Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India
Introduction: Acute Encephalitis Syndrome (AES) is a group of neurologic manifestation caused by wide range of microbes, chemicals and toxins. Japanese Encephalitis Virus (JEV) is the major cause of AES in India. Isolation of aetiological agent in AES cases presents a fundamental challenge to preven...
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JCDR Research and Publications Private Limited
2022-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/16111/51692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SL)_PB(SC_SHU)_PN(SHU).pdf |
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| author | Sujit Kumar Chakrabarti Sribas Das Prasenjit Das Sanjib Kumar Debbarma |
| author_facet | Sujit Kumar Chakrabarti Sribas Das Prasenjit Das Sanjib Kumar Debbarma |
| author_sort | Sujit Kumar Chakrabarti |
| collection | DOAJ |
| description | Introduction: Acute Encephalitis Syndrome (AES) is a group of neurologic manifestation caused by wide range of microbes, chemicals and toxins. Japanese Encephalitis Virus (JEV) is the major cause of AES in India. Isolation of aetiological agent in AES cases presents a fundamental challenge to prevention and management. Lack of study on AES in the paediatric population of Tripura prompted the authors to take up this study.
Aim: To determine the clinical profile and short term outcome of children with AES from Tripura, India.
Materials and Methods: This hospital-based cross-sectional observational study was conducted from November 2017 to April 2019 in the Department of Paediatrics at Agartala Government Medical College (AGMC), Tripura, India. Total 100 children, from 1 month to 12 years of age, fulfilling definition of AES were enrolled in the study. All the cases were managed as per institutional treatment protocol and were followed-up at one and three months following discharge. Case record, patient profile records and reports of investigations were the study tools. Chi-square test and Fisher’s-exact test were used as per applicability to test the significance of difference of proportions using Statistical Package for the Social Sciences (SPSS) version 15.0. The difference was considered significant for a p-value <0.05.
Results: Out of total, 30 patients (30%) were in 9-12 years age group, with slight male preponderance (1.1:1). Total 72 cases (72%) were from rural area. Common clinical features were fever, altered sensorium, seizures, irritability, abnormal movement, pallor, papilloedema, and lethargy. Abnormal laboratory parameters included leucocytosis (62%), anaemia (27%), hyponatremia (35%), and hypoglycaemia (16%) and elevated liver enzymes (15%). Immunoglobulin M (IgM) serology was positive for JEV (19%), scrub typhus (6%), herpes simplex virus (2%), dengue (2%), measles (1%), and enterovirus (1%). Magnetic resonance imaging brain was normal in 37% of the cases. About 54% of the cases recovered completely, 20% of the cases died and remaining 26% survived with sequelae.
Conclusion: The AES is common among older male children from the rural area. Serologically JEV is most common cause. Total 54% cases recovered completely. Proportion of death and residual sequelae were higher in the JEV category. The observations of the study indicate need of extensive studies and scaling up of JE vaccination. |
| first_indexed | 2024-04-10T16:56:34Z |
| format | Article |
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| language | English |
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| publishDate | 2022-03-01 |
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| spelling | doaj.art-95b087a3b6484b748d909418b543c4ac2023-02-07T07:18:07ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-03-01163SC06SC1010.7860/JCDR/2022/51692.16111Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, IndiaSujit Kumar Chakrabarti0Sribas Das1Prasenjit Das2Sanjib Kumar Debbarma3Associate Professor, Department of Paediatrics, Agartala Government Medical College, Agartala, Tripura, India.Assistant Professor, Department of Paediatrics, Agartala Government Medical College, Agartala, Tripura, India.Resident, Department of Paediatrics, Agartala Government Medical College, Agartala, Tripura, India.Professor, Department of Paediatrics, Agartala Government Medical College, Agartala, Tripura, India.Introduction: Acute Encephalitis Syndrome (AES) is a group of neurologic manifestation caused by wide range of microbes, chemicals and toxins. Japanese Encephalitis Virus (JEV) is the major cause of AES in India. Isolation of aetiological agent in AES cases presents a fundamental challenge to prevention and management. Lack of study on AES in the paediatric population of Tripura prompted the authors to take up this study. Aim: To determine the clinical profile and short term outcome of children with AES from Tripura, India. Materials and Methods: This hospital-based cross-sectional observational study was conducted from November 2017 to April 2019 in the Department of Paediatrics at Agartala Government Medical College (AGMC), Tripura, India. Total 100 children, from 1 month to 12 years of age, fulfilling definition of AES were enrolled in the study. All the cases were managed as per institutional treatment protocol and were followed-up at one and three months following discharge. Case record, patient profile records and reports of investigations were the study tools. Chi-square test and Fisher’s-exact test were used as per applicability to test the significance of difference of proportions using Statistical Package for the Social Sciences (SPSS) version 15.0. The difference was considered significant for a p-value <0.05. Results: Out of total, 30 patients (30%) were in 9-12 years age group, with slight male preponderance (1.1:1). Total 72 cases (72%) were from rural area. Common clinical features were fever, altered sensorium, seizures, irritability, abnormal movement, pallor, papilloedema, and lethargy. Abnormal laboratory parameters included leucocytosis (62%), anaemia (27%), hyponatremia (35%), and hypoglycaemia (16%) and elevated liver enzymes (15%). Immunoglobulin M (IgM) serology was positive for JEV (19%), scrub typhus (6%), herpes simplex virus (2%), dengue (2%), measles (1%), and enterovirus (1%). Magnetic resonance imaging brain was normal in 37% of the cases. About 54% of the cases recovered completely, 20% of the cases died and remaining 26% survived with sequelae. Conclusion: The AES is common among older male children from the rural area. Serologically JEV is most common cause. Total 54% cases recovered completely. Proportion of death and residual sequelae were higher in the JEV category. The observations of the study indicate need of extensive studies and scaling up of JE vaccination.https://www.jcdr.net/articles/PDF/16111/51692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SL)_PB(SC_SHU)_PN(SHU).pdfglasgow coma scaleherpes simplex virusjapanese encephalitis virusvaricella-zoster virus |
| spellingShingle | Sujit Kumar Chakrabarti Sribas Das Prasenjit Das Sanjib Kumar Debbarma Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India Journal of Clinical and Diagnostic Research glasgow coma scale herpes simplex virus japanese encephalitis virus varicella-zoster virus |
| title | Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India |
| title_full | Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India |
| title_fullStr | Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India |
| title_full_unstemmed | Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India |
| title_short | Clinical Profile and Short Term Outcome of Acute Encephalitis Syndrome in Children: An Observational Study from a Tertiary Care Centre, Tripura, India |
| title_sort | clinical profile and short term outcome of acute encephalitis syndrome in children an observational study from a tertiary care centre tripura india |
| topic | glasgow coma scale herpes simplex virus japanese encephalitis virus varicella-zoster virus |
| url | https://www.jcdr.net/articles/PDF/16111/51692_CE[Ra1]_F(KR)_PF1(SC_SS)_PFA(SL)_PB(SC_SHU)_PN(SHU).pdf |
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