Comparison of Clinical Profile and Outcomes of Japanese Encephalitis and Acute Encephalitis Syndrome among Rural...

Area of Science:

• Pediatrics
• Infectious Diseases
• Neurology

Background:

• Acute Encephalitis Syndrome (AES) is a significant public health concern in children, with Japanese Encephalitis (JE) being a major etiological agent in endemic regions.
• Differentiating JE from other causes of AES is crucial for appropriate management and understanding disease-specific outcomes.

Purpose of the Study:

• To compare the clinical characteristics and outcomes of children diagnosed with Japanese Encephalitis (JE) versus non-JE Acute Encephalitis Syndrome (AES).
• To identify clinical and laboratory predictors of mortality in JE and non-JE AES pediatric cases.

Main Methods:

• A comparative study included 56 children diagnosed with AES based on WHO criteria from June 2018 to June 2020.
• Patients were categorized into JE (n=24) and non-JE AES (n=32) groups based on JE-specific IgM antibody testing in serum or CSF.
• Clinical presentation, laboratory findings, and mortality rates were analyzed, with statistical significance set at p < 0.05.

Main Results:

• Fever, seizures, and altered sensorium were common presenting symptoms in both groups.
• In JE patients, low Glasgow Coma Scale (GCS), status epilepticus, meningeal irritation, elevated CSF protein, and INR > 1.5 were significantly associated with mortality (p < 0.05).
• Only low GCS was significantly associated with mortality in non-JE AES cases. JE-specific mortality was 29% compared to 41% in non-JE AES.

Conclusions:

• While JE and non-JE AES share similar clinical profiles in children, specific clinical and laboratory parameters are critical predictors of adverse outcomes exclusively in JE cases.
• Prognostic indicators for mortality differ between JE and other causes of AES, highlighting the importance of etiological diagnosis.