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

Abstract

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
1.
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 14Nov.2019];46(1):13-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/848
Section
Articles
Author Biographies

I Komang Kari

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

Wei Liu

International Vaccine Institute, Seoul,
Korea

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

References

1. Reppley MC. Epidemiology of Japanese encephali-
tis. In: Matheson Commission. Epidemic encepha-
litis. 3rd report. New York: Columbia University;
1993. p. 157.
2. Igarashi A. Control of Japanese encephalitis in Japan:
Immunization of humans and animal, and vector con-
trol. In: Mackenzie JS, Barrett ADT, Denbel V, edi-
tors. Japanese encephalitis and West Nile Viruses. 1st
ed. Springer-Verlag Berlin Eidenberg.
3. Solomon T, Dung NM, Kneen R, Gainsborough M,
Vaugh DW, Khankh NT. Japanese encephalitis. J Neu-
ral Neurosurg Psychiatry 2000;68:405-15.
4. Reuben R, Gajanana A. Japanese encephalitis in In-
dia. Indian J Pediatr 1997;64:243-51.
5. Burke DS, Lorsomrudee W, Leake CJ, Hoke CH, Nisalak
A, Chongswasdi, et al. Fatal outcome in Japanese en-
cephalitis. Am J Trop Med Hyg 1985;34:1203-10.
6. Dapeng L, Jindows, Huijun Y, Renguo Y, Ze W. Prog-
nostic factor of early sequelae and fatal outcome of
Japanese encephalitis. Southeast Asian J Trop Med
Public Health 1995;26:694-8.
7. Weil ML, Toumanen E, Israele N, Rust R, Menkes JH.
Infection of the nervous system. In: Menkes JH, Sarnat
HB, editors. Child Neurology. 7th ed. Philadelphia:
Lippincott Williams & Wilkins; 2000. p. 467-626.
8. Solomon T, Kneen R, Dung NM, Khanh VC, Thuy
TTN, Ha DQ, et al. Poliomyelitis-like illness due to
Japanese encephalitis virus. Lancet 1998;351:1094-7.
9. Lubis I, Wuryadi S. Penyakit Japanese encephalitis pada
anak-anak di dua rumah sakit di Jakarta. Bull Penelit
1981;11:18-22.
10. Kari K. Japanese encephalitis at Sanglah central hos-
pital, Denpasar. Presented at 10th National Congress
of Child Health; 1996 Jun 18-20; Bukittinggi, Indo-
nesia.
11. Burke DS, Nisalak A. Detection of Japanese encepha-
litis virus immunoglobulin M antibodies in serum by
antibody capture radioimmunoassay. J Clin Microbiol
1982;15:353-61.
12. Burke DS, Nisalak A, Ussery MA. Antibody capture
immunoassay detection of Japanese encephalitis virus
immunoglobulin M and G antibodies in cerebrospinal
fluid. J Clin Microbiol 1982;16:1034-42.
13. Innis BC, Nisalak A, Nimmannitya S, Kusalerdchariya
S, Chongswasdi V, Suntayakorn S, et al. An enzym-
linked immunosorbent assay to characterize dengue
infections where dengue and Japanese encephalitis co-
circulate. Am J Trop Med Hyg 1989;40:418-27.
14. Hoke CH, Vaughan DW, Nisalak A, Intralawan P,
Poolsuppasit S, Jongsawas V, et al. Effect of high-dose
dexamethason on the outcome of acute encephalitis
due to Japanese encephalitis virus. J Infect Dis
1992;165:631-7.
15. Bell WE, McCormick WF. Neurologic infections in
children. 2nd ed. Philadelphia: WB Saunders Com-
pany; 1981. p. 290-358.
16. Lee VH, Atmosodjono S, Rusmiarto S, Aep S,
Semendra W. Mosquitoes of Bali island, Indonesia:
Common species in the village environment. South-
east Asian J Trop Med Public Health 1983;14:298-307.
17. Vaugh DW, Hoke CH. The epidemiology of Japanese
encephalitis: Prospects for prevention. Epidemiol Rev
1992;14:197-221.
18. Kumar R, Mathur A, Kumar A, Sharma S, Chakrabortys,
Chaturvedi MC. Clinical features and prognostic indi-
cator of Japanese encephalitis in children in Lucknow
(India). Indian J Med Res 1990;91:321-7.
19. Rao PN, Saraswati I, Gopal KPV, Kishan RB, Ashok
G. Nineteen years study of epidemiology of Japanese
encephalitis in children of Andhra Pradesh from 1979
to 1977. Proceedings of the 38th National Conference
of Indian Academy of Pediatrics; 2000 Jan 27-30, p.
207.
20. Macdonald WB, Tink AR, Ouvrier RA, Menser MA,
de Silva LM, Naim H, et al. Japanese encephalitis after a
two-week holiday in Bali. Med J Aust 1989;150:334-6.
21. Wittesjö B, Eitrem R, Niklasson B, Vene S, Mangiafico
JA. Japanese encephalitis after a 10-day holiday in Bali.
Lancet 1995;345:856.
22. Buhl Mr, Black FT, Anderson PL, Laursen A. Fatal
Japanese encephalitis in Danish tourist visiting Bali for
12 days. Scand J Infect Dis 1996;28:189.
23. Thisyakorn U, Nimmannitya S. Japanese encephalitis
in Thai children. Southeast Asian J Trop Med Pub Hlth
1985;16:93-7.
24. Solomon T, Dung MN, Kneen R, Thao LTT,
Gainsborough M, Nisalak A, et al. Seizures and raised
intracranial pressure in Vietnamese patients with
Japanese encephalitis. Brain 2002;120:1084-93.