Clinical profiles and some associated factors of Japanese encephalitis in Bali

Main Article Content

I Komang Kari
Wei Liu
I Made Kompiang Gautama
I Ketut Subrata
Zhi Yi Xu


Background Japanese Encephalitis (JE) is a mosquito-borne vi-
ral disease that can affect the central nervous system and cause
several complications and death. In Indonesia, particularly in Bali,
studies of JE in humans are still very limited.
Objective To assess the clinical manifestations and outcome of
JE in Bali and to identify some possible associated factors and
monthly distribution of admission to the hospitals.
Methods A cross-sectional study was conducted in 8 district hospi-
tals, army hospital, and Sanglah central hospital, as surveillance cen-
ters in Bali, from July 2001 through January 2003. Subjects less than
12 years of age and residences of Bali province who were suspected
of having acute viral encephalitis, aseptic meningitis, and acute flac-
cid paralysis referred from all health facilities were included in this
study. The diagnosis of JE was established by detection of virus-spe-
cific IgM in CSF and serum, with IgM capture enzyme-linked
immunosorbent assay (MAC ELISA)
Results During the study, 158 subjects with encephalitis were in-
cluded; 55 (34.8%) were caused by JE and 103 (65.2%) were caused
by non-JE. It showed that pig owning and rice farming were signifi-
cantly associated with JE (PR= 3.02, 95% CI 1.29; 7.10; P= 0.009
and PR= 2.86, 95% CI 1.30; 6,31, P= 0.008, respectively). Most
subjects (46.2%) were under 2 years old with mean age of 37.24
(SD 32.24) months. Forty-two (26.6%) subjects had nuchal rigidity,
and all of them had aseptic meningitis. Denpasar had the highest
prevalence of non-JE cases. Bangli and Klungkung had the lowest
prevalence of JE and non-JE. The highest prevalence of JE was in
Gianyar. Peak prevalences of JE were in April and May 2002. Peak
prevalences of non-JE were during August-October 2001 and in
March-April 2002. Four (7.3%) subjects of JE group and 25 (24.3%)
subjects of non-JE died. There were 25 (45.5%) out of 55 subjects
who survived with disability. Twenty-four (43.6%) JE subjects and
34 (33.0%) non-JE subjects had good outcome.
Conclusions Around one third of the subjects were positively di-
agnosed as JE. The highest prevalence of JE was found in Gianyar.
Peak prevalences of JE are in April and May 2002. Pig owning and
rice farming are associated factors. Almost half of JE subjects sur-
vived with disability

Article Details

How to Cite
Kari I, Liu W, Gautama IM, Subrata I, Xu Z. Clinical profiles and some associated factors of Japanese encephalitis in Bali. PI [Internet]. 18Oct.2016 [cited 26Aug.2019];46(1):13-. Available from:
Author Biographies

I Komang Kari

Department of Child Health, Medical School, Udayana
University, Bali, Indonesia

Wei Liu

International Vaccine Institute, Seoul,

I Made Kompiang Gautama

Indonesian Pediatric Association, Bali Branch

I Ketut Subrata

Center for Disease Control and Prevention, Bali, Indonesia

Zhi Yi Xu

Center for Disease Control and Prevention, Bali, Indonesia
Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-18


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