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Long-Term Outcomes in Children Surviving Tropical Arboviral Encephalitis: A Systematic Review
Christal Chow1, Walter Dehority2
1Division of Infectious Diseases, Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM 87131-0001, USA.
Journal of Tropical Pediatrics
|June 10, 2021
Summary
Survivors of childhood encephalitis often face long-term physical and cognitive deficits, especially in tropical regions. Research on outcomes and rehabilitation for arboviral encephalitis in children is critically limited, highlighting an urgent need for further investigation.
Area of Science:
- Tropical Medicine
- Neuroscience
- Infectious Diseases
Background:
- Childhood encephalitis, often caused by arboviruses in tropical areas, leads to significant physical and neurocognitive sequelae.
- Limited resources in these regions exacerbate the burden of chronic morbidities in survivors.
- Existing research on outcomes and rehabilitation following childhood encephalitis is insufficient.
Purpose of the Study:
- Systematically review the literature on outcomes following childhood arboviral encephalitis in tropical regions.
- Identify gaps in knowledge regarding sequelae, pathogen-specific outcomes, and rehabilitative efforts.
- Inform future research priorities and resource allocation for managing chronic morbidities.
Main Methods:
- Conducted a systematic literature search of PubMed, Web of Knowledge, and Cochrane databases (Jan-Feb 2020).
- Utilized 17 search terms for sequelae and 14 for tropical arboviral pathogens.
- Included studies with ≥3 months post-discharge follow-up and clinical outcome assessment in children (≤18 years) diagnosed with arboviral encephalitis.
Main Results:
- 35 studies comprising 693 children were eligible; Japanese encephalitis was predominant (93.2%).
- Approximately 60% of subjects overall and those with Japanese encephalitis experienced sequelae.
- Non-Japanese encephalitis virus encephalitides showed higher sequelae rates (78.1%), but lacked comprehensive neurocognitive testing or assessment of rehabilitation efficacy.
Conclusions:
- There is a significant lack of research on long-term outcomes of tropical childhood encephalitis, particularly neurocognitive sequelae.
- Serial assessments and the efficacy of rehabilitative measures remain understudied.
- Further investigation is crucial to understand and address the long-term impact of arboviral encephalitis in children.
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