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A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia

BACKGROUND: Japanese encephalitis (JE) is presumed to be endemic throughout Asia, yet only a few cases have been reported in tropical Asian countries such as Indonesia, Malaysia and the Philippines. To estimate the true disease burden due to JE in this region, we conducted a prospective, hospital-ba...

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Autores principales: Kari, Komang, Liu, Wei, Gautama, Kompiang, Mammen, Mammen P, Clemens, John D, Nisalak, Ananda, Subrata, Ketut, Kim, Hyei Kyung, Xu, Zhi-Yi
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1481508/
https://www.ncbi.nlm.nih.gov/pubmed/16603053
http://dx.doi.org/10.1186/1741-7015-4-8
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author Kari, Komang
Liu, Wei
Gautama, Kompiang
Mammen, Mammen P
Clemens, John D
Nisalak, Ananda
Subrata, Ketut
Kim, Hyei Kyung
Xu, Zhi-Yi
author_facet Kari, Komang
Liu, Wei
Gautama, Kompiang
Mammen, Mammen P
Clemens, John D
Nisalak, Ananda
Subrata, Ketut
Kim, Hyei Kyung
Xu, Zhi-Yi
author_sort Kari, Komang
collection PubMed
description BACKGROUND: Japanese encephalitis (JE) is presumed to be endemic throughout Asia, yet only a few cases have been reported in tropical Asian countries such as Indonesia, Malaysia and the Philippines. To estimate the true disease burden due to JE in this region, we conducted a prospective, hospital-based surveillance with a catchment population of 599,120 children less than 12 years of age in Bali, Indonesia, from July 2001 through December 2003. METHODS: Balinese children presenting to any health care facility with acute viral encephalitis or aseptic meningitis were enrolled. A "confirmed" diagnosis of JE required the detection of JE virus (JEV)-specific IgM in cerebrospinal fluid, whereas a diagnosis of "probable JE" was assigned to those cases in which JEV-specific IgM was detected only in serum. RESULTS: In all, 86 confirmed and 4 probable JE cases were identified. The annualized JE incidence rate was 7.1 and adjusted to 8.2 per 100,000 for children less than 10 years of age over the 2.5 consecutive years of study. Only one JE case was found among 96,920 children 10–11 years old (0.4 per 100,000). Nine children (10%) died and 33 (37%) of the survivors had neurological sequelae at discharge. JEV was transmitted in Bali year-round with 70% of cases in the rainy season. CONCLUSION: JE incidence and case-fatality rates in Bali were comparable to those of other JE-endemic countries of Asia. Our findings contradict the common wisdom that JE is rare in tropical Asia. Hence, the geographical range of endemic JE is broader than previously described. The results of the study support the need to introduce JE vaccination into Bali.
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spelling pubmed-14815082006-06-22 A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia Kari, Komang Liu, Wei Gautama, Kompiang Mammen, Mammen P Clemens, John D Nisalak, Ananda Subrata, Ketut Kim, Hyei Kyung Xu, Zhi-Yi BMC Med Research Article BACKGROUND: Japanese encephalitis (JE) is presumed to be endemic throughout Asia, yet only a few cases have been reported in tropical Asian countries such as Indonesia, Malaysia and the Philippines. To estimate the true disease burden due to JE in this region, we conducted a prospective, hospital-based surveillance with a catchment population of 599,120 children less than 12 years of age in Bali, Indonesia, from July 2001 through December 2003. METHODS: Balinese children presenting to any health care facility with acute viral encephalitis or aseptic meningitis were enrolled. A "confirmed" diagnosis of JE required the detection of JE virus (JEV)-specific IgM in cerebrospinal fluid, whereas a diagnosis of "probable JE" was assigned to those cases in which JEV-specific IgM was detected only in serum. RESULTS: In all, 86 confirmed and 4 probable JE cases were identified. The annualized JE incidence rate was 7.1 and adjusted to 8.2 per 100,000 for children less than 10 years of age over the 2.5 consecutive years of study. Only one JE case was found among 96,920 children 10–11 years old (0.4 per 100,000). Nine children (10%) died and 33 (37%) of the survivors had neurological sequelae at discharge. JEV was transmitted in Bali year-round with 70% of cases in the rainy season. CONCLUSION: JE incidence and case-fatality rates in Bali were comparable to those of other JE-endemic countries of Asia. Our findings contradict the common wisdom that JE is rare in tropical Asia. Hence, the geographical range of endemic JE is broader than previously described. The results of the study support the need to introduce JE vaccination into Bali. BioMed Central 2006-04-07 /pmc/articles/PMC1481508/ /pubmed/16603053 http://dx.doi.org/10.1186/1741-7015-4-8 Text en Copyright © 2006 Kari et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kari, Komang
Liu, Wei
Gautama, Kompiang
Mammen, Mammen P
Clemens, John D
Nisalak, Ananda
Subrata, Ketut
Kim, Hyei Kyung
Xu, Zhi-Yi
A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title_full A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title_fullStr A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title_full_unstemmed A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title_short A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia
title_sort hospital-based surveillance for japanese encephalitis in bali, indonesia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1481508/
https://www.ncbi.nlm.nih.gov/pubmed/16603053
http://dx.doi.org/10.1186/1741-7015-4-8
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