2. Compare Prerelease Mitigation Strategies
To reduce the number of infected mosquitoes released and more efficiently establish a stable Wolbachia infection, integrated control strategies are often implemented to reduce the wild mosquito population before releasing the infected mosquitoes. We evaluated the establishment of Wolbachia when combining prerelease mitigation approaches, including larviciding and thermal fogging. Not all of those strategies are primary vector control interventions in Haiti. Nevertheless, our results can inform the potential effectiveness should such interventions become prevalent in the area.
Larviciding treats mosquito breeding sites with bacterial or chemical insecticides to kill the aquatic stage of mosquitoes. Field studies of bacterial larvicide products, targeting
Anopheles larval habitats, report a larval reduction between 47% and 100% [
28]. Our model simulated a range of mitigation efficacy (in reducing population) from a more challenging setting of 0.2 to a high efficacy of 0.6.
Space spraying or
thermal fogging refers to dispersing a liquid fog of insecticide into an outdoor area to kill adult insects. The insecticide may be delivered using hand-held, vehicle-mounted, or aircraft-mounted equipment [
29]. The impact of fogging as a malaria vector control intervention for reducing adult
Anopheles mosquitoes fluctuates between 50∼100% [
30], and we evaluated the impact of thermal fogging for a moderate range of efficacy, where the mitigation efficacy varied from 0.2∼0.6.
As summarized in
Table 5, starting from the baseline DFE state, we simulated the prerelease mitigation (column 1) at different intensities by adjusting the DFE according to the mitigation efficacy at the targeting stage(s) (columns 2–3). We assumed that the prerelease mitigations only impacted the wild mosquitoes and not the released infected mosquitoes. We then released an equal number of infected males and females, and we identified the threshold quantity (needed for establishing the
Wolbachia endemic state) without a time limit (column 4) and with a time limit of two months (column 5). The release size was quantified using the
release factor, which is the ratio between the number of released mosquitoes and the number of females at DFE, i.e.,
in Equation (
6).
With prerelease mitigation, a larger mitigation efficacy reduced the release factor for both thermal fogging and larviciding. This was expected since the threshold was determined by the competition (or ratio) between the infected and uninfected cohorts. Fewer infected mosquitoes were needed to match the competition if there were fewer uninfected mosquitoes in the field.
Under the same release size, prerelease mitigation helped to speed up the establishment of the
Wolbachia endemic equilibrium (
Figure 3). We also saw that thermal fogging required a slightly smaller release size than larviciding under the same intervention intensity. When applying two interventions together, it outperformed the individual case as expected. When releasing just above the threshold, it may take a long time to establish a
Wolbachia endemic state. The identified threshold value may not be practical due to various model assumptions, such as seasonality. When imposing a two-month time limit, many more infected mosquitoes must be released. Such a large release size may not be practical for field trial implementation; thus, we study the multiple-release strategy next.
Figure 3.
Simulations for different release scenarios. The left figure displays the mosquito populations for a single release of infected mosquitoes when there is no prerelease mitigation. The middle and right figures compare releasing all the mosquitoes in a single release and in multiple batches when there is prerelease mitigation. An equal number of infected male and female mosquitoes are released (release size = 2, relative to baseline female population size at DFE) without or with prerelease mitigation (reduced to 40% in both larvae and adults using hybrid fogging and larviciding, see
Table 5). The black line is the percent of infected mosquitoes that are infected as they are released in one batch or multiple batches. The
Wolbachia endemic state is established, and the infection reaches
infection around 143, 85, and 109 days after the initial release.
Figure 3.
Simulations for different release scenarios. The left figure displays the mosquito populations for a single release of infected mosquitoes when there is no prerelease mitigation. The middle and right figures compare releasing all the mosquitoes in a single release and in multiple batches when there is prerelease mitigation. An equal number of infected male and female mosquitoes are released (release size = 2, relative to baseline female population size at DFE) without or with prerelease mitigation (reduced to 40% in both larvae and adults using hybrid fogging and larviciding, see
Table 5). The black line is the percent of infected mosquitoes that are infected as they are released in one batch or multiple batches. The
Wolbachia endemic state is established, and the infection reaches
infection around 143, 85, and 109 days after the initial release.
