Japanese Encephalitis among Patients with Acute Encephalitic Syndrome Admitted to a Tertiary Hospital in Chitwan, Nepal – A Prospective Observational Study

Autor: Rana Pramendra Vir Singh, Ami Neuberger, Lekh Jung Thapa, Sundar Twayana Ram, Ben Shofty, Eli Schwartz
Rok vydání: 2014
Předmět:
Male
Travel-Associated Diseases
Viral Diseases
Pediatrics
genetic structures
lcsh:Medicine
Geographical Locations
Tertiary Care Centers
Infectious Diseases of the Nervous System
Zoonoses
Epidemiology
Medicine and Health Sciences
Child
lcsh:Science
Aged
80 and over
Multidisciplinary
Incidence (epidemiology)
Vaccination
Middle Aged
Infectious Diseases
Veterinary Diseases
Child
Preschool
Encephalitis
Female
Research Article
Neglected Tropical Diseases
Adult
medicine.medical_specialty
Asia
Adolescent
Antibodies
Nepal
Japanese Encephalitis
medicine
Humans
Encephalitis
Japanese
Aged
business.industry
lcsh:R
Biology and Life Sciences
Infant
Japanese encephalitis
Tropical Diseases
medicine.disease
eye diseases
Vector-Borne Diseases
Emerging Infectious Diseases
People and Places
Veterinary Science
Immunization
lcsh:Q
Observational study
business
Zdroj: PLoS ONE, Vol 9, Iss 6, p e99999 (2014)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0099999
Popis: Introduction The reported incidence of JE among patients with acute encephalitic syndrome (AES) in Nepal ranges between 20% to 62%. In light of the lack of up-to-date data, we sought to describe the epidemiology of JE in Chitwan, Nepal. Methods A prospective observational study was conducted during 2010–2012 in the College of Medical Science in the Chitwan District. Patients with suspected JE were tested for anti-JE IgM in serum and cerebrospinal fluid (CSF). Results Of 227 all patients tested, 18 (7.9%) were found positive for JE. 17/202 (8.4%) patients with AES had JE. All, with the exception of two patients, were diagnosed on the basis of positive a serologic test, both in serum and CSF samples. Patients with JE were significantly older (42.1±27.6 years) than patients without JE (25.6±25.2 years, p = 0.02). Half of JE cases occurred in adults older than 50. More of the JE cases (11/18, 61.1%) occurred during the rainy season when compared to the JE negative patients [71/209, (34%), p = 0.01]. None of the JE patients had a relevant travel history, and one recalled having been immunized against JE. There was a variation in the geographic distribution of cases across the districts of the central Terai. Conclusions In this cohort, the proportion of patients with AES who had JE was lower than in previous studies. In addition, most patients were adults, and cases were not distributed uniformly across the central Terai region. The risk of acquiring JE by short-term travelers in the area is likely to be low. Vector-control programs and the promotion of mosquito avoidance behavior in the Terai region should continue. The high proportions of adults among patients with JE may suggest recent changes in the epidemiology of JE in the central Terai region, and routine immunization of all adults should be considered.
Databáze: OpenAIRE
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