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Int J Infect Dis. 2020 Mar 20. pii: S1201-9712(20)30171-5. doi: 10.1016/j.ijid.2020.03.039. [Epub ahead of print]

A need to raise the bar - A systematic review of temporal trends in diagnostics for Japanese encephalitis virus infection, and perspectives for future research.

Author information

1
Department of Biochemistry, University of Oxford, Oxford, UK; Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit, Mahosot Hospital, Vientiane, Lao PDR. Electronic address: t.bharucha@doctors.org.uk.
2
Modelling and Simulation Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
3
Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit, Mahosot Hospital, Vientiane, Lao PDR.
4
Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit, Mahosot Hospital, Vientiane, Lao PDR; Institute of Research and Education Development, University of Health Sciences, Vientiane, Lao PDR.
5
Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France.
6
Department of Biochemistry, University of Oxford, Oxford, UK; Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit, Mahosot Hospital, Vientiane, Lao PDR; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
7
Department of Biochemistry, University of Oxford, Oxford, UK.
8
Lao-Oxford-Mahosot Hospital-Wellcome Trust-Research Unit, Mahosot Hospital, Vientiane, Lao PDR; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France.

Abstract

OBJECTIVE:

Japanese encephalitis virus infection (JEV) remains a leading cause of neurological infection in Asia, largely involving individuals living in remote areas with limited access to treatment centres and diagnostic facilities. Laboratory confirmation is fundamental for the justification and implementation of vaccination programmes. We sought to review the literature on historical developments and current diagnostic capability worldwide, to identify knowledge gaps and instil urgency to address them.

METHODS:

Searches were performed in Web of Science and PubMed using the text word term 'Japanese encephalitis' up to 13th October 2019. Studies reporting laboratory-confirmed symptomatic JE cases in humans were included, and data on details of diagnostic tests were extracted. A JE case was classified according to confirmatory levels (1-4), where level 1 represented the highest level of confidence.

FINDINGS:

20,212 published JE cases were identified from 205 studies. 15,167 (75%) of these positive cases were confirmed with the lowest confidence diagnostic test (level 3 or 4, or level 4). Only 109 (53%) of the studies reported contemporaneous testing for dengue-specific antibodies.

CONCLUSION:

A fundamental pre-requisite for the control of JE is lacking --- that of a simple and specific diagnostic procedure that can be adapted for point-of-care tests and readily used throughout JE endemic regions of the world.

KEYWORDS:

Flavivirus; Japanese encephalitis; Neurological infection; Public Health; Vaccination

PMID:
32205287
DOI:
10.1016/j.ijid.2020.03.039
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