3.3. Multiple Releases
Field trials often require periodic releases of batches of infected mosquitoes. We aimed to inform an optimal design of a multiple release strategy. We considered a certain number of mosquitoes (release size) split into multiple batches (release batches) released over two months. We assumed all the releases had the same number of infected mosquitoes. That is, each batch of released mosquitoes was the total release size divided by the number of batches, and they were released at regular time intervals. In
Figure 4, we plotted the time to achieve 90% infection when using different numbers of release batches and total release sizes, and we studied how the establishment time was impacted when using the prerelease mitigation.
For both scenarios, using a larger release size always helped to speed up the establishment of
Wolbachia infection for both release scenarios. Without prerelease mitigation (
Figure 4a), the optimal multiple-release strategy left about a two-week gap (four or five batches within two months) between two consecutive releases. The benefit of such a release gap was more significant as the overall release size increased. The necessity of the release gap resulted from the limited environmental resources available (carrying capacity). Releasing all the infections at once may not be as optimal as splitting the release into multiple batches due to the higher penalization from the carrying capacity. Nonetheless, using too many batches decreased the invasion efficiency.
On the other hand, when there was prerelease mitigation (
Figure 4b), it created a gap in the carrying capacity. This gap provided an opportunity for instant population replacement by the infected cohort. Thus, releasing infected mosquitoes all at once was more efficient than splitting the release of infection in batches.
3.4. Seasonality
Environmental and climactic covariates, such as rainfall and temperature, affect all the stages of the mosquito life cycle. They impact the density and distribution of vector breeding sites, the number of eggs laid, the ability of larvae to emerge from eggs once they are laid (hatching or emergence rate), and the adult mosquito lifespan. Regional carrying capacity is also affected as this parameter is directly influenced by the number of available vector breeding and egg-laying sites. It is important to account for those seasonality effects by adjusting parameters as these values influence the ability to achieve endemic, stable wAlbB transmission among the mosquito population.
We extracted the Climate Hazards Group InfraRed Precipitation with Station (CHIRPS) monthly data for the department of Grand Anse [
31] in Haiti, where most of the country’s malaria transmission occurs. In particular, we considered the seasonality pattern based on the rainfall, humidity, and temperature data. We include a summary of the data we used in
Table A1.
The monthly rainfall data suggested a bimodal seasonal pattern with the peak rainfall in May and September (
Figure A1). Therefore, we adapted our model to a time-dependent carrying capacity,
, which varied according to a fitted seasonality curve based on the rainfall data. We also simulated release scenarios starting in the dry or rainy season. There was a similar seasonal trend in the humidity data (
Figure A1), measured by the aridity index, with most of the year classified as humid. We captured the impact of humidity by using the same time-varying carrying capacity curve above, and we assumed that it did not impact other life traits of mosquitoes.
The monthly temperature data ranged from 25.7 to 29.8 degrees Celsius (78.2 to 85.7 degrees Fahrenheit). Temperature can influence egg laying rates, larval emergence rates, and adult mosquito lifespan; however, mean monthly temperature in our region of focus did not vary enough to influence rates for these parameters in our model [
32,
33].
We aimed to study the seasonality’s impact on field releases’ efficacy in establishing a
Wolbachia infection. For this purpose, we considered releasing an equal number of female and male infected mosquitoes with a release factor of one (as defined in
Table 5), relative to the uninfected female population at the DFE on day 1 of the year, i.e.,
). In addition, the total quantity was released in five batches.
Under the above setting, our simulation results suggested that it was more efficient to establish
Wolbachia during the dry season. Releasing infection during the dry season (
Figure 5a) required releasing fewer infected mosquitoes to exceed the threshold. In contrast, when releasing the same number of mosquitoes during the wet season (
Figure 5b), the infection failed to establish itself due to the abundance of wild mosquitoes (higher carrying capacity).
