Vector Competence of Aedes aegypti and Aedes albopictus for the Four Dengue Virus Serotypes: A Global Systematic Review and Meta-Analysis of the Infection-Dissemination-Transmission Cascade
Aedes aegypti and Aedes albopictus differ in their capacity to acquire, amplify and transmit dengue virus (DENV), yet quantitative summaries of this capacity across all four serotypes and across the successive internal barriers of the mosquito are lacking. We synthesised global experimental evidence on the infection–dissemination–transmission cascade. We systematically reviewed experimental oral-challenge studies reporting infection, dissemination or transmission rates for Ae. aegypti or Ae. albopictus and any DENV serotype. Each unique study × population × serotype combination formed one analytical record. Proportions were pooled by random-effects meta-analysis using a binomial–normal generalised linear mixed model on the logit scale, stratified by species × serotype and by species × world region; subgroups with fewer than three independent studies were not pooled. Progression across barriers and the influence of days post-infection were examined with rank correlations, with a prespecified sensitivity analysis on the full pre-deduplication dataset. 157 analytical records from 68 studies conducted in 39 countries (1992–2025) were eligible. Pooled infection rates were highest for Ae. aegypti with DENV-1 (72.2%, 95% CI 58.4–82.7) and lowest for Ae. albopictus with DENV-3 (15.4%, 95% CI 2.7–54.3), spanning 47.2–72.2% for Ae. aegypti and 15.4–57.3% for Ae. albopictus. Transmission was uniformly the lowest tier, peaking at 29.0% (95% CI 8.7–63.6) for Ae. albopictus with DENV-1. Regional pooled estimates varied more than twofold within species. Infection predicted dissemination (ρ = 0.35, P < 0.001) and dissemination predicted transmission only weakly (ρ = 0.30, P = 0.044), whereas infection was unrelated to transmission (ρ = −0.07, P = 0.670). Transmission rose with days post-infection (ρ = 0.38, P = 0.007), from a median of 0% at ≤7 days to 29–30% at 15–21 days. Heterogeneity was substantial (I² 17.8–96.0%, median 83.3%). Ae. aegypti is the more competent vector for most serotype–region combinations, but Ae. albopictus attains comparable or higher transmission for DENV-1 and in parts of Asia, and cannot be treated as epidemiologically negligible. Efficient midgut infection does not predict onward transmission: the salivary-gland barrier, not virus acquisition, is the decisive constraint. Transmission-based endpoints measured at biologically appropriate incubation times should therefore replace infection-based proxies in risk assessment, and the wide heterogeneity observed underscores an urgent need for standardised vector-competence protocols and reporting.