Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis

Background Central nervous system (CNS) infections are important contributors to morbidity and mortality and the causative agents for ~50% patients are never identified. The causative agents of some CNS infections have distinct spatial and temporal patterns. Methodology/Principal findings Here we p...

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Príomhchruthaitheoirí: Rattanavong, S, Dubot-Pérès, A, Mayxay, M, Vongsouvath, M, Lee, SJ, Cappelle, J, Newton, PN, Parker, DM
Formáid: Journal article
Teanga:English
Foilsithe / Cruthaithe: Public Library of Science 2020
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author Rattanavong, S
Dubot-Pérès, A
Mayxay, M
Vongsouvath, M
Lee, SJ
Cappelle, J
Newton, PN
Parker, DM
author_facet Rattanavong, S
Dubot-Pérès, A
Mayxay, M
Vongsouvath, M
Lee, SJ
Cappelle, J
Newton, PN
Parker, DM
author_sort Rattanavong, S
collection OXFORD
description Background Central nervous system (CNS) infections are important contributors to morbidity and mortality and the causative agents for ~50% patients are never identified. The causative agents of some CNS infections have distinct spatial and temporal patterns. Methodology/Principal findings Here we present the results of a spatial epidemiological and ecological analysis of CNS infections in Lao PDR (2003–2011). The data came from hospitalizations for suspected CNS infection at Mahosot Hospital in Vientiane. Out of 1,065 patients, 450 were assigned a confirmed diagnosis. While many communities in Lao PDR are in rural and remote locations, most patients in these data came from villages along major roads. Japanese encephalitis virus ((JEV); n = 94) and Cryptococcus spp. (n = 70) were the most common infections. JEV infections peaked in the rainy season and JEV patients came from villages with higher surface flooding during the same month as admission. JEV infections were spatially dispersed throughout rural areas and were most common in children. Cryptococcus spp. infections clustered near Vientiane (an urban area) and among adults. Conclusions/Significance The spatial and temporal patterns identified in this analysis are related to complex environmental, social, and geographic factors. For example, JEV infected patients came from locations with environmental conditions (surface water) that are suitable to support larger mosquito vector populations. Most patients in these data came from villages that are near major roads; likely the result of geographic and financial access to healthcare and also indicating that CNS diseases are underestimated in the region (especially from more remote areas). As Lao PDR is undergoing major developmental and environmental changes, the space-time distributions of the causative agents of CNS infection will also likely change. There is a major need for increased diagnostic abilities; increased access to healthcare, especially for rural populations; and for increased surveillance throughout the nation.
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spelling oxford-uuid:a83df137-45af-488c-a353-f924a84632662022-03-27T03:00:06ZSpatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a83df137-45af-488c-a353-f924a8463266EnglishSymplectic ElementsPublic Library of Science2020Rattanavong, SDubot-Pérès, AMayxay, MVongsouvath, MLee, SJCappelle, JNewton, PNParker, DMBackground Central nervous system (CNS) infections are important contributors to morbidity and mortality and the causative agents for ~50% patients are never identified. The causative agents of some CNS infections have distinct spatial and temporal patterns. Methodology/Principal findings Here we present the results of a spatial epidemiological and ecological analysis of CNS infections in Lao PDR (2003–2011). The data came from hospitalizations for suspected CNS infection at Mahosot Hospital in Vientiane. Out of 1,065 patients, 450 were assigned a confirmed diagnosis. While many communities in Lao PDR are in rural and remote locations, most patients in these data came from villages along major roads. Japanese encephalitis virus ((JEV); n = 94) and Cryptococcus spp. (n = 70) were the most common infections. JEV infections peaked in the rainy season and JEV patients came from villages with higher surface flooding during the same month as admission. JEV infections were spatially dispersed throughout rural areas and were most common in children. Cryptococcus spp. infections clustered near Vientiane (an urban area) and among adults. Conclusions/Significance The spatial and temporal patterns identified in this analysis are related to complex environmental, social, and geographic factors. For example, JEV infected patients came from locations with environmental conditions (surface water) that are suitable to support larger mosquito vector populations. Most patients in these data came from villages that are near major roads; likely the result of geographic and financial access to healthcare and also indicating that CNS diseases are underestimated in the region (especially from more remote areas). As Lao PDR is undergoing major developmental and environmental changes, the space-time distributions of the causative agents of CNS infection will also likely change. There is a major need for increased diagnostic abilities; increased access to healthcare, especially for rural populations; and for increased surveillance throughout the nation.
spellingShingle Rattanavong, S
Dubot-Pérès, A
Mayxay, M
Vongsouvath, M
Lee, SJ
Cappelle, J
Newton, PN
Parker, DM
Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title_full Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title_fullStr Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title_full_unstemmed Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title_short Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003-2011): A retrospective analysis
title_sort spatial epidemiology of japanese encephalitis virus and other infections of the central nervous system infections in lao pdr 2003 2011 a retrospective analysis
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