4. Discussion and Conclusions
We developed and analyzed a compartmental ODE model to describe the establishment of Wolbachia infection in wild Anopheles mosquitoes. The model tracked male and female mosquitoes through the egg, larval, and adult stages. The model accounted for maternal transmission of Wolbachia, cytoplasmic incompatibility, and fitness cost induced from Wolbachia infection. Moreover, we incorporated carrying capacity constraints on mosquito population size to study the impact of seasonality, specific to Haiti.
Our model presented a similar analytical behavior to other
Wolbachia models with similar modeling structures. The basic reproductive number
was derived and written as the ratio of the two next-generation numbers [
23,
24,
25],
and
, which corresponded to the number of new offspring reproduced per generation for the uninfected and infected mosquitoes. The stability analysis of the model gave a backward bifurcation, where an unstable endemic equilibrium separated a disease-free equilibrium and a stable complete-infection equilibrium. This was also observed in previous
Wolbachia modeling studies [
23,
24,
25,
34,
35] as well as in epidemic models for different diseases [
36]. The bistability of the system identified a threshold infection rate that needed to be exceeded to establish a stable
Wolbachia infection. This observation supports what has been reported in field trials [
12] and mosquito cage experiments [
37].
Our numerical simulations on
Wolbachia releases with prerelease mitigations showed that the prerelease mitigations reduced the number of infected mosquitoes needed to exceed the threshold condition and accelerated the establishment of
Wolbachia infection. In particular, we analyzed baseline mitigation strategies using larviciding and thermal fogging to reduce the wild mosquito population. These approaches do not reflect all the current interventions in Haiti [
38], such as insecticide-treated nets [
39], which require coupling the current mosquito model with human hosts. These need to be considered in future studies when estimating the impact of the
Wolbachia-based strategy on malaria transmission among human populations.
We also numerically investigated the impact of seasonality by varying the mosquito population’s carrying capacity. Our simulation results indicated that releasing
Wolbachia-infected mosquitoes in the dry season was more effective than in the wet season when fewer uninfected mosquitoes were in the wild for competition. This observation agrees with a previous statistical study [
40] as well as a field study [
41]. We note that mathematical models simplify field conditions, and this conclusion (and many others) depends on our model parametrizations. While incorporating seasonality by only varying carrying capacity is an appropriate approximation for Haiti’s mild variation in temperature and humidity, a more complex model would be necessary for studying locations where seasonality is more prominent.
As in many modeling studies, there are major model limitations related to parametrization. First, our modeling results are only valid for the
wAlbB strain of
Wolbachia, and we assumed perfect maternal transmission and
Wolbachia-induced CI. Parameter values would differ for other strains where these two assumptions do not hold. Moreover, the sparse publication of parameter values for
Wolbachia-infection in African
Anopheles vectors results in large uncertainties in our parameter estimates. Most of our baseline parameters were based on Joshi et al. [
6], which characterized the life parameters of the mosquitoes in an ideal lab setting. We employed a sensitivity analysis to identify sensitive parameters for various quantities related to the
Wolbachia establishment. We found that the maternal transmission rate was the most sensitive parameter to all the quantities considered. The other sensitive parameters included egg-laying rates and the lifespans of adult females. Thus, additional studies from lab and field settings on these parameters for both infected and uninfected cohorts will reduce the potential bias in our conclusions.
Our ODE model assumed that the fraction of infection among mosquitoes was homogeneous in space. However, this may not hold in field settings, especially when modeling a local release of infected mosquitoes. Therefore, it is essential to include the impact of spatial dynamics to determine the threshold condition for field releases. We are developing a partial differential equation (PDE) model to study the invasion dynamics of
Wolbachia infection among mosquitoes in a more realistic field setting. This reaction–diffusion-type model accounts for complex maternal transmission and spatial mosquito dispersion. Our initial studies identified an optimal bubble-shaped distribution to minimize the number of mosquitoes needed to exceed the threshold conditions [
42].