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

Rattanavong Sayaphet, Dubot-Pérès Audrey, Mayxay Mayfong, Vongsouvath Manivanh, Lee Sue J., Cappelle Julien, Newton Paul, Parker Daniel M.. 2020. Spatial epidemiology of Japanese encephalitis virus and other infections of the central nervous system infections in Lao PDR (2003–2011): A retrospective analysis. PLoS Neglected Tropical Diseases, 14 (5):e0008333, 18 p.

https://doi.org/10.1371/journal.pntd.0008333

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Quartile : Q1, Sujet : PARASITOLOGY / Quartile : Q1, Sujet : TROPICAL MEDICINE

Résumé : 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.

Mots-clés Agrovoc : virus encéphalite japonaise, épidémiologie, trouble du système nerveux, maladie infectieuse, cryptococcose, système nerveux central, distribution spatiale

Mots-clés géographiques Agrovoc : République démocratique populaire lao

Mots-clés libres : Central nervous system, Diagnostic medicine, Cryptococcus, Vaccines, Dengue virus, Murine typhus, Lao people, Japanese encephalitis

Classification Agris : L73 - Maladies des animaux

Champ stratégique Cirad : CTS 4 (2019-) - Santé des plantes, des animaux et des écosystèmes

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