| Autor: |
Horwood PF; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Duong V; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Laurent D; Kantha Bopha Hospital, Phnom Penh 12000, Cambodia., Mey C; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Sothy H; Kantha Bopha Hospital, Phnom Penh 12000, Cambodia., Santy K; Kantha Bopha Hospital, Phnom Penh 12000, Cambodia., Richner B; Kantha Bopha Hospital, Phnom Penh 12000, Cambodia., Heng S; Medical Laboratory, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Hem S; Medical Laboratory, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Cheval J; PathoQuest SAS, Paris 75013, France., Gorman C; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Dussart P; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., de Jong MD; Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam 1012, The Netherlands., Kerleguer A; Medical Laboratory, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Guillard B; Medical Laboratory, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Murgue B; World Health Organization, Geneva 1211, Switzerland., Lecuit M; Biology of Infection Unit, Institut Pasteur, Inserm U1117, Paris 75015, France., de Lamballerie X; Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, Marseille 35043, France., Farrar JJ; Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City P1Q5, Vietnam., Tarantola A; Epidemiology &Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia., Eloit M; PathoQuest SAS, Paris 75013, France.; Biology of Infection Unit, Institut Pasteur, Inserm U1117, Paris 75015, France., Buchy P; Virology Unit, Institut Pasteur in Cambodia, Phnom Penh 12000, Cambodia.; GlaxoSmithKline Vaccines Asia-Pacific, Singapore 189720, Singapore. |
| Abstrakt: |
Acute meningoencephalitis (AME) is associated with considerable morbidity and mortality in children in developing countries. Clinical specimens were collected from children presenting with AME at two Cambodian paediatric hospitals to determine the major aetiologies associated with AME in the country. Cerebrospinal fluid (CSF) and blood samples were screened by molecular and cell culture methods for a range of pathogens previously associated with AME in the region. CSF and serum (acute and convalescent) were screened for antibodies to arboviruses such as Japanese encephalitis virus (JEV), dengue virus (DENV), and chikungunya virus (CHIKV). From July 2010 through December 2013, 1160 children (one month to 15 years of age) presenting with AME to two major paediatric hospitals were enroled into the study. Pathogens associated with AME were identified using molecular diagnostics, cell culture and serology. According to a diagnostic algorithm, a confirmed or highly probable aetiologic agent was detected in 35.0% (n=406) of AME cases, with a further 9.2% (total: 44.2%, n=513) aetiologies defined as suspected. JEV (24.4%, n=283) was the most commonly identified pathogen followed by Orientia tsutsugamushi (4.7%, n=55), DENV (4.6%, n=53), enteroviruses (3.5%, n=41), CHIKV (2.0%, n=23) and Streptococcus pneumoniae (1.6%, n=19). The majority of aetiologies identified for paediatric AME in Cambodia were vaccine preventable and/or treatable with appropriate antimicrobials. |
