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Hsu JY, Hung CC, Tsou TP, Chen WC. Epidemiology and risk factors of Japanese encephalitis in Taiwan, 2010-2022. PLoS Negl Trop Dis 2023; 17:e0011421. [PMID: 37782654 PMCID: PMC10569588 DOI: 10.1371/journal.pntd.0011421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/12/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Taiwan introduced a two-dose inactivated Japanese encephalitis (JE) mouse brain-derived (JE-MB) vaccine into routine childhood immunization in 1968, with booster vaccination implemented in 1974 and 1983. In 2017, JE-MB vaccine was replaced by a two-dose live-attenuated chimeric vaccine (JE-CV). After implementation of JE vaccination programs, JE cases have shifted from children to adults. In this study, we described the JE epidemiology and identify high-risk groups to further inform vaccine policy. METHODOLOGY/PRINCIPAL FINDINGS We extracted data from Taiwan's notifiable disease surveillance database, vital statistics, and employment statistics from 2010 to 2022. Diagnosis of JE was confirmed by JE seroconversion, a four-fold increase in virus-specific antibodies, a positive JE viral nucleic-acid test, or JE virus isolation. From 2010 to 2022, a total of 313 cases of JE were diagnosed, resulting in an overall incidence rate of 0.10 cases per 100,000 person-years and a mortality rate of 0.006 per 100,000 population per year. Among these patients, 64% were male, and the median age was 51 years (range 0-82). Compared with people born in or after 1976 (vaccinated with four doses of JE-MB vaccine or two doses of JE-CV), those born in or before 1962 (unvaccinated) and those born during 1963-1975 (vaccinated with two or three doses of JE-MB vaccine) had a 4.2-fold (95% confidence interval [CI] 3.0-5.7) and 5.9-fold (95% CI 4.3-8.1) higher risk of JE, respectively. The relative risk of working in agriculture, forestry, fishing, or animal husbandry, compared to other occupations, was 5.0 (95% CI 3.5-7.0). CONCLUSIONS/SIGNIFICANCE In Taiwan, individuals born before 1976 and those employed in agriculture, forestry, fishing, or animal husbandry had a higher risk of JE. We recommend JE vaccination for people in these high-risk groups who have not been fully vaccinated or have an unknown vaccination history.
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Affiliation(s)
- Jen-Yu Hsu
- Department of Occupational Medicine and Clinical Toxicology, Taipei Veterans General Hospital, Taipei, Taiwan
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Tsung-Pei Tsou
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Wan-Chin Chen
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
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Piamonte BLC, Easton A, Wood GK, Davies NWS, Granerod J, Michael BD, Solomon T, Thakur KT. Addressing vaccine-preventable encephalitis in vulnerable populations. Curr Opin Neurol 2023; 36:185-197. [PMID: 37078664 DOI: 10.1097/wco.0000000000001158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE OF REVIEW Vaccinations have been pivotal in lowering the global disease burden of vaccine-preventable encephalitides, including Japanese encephalitis, tick-borne encephalitis, measles encephalitis, and rabies encephalitis, among others. RECENT FINDINGS Populations vulnerable to vaccine-preventable infections that may lead to encephalitis include those living in endemic and rural areas, military members, migrants, refugees, international travelers, younger and older persons, pregnant women, the immunocompromised, outdoor, healthcare and laboratory workers, and the homeless. There is scope for improving the availability and distribution of vaccinations, vaccine equity, surveillance of vaccine-preventable encephalitides, and public education and information. SUMMARY Addressing these gaps in vaccination strategies will allow for improved vaccination coverage and lead to better health outcomes for those most at risk for vaccine-preventable encephalitis.
