Clinical Profile and Outcome of Acute Encephalitis Syndrome in Dhulikhel Hospital of Nepal

Dongol, Srijana; Shrestha, S.; Shrestha, Niti; Adhikari, Janak

doi:10.3126/jnps.v32i3.6683

Cited by 6 publications

(11 citation statements)

References 12 publications

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“…Dangol et al 10 Clinical profile of AES in our study was similar to that done by Rayamajhi et al 4 , Khinchi et al 14…”

Section: Discussionsupporting

confidence: 89%

“…Kolkati et al 12 The incidence of JE (12.80%) was higher than that of Dangol et al 10 (2.10%) as our study area is endemic for JE. However, it is lower than Kolkati et al 12 (30%) done in India due to current AES/JE surveillance system and free vaccination program in India.…”

Section: Andcontrasting

confidence: 56%

“…The mortality rate was of 2% to 3% and 16% to 17% had complications during discharge. 7,8,9,10 As there have been little publications on clinical, demographic parameters, and outcome among AES patients in children in Nepal, 4,10,11,13 a hospital based study was done. Table 9.…”

Section: Introductionmentioning

confidence: 99%

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A Clinico-Demographic Profile of Acute Encephalitis Syndrome and its Outcome Among Children

Shrestha

Gupta

2019

Med. J. Shree Birendra Hosp.

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Introduction: Acute Encephalitis Syndrome (AES) is defined as acute onset of fever and a change in mental status and/or new onset of seizures in a person of any age, in any geographical region, at any time of year. It may be due to viral or bacterial etiology. Dysfunction of motor system and mental retardation are common complications. Methods: A prospective cross-sectional hospital based study was done among children from 1 month to 15 years of age admitted with diagnosis of AES from October 2014 to October 2015. The clinical details and reports of CSF analysis were recorded and analyzed. Results: Out of 70 patients of AES admitted, 40 (57.10%) were male and 30 (42.90%) were female. The highest number of cases were in age group of 6-10 years i.e. 26(37.2%); whereas 20 (28.5%) were 11-15 years, 17(24.30%) were among 2-5 years and 7(10%) were below 2 years. The patients were predominantly from Far- Western and Mid-Western region of Nepal. The maximum AES cases were of farmers of lower education level from rural area with low socio economic group and were reported during monsoon. The clinical profiles of AES were fever, altered sensorium and convulsion followed by irritability, headache, vomiting, lethargy, photophobia and ear discharge. 50 patients had AES with viral origin including nine were Japanese Encephalitis and 41 were Viral with unknown etiology whereas 20 were of Bacterial origin which includes 15 were Bacterial (septic) meningitis and five of Tubercular meningitis. Three children (4.3%) died with diagnosis of viral encephalitis. 29 (41.4%) had complete recovery and 15 (21.4%) had partial recovery, nine (12.9%) went LAMA (left against medical advice) and 14 (20%) were DOPR (discharge on patient request). The partially recovered patients had sequelae of motor system dysfunction and mental retardation. Conclusion: Acute encephalitis syndrome is a medical emergency in which early detection and treatment is very essential and remains a serious threat to global health, especially in the developing countries.

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“…Dangol et al 10 Clinical profile of AES in our study was similar to that done by Rayamajhi et al 4 , Khinchi et al 14…”

Section: Discussionsupporting

confidence: 89%

Section: Andcontrasting

confidence: 56%

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A Clinico-Demographic Profile of Acute Encephalitis Syndrome and its Outcome Among Children

Shrestha

Gupta

2019

Med. J. Shree Birendra Hosp.

