Aetiology of acute meningoencephalitis in Cambodian children, 2010–2013

Horwood, Paul, Duong, Veasna, Laurent, Denis, Mey, Channa, Sothy, Heng, Santy, Ky, Richner, Beat, Heng, Seiha, Hem, Sopheak, Cheval, Justine, Gorman, Christopher, Dussart, Philippe, de Jong, Menno D., Kerleguer, Alexandra, Guillard, Bertrand, Murgue, Bernadette, Lecuit, Marc, de Lamballerie, Xavier, Farrar, Jeremy J., Tarantola, Arnaud, Eloit, Marc, and Buchy, Philippe (2017) Aetiology of acute meningoencephalitis in Cambodian children, 2010–2013. Emerging Microbes & Infections, 6. e35.

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Abstract

Acute meningoencephalitis (AME) is associated with considerable morbidity and mortality in children in developing countries. Clinical specimens were collected from children presenting with AME at two Cambodian paediatric hospitals to determine the major aetiologies associated with AME in the country. Cerebrospinal fluid (CSF) and blood samples were screened by molecular and cell culture methods for a range of pathogens previously associated with AME in the region. CSF and serum (acute and convalescent) were screened for antibodies to arboviruses such as Japanese encephalitis virus (JEV), dengue virus (DENV), and chikungunya virus (CHIKV). From July 2010 through December 2013, 1160 children (one month to 15 years of age) presenting with AME to two major paediatric hospitals were enroled into the study. Pathogens associated with AME were identified using molecular diagnostics, cell culture and serology. According to a diagnostic algorithm, a confirmed or highly probable aetiologic agent was detected in 35.0% (n=406) of AME cases, with a further 9.2% (total: 44.2%, n=513) aetiologies defined as suspected. JEV (24.4%, n=283) was the most commonly identified pathogen followed by Orientia tsutsugamushi (4.7%, n=55), DENV (4.6%, n=53), enteroviruses (3.5%, n=41), CHIKV (2.0%, n=23) and Streptococcus pneumoniae (1.6%, n=19). The majority of aetiologies identified for paediatric AME in Cambodia were vaccine preventable and/or treatable with appropriate antimicrobials.

Item ID: 49021
Item Type: Article (Research - C1)
ISSN: 2222-1751
Keywords: chikungunya virus; dengue virus; encephalitis; Japanese encephalitis virus; meningoencephalitis; meningitis; paediatric; scrub typhus
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© The Author(s) 2017. This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0.

Funders: Li Ka Shing Foundation-University of Oxford Global Health Programme, PathoQuest, Institut Microbiology and Maladies Infectieuses (IMMI)
Projects and Grants: IMMI NO 201103
Date Deposited: 11 Jul 2017 23:50
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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