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Affiliation(s)
- Bernadeth Lyn C Piamonte
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Ava Easton
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
| | - Greta K Wood
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
| | - Nicholas W S Davies
- The Encephalitis Society, Malton
- Department of Neurology, Chelsea and Westminster Hospital, NHS Trust
| | - Julia Granerod
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- Dr JGW Consulting Ltd., London
| | - Benedict D Michael
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
| | - Tom Solomon
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
- Department of Neurological Science, University of Liverpool, Liverpool, United Kingdom
| | - Kiran T Thakur
- The Encephalitis Society, Malton
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, USA
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Feifei L, Hairong L, Linsheng Y, Li W, Lijuan G, Gemei Z, Lan Z. The spatial-temporal pattern of Japanese encephalitis and its influencing factors in Guangxi, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 111:105433. [PMID: 37037290 DOI: 10.1016/j.meegid.2023.105433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/01/2023] [Accepted: 04/06/2023] [Indexed: 04/12/2023]
Abstract
Japanese encephalitis (JE) is a major global public health threat. Using Japanese encephalitis incidence data from 2004 to 2010 in Guangxi Province, China, this study comprehensively explored the driving forces and the interactive effects between environmental and social factors of Japanese encephalitis using the Geo-detector method. The results indicated that the incidence of Japanese encephalitis showed a fluctuating downward trend from 2004 to 2010. The onset of JE was seasonal, mainly concentrated in June-July, and highly aggregated in northwestern Guangxi. Among the factors associated with Japanese encephalitis, days with temperatures >30 °C, accumulated temperatures >25 °C, slope, the normalized difference vegetation index, the gross domestic product of tertiary industries, the gross domestic product of primary industries and the number of pigs slaughtered showed higher contributions to Japanese encephalitis incidence. An enhanced interactive effect was found between environmental and social factors, and the interaction between days with humidity levels >80% and the gross domestic product of tertiary industries had the greatest combined effect on JE. These findings enhanced the understanding of the combined effect of social and environmental factors on the incidence of Japanese encephalitis and could help improve Japanese encephalitis transmission control and prevention strategies.
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Affiliation(s)
- Li Feifei
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Li Hairong
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Yang Linsheng
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Wang Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Gu Lijuan
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Zhong Gemei
- Guangxi Center for Disease Prevention and Control, Guangxi 530000, China
| | - Zhang Lan
- National Institute of Environmental Health, China CDC, Beijing 100021, China
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Liu MD, Li CX, Cheng JX, Zhao TY. Spatial statistical and environmental correlation analyses on vector density, vector infection index and Japanese encephalitis cases at the village and pigsty levels in Liyi County, Shanxi Province, China. Parasit Vectors 2022; 15:171. [PMID: 35590422 PMCID: PMC9118647 DOI: 10.1186/s13071-022-05305-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background In the eco-epidemiological context of Japanese encephalitis (JE), geo-environmental features influence the spatial spread of the vector (Culex tritaeniorhynchus, Giles 1901) density, vector infection, and JE cases. Methods In Liyi County, Shanxi Province, China, the spatial autocorrelation of mosquito vector density, vector infection indices, and JE cases were investigated at the pigsty and village scales. The map and Enhanced Thematic Mapper (ETM) remote sensing databases on township JE cases and geo-environmental features were combined in a Geographic Information System (GIS), and the connections among these variables were analyzed with regression and spatial analyses. Results At the pigsty level, the vector density but not the infection index of the vector was spatially autocorrelated. For the pigsty vector density, the cotton field area was positively related, whereas the road length and the distance between pigsties and gullies were negatively related. In addition, the vector infection index was correlated with the pigsty vector density (PVD) and the number of pigs. At the village level, the vector density, vector infection index, and number of JE cases were not spatially autocorrelated. In the study area, the geo-environmental features, vector density, vector infection index, and JE case number comprised the Geo-Environment-Vector-JE (GEVJ) intercorrelation net system. In this system, pig abundance and cotton area were positive factors influencing the vector density first. Second, the infection index was primarily influenced by the vector density. Lastly, the JE case number was determined by the vector infection index and the wheat area. Conclusions This study provided quantitative associations among geo-environmental features, vectors, and the incidence of JE in study sties, one typical northern Chinese JE epidemiological area without rice cultivation. The results highlighted the importance of using a diverse range of environmental management methods to control mosquito disease vectors and provided useful information for improving the control of vector mosquitoes and reducing the incidence of JE in the northern Chinese agricultural context. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05305-8.
