TY - JOUR
T1 - Hospital-based surveillance for Japanese encephalitis in Bangladesh, 2007–2016
T2 - Implications for introduction of immunization
AU - Paul, Kishor Kumar
AU - Sazzad, Hossain M.S.
AU - Rahman, Mahmudur
AU - Sultana, Sharmin
AU - Hossain, M. Jahangir
AU - Ledermann, Jeremy P.
AU - Burns, Paul
AU - Friedman, Michael S.
AU - Flora, Meerjady S.
AU - Fischer, Marc
AU - Hills, Susan
AU - Luby, Stephen P.
AU - Gurley, Emily S.
N1 - Funding Information:
This work was supported by Centers for Disease Control and Prevention (CDC), USA [cooperative agreement no: 5U01CI000628]; this financial support was in part from a grant to CDC provided by The Bill & Melinda Gates Foundation (grant #OPPGH5333). In addition, the Government of Bangladesh, Canada, Sweden and the UK provided core/unrestricted funding support for this work.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/10
Y1 - 2020/10
N2 - Background: Japanese encephalitis (JE) virus is recognized as a major cause of encephalitis in Bangladesh. The World Health Organization (WHO) recommends human immunization as the most effective means to control JE. Several WHO-prequalified vaccines are available to prevent JE but no vaccination program has been implemented in Bangladesh. Methods: We conducted hospital-based surveillance for acute meningitis-encephalitis syndrome (AMES) to describe JE epidemiology and help inform policy decisions about possible immunization strategies for Bangladesh. Results: During 2007–2016, a total of 6543 AMES patients were identified at four tertiary hospitals. Of the 6525 patients tested, 548 (8%) were classified as JE cases. These 548 patients resided in 36 (56%) out of 64 districts of Bangladesh, with the highest proportion of JE cases among AMES patients (12% and 7%) presenting at two hospitals in the northwestern part of the country. The median age of JE cases was 30 years, and 193 (35%) were aged ≤15 years. The majority of JE cases (80%) were identified from July through November. Conclusions: Surveillance results suggest that JE continues to be an important cause of meningo-encephalitis in Bangladesh. Immunization strategies including JE vaccine introduction into the routine childhood immunization program or mass vaccination in certain age groups or geographic areas need to be examined, taking into consideration the cost-effectiveness ratio of the approach and potential for decreasing disease burden.
AB - Background: Japanese encephalitis (JE) virus is recognized as a major cause of encephalitis in Bangladesh. The World Health Organization (WHO) recommends human immunization as the most effective means to control JE. Several WHO-prequalified vaccines are available to prevent JE but no vaccination program has been implemented in Bangladesh. Methods: We conducted hospital-based surveillance for acute meningitis-encephalitis syndrome (AMES) to describe JE epidemiology and help inform policy decisions about possible immunization strategies for Bangladesh. Results: During 2007–2016, a total of 6543 AMES patients were identified at four tertiary hospitals. Of the 6525 patients tested, 548 (8%) were classified as JE cases. These 548 patients resided in 36 (56%) out of 64 districts of Bangladesh, with the highest proportion of JE cases among AMES patients (12% and 7%) presenting at two hospitals in the northwestern part of the country. The median age of JE cases was 30 years, and 193 (35%) were aged ≤15 years. The majority of JE cases (80%) were identified from July through November. Conclusions: Surveillance results suggest that JE continues to be an important cause of meningo-encephalitis in Bangladesh. Immunization strategies including JE vaccine introduction into the routine childhood immunization program or mass vaccination in certain age groups or geographic areas need to be examined, taking into consideration the cost-effectiveness ratio of the approach and potential for decreasing disease burden.
KW - Causes of encephalitis
KW - Hospital-based surveillance
KW - Japanese encephalitis
KW - Vaccination
KW - Vaccine-preventable disease
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U2 - 10.1016/j.ijid.2020.07.026
DO - 10.1016/j.ijid.2020.07.026
M3 - Article
C2 - 32721530
AN - SCOPUS:85089493592
VL - 99
SP - 69
EP - 74
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -