Abstract
BackgroundMyanmar is endemic for Japanese encephalitis (JE) and has experienced several outbreaks in recent years. The vector-borne disease control (VBDC) program has collected hospital-based surveillance data since 1974. There is an urgent need to collate, analyze, and interpret the most recent information. The study aimed to describe (i) hospital-based JE cases and deaths between 2012 and 2017, (ii) a catch-up vaccination campaign in children in 2017, and (iii) health service provider perceptions about JE in one township in 2018.MethodsThis was a cross-sectional study of cases, deaths, and catch-up childhood vaccinations using secondary data from program records and a survey database of health service provider perceptions.ResultsBetween 2012 and 2017, there were 872 JE cases and 79 deaths with a case fatality rate of 91 per 1000; 2016 was the year with most cases and deaths. Most cases (n = 324) and deaths (n = 37) occurred in children aged 5–9 years. Large case numbers were reported in delta and lowland regions (n = 550) and during the wet season (n = 580). The highest case fatality rates were observed in the hills and coastal regions (120 and 112 per 1000, respectively). Nationwide coverage of the catch-up JE vaccination campaign among 13.7 million eligible children was 92%, with coverage lower in the hills and coastal regions (84%) compared with delta and lowland regions and plains (94%). More vaccinations (65%) occurred through school-based campaigns with the remainder (35%) vaccinated through community-based campaigns. Structured interviews in one township showed that service providers (n = 47) had good perceptions about various aspects of JE, although perceived benefits of specific vector control measures were poor: spraying/fumigation (38%), garbage removal (36%), larvicide use (36%), and drainage of standing/stagnant water (32%).ConclusionThe catch-up vaccination campaign was a successful response to high JE case numbers and deaths in children. However, ongoing surveillance for JE needs to continue and be strengthened to ensure comprehensive reporting of all cases, more knowledge is needed on disability in JE survivors, and all attempts must be made to ensure high percentage coverage of vaccination through routine and catch-up campaigns.
Highlights
Myanmar is endemic for Japanese encephalitis (JE) and has experienced several outbreaks in recent years
The catch-up vaccination campaign was a successful response to high JE case numbers and deaths in children
Hospital-recorded cases of JE and JE deaths The annual number of hospital-reported cases of JE and associated deaths are shown in Figs. 1 and 2
Summary
Myanmar is endemic for Japanese encephalitis (JE) and has experienced several outbreaks in recent years. Japanese encephalitis (JE) is an acute inflammatory disease caused by the Japanese encephalitis virus (JEV), 1 of 70 viruses in the Flavivirus genus of the family Flaviviridae. It is the main cause of viral encephalitis in Asia and a large area of the Western Pacific with an estimated 68,000 clinical cases of encephalitis every year [1]. It is mosquito-borne, with the main vector in tropical and subtropical regions being Culex tritaeniorhynchus, which bites mainly at night [1]. The occurrence of JE is seasonal in temperate climes with the main period of risk being May to October, but in tropical regions, the risk is all year round
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