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“…Similar results were observed, AES was high in males (64.7%) than females (35.3%) in Karnataka, India and in Nepal 34 (72.34%) male in comparison to 13 (27.65%) female. 5,6 Common age group is 1-5 years similar to study done followed by 6-10 years age group but majority belongs to age group >5-10 years. 3,4 Similar result as higher proportion of subjects were toddlers (30.1%) followed by pre-school children (26.5%).…”

Section: Resultsmentioning

confidence: 55%

“…Similar results are shown where viral etiology is most common. [5][6][7] JE cases contribute to 14.35% of total cases. Similar result was found where 12.21% cases were found to be positive for JE.…”

Section: Resultsmentioning

confidence: 99%

A six years prospective epidemiological study of acute encephalitis syndrome among children admitted in a rural tertiary care center

Datta

Karmakar

2019

Int J Contemp Pediatr

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Background: Acute Encephalitis Syndrome (AES) is a major public health issue in India. The common etiologies of AES in India are various infectious agents. There are seasonal and regional variations in etiologies making diagnosis and effective intervention often difficult. Our study represents the epidemiological data that will help in planning management in larger perspective.Methods: This is a six years prospective observational study conducted in the Department of Pediatrics, North Bengal Medical College Hospital, Darjeeling from January 1st, 2013 to December 31st, 2018. In this study all clinically diagnosed AES cases were included fulfilling inclusion and exclusion criterion.Results: 585 out of 39420 patients (1.48%) were diagnosed clinically as AES over six years. Male patients (372) contributing to 63.6% and female patients (213) 36.4% of the study. Majority cases (271) were seen in the age group of 1-5 years amounting to 46.3% with mean age 5.1±3.6 years. In July 2014 number of cases were maximum 59 (10%) followed by May 2013 20 (3.4%). Among the 585 AES cases, 263 (45%) were suspected for viral etiology (JE= 84, 14.3%). Total 457 cases (78.1%) were alive with insignificant to age and gender variance. Vaccination status revealed 11 among 15 JE deaths were unimmunized which is statistically significant (p < 0.05) by Chi-square test.Conclusions: The magnitude and etiologies of AES need to be explored and understood in various geographic regions and in different seasons to have a better insight for development of future policies to reduce the burden.

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Predictors of mortality in acute encephalitis syndrome in children

Kiro,

Majhi,

Nayak

et al. 2024

PJMS

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Encephalitis is an important cause of morbidity, mortality and neurological sequelae in children globally. Causes are diverse and include viral and non-viral etiology as well as autoimmune processes. In the west autoimmune encephalitis are now most common than any single infectious cause, but in India infectious causes are still most common. It is critical to evaluate the immediately to reduce mortality and sequalae in Acute Encephalitis Syndrome (AES) patients. This study has been done to find out different predictors of mortality in outcome of AES at the end of hospital stay. To find out the predictors of mortality in children with acute encephalitis syndrome between age group of 1 month to 14 years. This was a cross sectional analytical study conducted over a period of two years. A total of 310 subjects were included in the study. Different clinical and laboratory parameters were taken to know the different significant predictors of mortality. A total of 310 cases were taken for the study from the age group of 1 month to 14 years. Out of these AES cases 22.5% cases died and 77.5% patients were discharged. Higher mortality was seen in 11-14 years of age group and females had higher mortality as compared to males. Only 5 variables that is refractory seizure, GCS<8, features of raised ICT, shock and requirement of ventilatory support were found to be significant (p<0.05) in predictors of mortality. Other variables like age, sex, socioeconomic status, fever altered sensorium, seizure, meningeal sign, laboratory investigations like serum sodium, total leucocyte count, serum creatinine, duration of hospitalisation were not found to be significant(p>0.05). AES is a disorder of multiple and varying etiology with significant mortality and morbidity. Early diagnosis, appropriate investigation, prompt management go a long way in reducing mortality and sequalae in AES. Refractory seizure, Glasgow Coma Score<8, features of raised Intracranial Tension, Shock and requirement of ventilatory support prognosticate the outcome of Acute Encephalitis Syndrome.

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Clinical Profile and Outcome of Acute Encephalitis Syndrome in Dhulikhel Hospital of Nepal

Cited by 6 publications

References 12 publications

A Clinico-Demographic Profile of Acute Encephalitis Syndrome and its Outcome Among Children

A Clinico-Demographic Profile of Acute Encephalitis Syndrome and its Outcome Among Children

A six years prospective epidemiological study of acute encephalitis syndrome among children admitted in a rural tertiary care center

Predictors of mortality in acute encephalitis syndrome in children

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