Acute Encephalitis Syndrome Surveillance, Kushinagar District, Uttar Pradesh, India, 2011–2012

Abstract

In India, quality surveillance for acute encephalitis syndrome (AES), including laboratory testing, is necessary for understanding the epidemiology and etiology of AES, planning interventions, and developing policy. We reviewed AES surveillance data for January 2011–June 2012 from Kushinagar District, Uttar Pradesh, India. Data were cleaned, incidence was determined, and demographic characteristics of cases and data quality were analyzed. A total of 812 AES case records were identified, of which 23% had illogical entries. AES incidence was highest among boys <6 years of age, and cases peaked during monsoon season. Records for laboratory results (available for Japanese encephalitis but not AES) and vaccination history were largely incomplete, so inferences about the epidemiology and etiology of AES could not be made. The low-quality AES/Japanese encephalitis surveillance data in this area provide little evidence to support development of prevention and control measures, estimate the effect of interventions, and avoid the waste of public health resources.

The syndrome of acute encephalitis in children in India: Need for new thinking

“…In recent years, a diagnosis of ‘acute encephalitis syndrome’ (AES) has crept into medical literature in India, with a definition at variance from that of acute encephalitis in paediatric textbooks 10 14 25 26 . For example, AES was defined in one study as ‘clinical neurologic manifestations caused by wide range of viruses, bacteria, fungus, parasites, spirochetes, chemicals and toxins’ 26 .…”

Spatial data issues in geographical zoonoses research

“…The accuracy and validity of JE surveillance data was questioned by Kakkar et al (), who examined AES and JE surveillance data in the Kushinagar District in Uttar Pradesh, India and determined that the quality of this data was so low that reliable control/prevention measures should not be based on it (Kakkar et al ). Kakkar et al () examined a total of 812 AES records, and found that 23% contained problematic or missing entries. It is thought that such data complications contribute to inadequate surveillance, which may be exacerbated in low‐income settings.…”

Increased serum vascular endothelial growth factor is associated with acute viral encephalitis in Bangladeshi children

“…In industrialized countries, the incidence of encephalitis ranges from 5.23–7.3 cases/100,000 population/year 1 , 2 with a mortality rate of 4.6–7.4% 3 , 4 . In developing countries, the situation is more severe; in India, the incidence is 20.2 cases/100,000/year 5 , and in Vietnam, 30% of hospitalized children with encephalitis die and 25% develop sequelae 6 . In 59–89.9% of encephalitis cases in developing countries, the aetiology is unknown 6 – 10 .…”