Identifying sources, pathways and risk drivers in ecosystems of Japanese Encephalitis in an epidemic-prone north Indian district

Autor: Pranab Chatterjee, Sanjay Chaturvedi, Vidya Venkataramanan, Manish Kakkar, Ashok Kumar, Vijay Kumar Saxena, Elizabeth T. Rogawski, Syed Shahid Abbas, Tapan N. Dhole
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Culex vishnui
Male
Multivariate analysis
Cross-sectional study
Swine
Physiology
Indoor residual spraying
lcsh:Medicine
Disease Vectors
Antibodies
Viral
Mosquitoes
Geographical Locations
Families
0302 clinical medicine
Environmental protection
Risk Factors
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Child
Children
Mammals
Encephalitis Virus
Japanese
Multidisciplinary
biology
Vaccination and Immunization
Body Fluids
Vaccination
Insects
Infectious Diseases
Blood
Child
Preschool
Vertebrates
Female
Anatomy
Encephalitis
Research Article
Asia
Arthropoda
Infectious Disease Control
Adolescent
030231 tropical medicine
Immunology
India
Enzyme-Linked Immunosorbent Assay
03 medical and health sciences
Young Adult
Environmental health
medicine
Animals
Humans
Encephalitis
Japanese
Ecosystem
business.industry
lcsh:R
Organisms
Outbreak
Biology and Life Sciences
Infant
Japanese encephalitis
medicine.disease
biology.organism_classification
Invertebrates
Insect Vectors
Vector-Borne Diseases
Species Interactions
Cross-Sectional Studies
Culicidae
Immunoglobulin M
Age Groups
Immunoglobulin G
Amniotes
People and Places
lcsh:Q
Population Groupings
Preventive Medicine
business
Chickens
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 5, p e0175745 (2017)
ISSN: 1932-6203
Popis: Japanese Encephalitis (JE) has caused repeated outbreaks in endemic pockets of India. This study was conducted in Kushinagar, a highly endemic district, to understand the human-animal-ecosystem interactions, and the drivers that influence disease transmission. Utilizing the ecosystems approach, a cross-sectional, descriptive study, employing mixed methods design was employed. Four villages (two with pig-rearing and two without) were randomly selected from a high, a medium and a low burden (based on case counts) block of Kushinagar. Children, pigs and vectors were sampled from these villages. A qualitative arm was incorporated to explain the findings from the quantitative surveys. All human serum samples were screened for JE-specific IgM using MAC ELISA and negative samples for JE RNA by rRT-PCR in peripheral blood mononuclear cells. In pigs, IgG ELISA and rRT-PCR for viral RNA were used. Of the 242 children tested, 24 tested positive by either rRT-PCR or MAC ELISA; in pigs, 38 out of the 51 pigs were positive. Of the known vectors, Culex vishnui was most commonly isolated across all biotopes. Analysis of 15 blood meals revealed human blood in 10 samples. Univariable analysis showed that gender, religion, lack of indoor residual spraying of insecticides in the past year, indoor vector density (all species), and not being vaccinated against JE in children were significantly associated with JE positivity. In multivariate analysis, only male gender remained as a significant risk factor. Based on previous estimates of symptomatic: asymptomatic cases of JE, we estimate that there should have been 618 cases from Kushinagar, although only 139 were reported. Vaccination of children and vector control measures emerged as major control activities; they had very poor coverage in the studied villages. In addition, lack of awareness about the cause of JE, lack of faith in the conventional medical healthcare system and multiple referral levels causing delay in diagnosis and treatment emerged as factors likely to result in adverse clinical outcomes.
Databáze: OpenAIRE
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