ACUTE ENCEPHALITIS SYNDROME IN A TERTIARY CARE SETTING WITH SPECIAL REFERENCE TO JAPANESE ENCEPHALITIS: AN OBSERVATIONAL STUDY IN ASSAM, INDIA

Abstract

Acute Encephalitis Syndrome (AES) is a major public health problem and Japanese Encephalitis (JE) is one of the most important causes of AES. Therefore, it is crucial to know the etiology of AES for patient management and decision making. The present study aimed to assess the morbidity and mortality prole of AES/JE patients admitted in tertiary care setting. An observational prospective cross-sectional study was conducted among 140 hospitalized AES patients admitted in Pediatric and Medicine ward of Jorhat Medical College and Hospital (JMCH), Jorhat over a period from August, 2017 to July 2018. Blood serum and cerebrospinal uids (CSF) were tested for presence of JE specic IgM antibody by Mac ELISA during acute illness of AES. The data were compiled and analyzed using the IBM SPSS, V23.0. Of the total 140 AES cases, majority (60%) were below 15 years age (p-value 0.180). Signicantly higher proportion of AES cases were from rural areas (94.3%) (p-value <0.0001). The male and female ratio was 1.3:1. The most common presenting symptoms in AES patients were fever (100%), change in mental status (100%), seizure (56.4%) and headache (42.9%). Signs of meningeal irritation were present in 69.3% of cases. Around 22.9% AES patients had GCS ≤ 8. A total 49 (35%) cases were found to be laboratory conrmed JE following detection of JE specic IgM antibody. Among the JE patients, only 4.1% were immunized with SA 14-14-2 vaccine and 14% died before discharge. The complete recoveries were observed in 78% of cases. JE is one of the major causes of AES which is highly prevalent in this part of India. The signicant ndings in the present study calls for policy decision to combat JE.