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Affiliation(s)
- Mei-De Liu
- Academy of Military Medical Sciences State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, People's Republic of China
| | - Chun-Xiao Li
- Academy of Military Medical Sciences State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, People's Republic of China
| | - Jing-Xia Cheng
- Shanxi Centers for Disease Control and Prevention, Taiyuan, 030012, People's Republic of China
| | - Tong-Yan Zhao
- Academy of Military Medical Sciences State Key Laboratory of Pathogen and Biosecurity, Beijing, 100071, People's Republic of China.
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Subedi D, Gautam A, Sapkota D, Subedi S, Sharma S, Abdulkareem M, Kandel M, Ghimire H, Odetokun IA. Knowledge and perception of veterinary students on One Health: A first nationwide multi-institutional survey in Nepal. INTERNATIONAL JOURNAL OF ONE HEALTH 2022. [DOI: 10.14202/ijoh.2022.34-42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background and Aim: One Health (OH) is a collaborative, multisectoral, and holistic approach for the prevention and control of emerging and re-emerging zoonotic diseases affecting animals and humans. In Nepal, the OH concept remains rudimentary. However, the recently formed "One Health Strategy" is a ray of hope. Veterinary students are the future of animal health, a major component of OH. This study aimed to determine the knowledge and perception of Nepalese veterinary students toward OH.
Materials and Methods: A cross-sectional questionnaire survey was conducted among veterinary students in all four veterinary colleges in Nepal to obtain knowledge on OH and zoonotic disease and understand the perception of the benefits of OH obtained using an online survey tool through a convenience sampling technique. Data collected were subjected to descriptive statistics, Chi-Square test, and logistic regression analysis.
Results: A total of 333 participants, including recent graduates (mean age: 22.3±2.2 years) participated in this study. The mean knowledge score was 19.8±3.8 and about half of the respondents, 185 (55.6%) demonstrated satisfactory scores on OH. Most of the respondents have a positive perception of the benefits of OH as participants largely agreed that the OH approach needs to become a regular, routine, and institutionalized process at the project, program, and policy levels; is useful in addressing complex challenges that threaten human and animal health, food security, poverty, and the environments where diseases flourish; and it creates added value in terms of human and animal health, financial savings or social and environmental benefits from closer professional cooperation. Binary logistic regression analysis revealed that age, educational, and academic levels were significant factors influencing satisfactory knowledge on OH among respondents.
Conclusion: Nepalese veterinary students demonstrated satisfactory knowledge of OH and a good level of perception of the benefits of OH. An apprehensive understanding of the current status of the OH approach in Nepal through studies like this is crucial for the future improvement of public and animal health.
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Affiliation(s)
- Deepak Subedi
- Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Rupandehi, Nepal
| | - Anil Gautam
- Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Rupandehi, Nepal
| | - Deepak Sapkota
- Faculty of Animal Science, Veterinary Science and Fisheries, Agriculture and Forestry University, Chitwan, Nepal
| | - Sanju Subedi
- School of Public Health, Chitwan Medical College, Chitwan, Nepal
| | - Shreeya Sharma
- Faculty of Veterinary Science, Himalayan College of Agricultural Sciences Technology, Purbanchal University, Kathmandu, Nepal
| | - Madinat Abdulkareem
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin, Nigeria
| | - Milan Kandel
- Faculty of Animal Science, Veterinary Science and Fisheries, Agriculture and Forestry University, Chitwan, Nepal
| | | | - Ismail A. Odetokun
- Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin, Nigeria
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Durrance-Bagale A, Rudge JW, Singh NB, Belmain SR, Howard N. Drivers of zoonotic disease risk in the Indian subcontinent: A scoping review. One Health 2021; 13:100310. [PMID: 34458546 PMCID: PMC8379342 DOI: 10.1016/j.onehlt.2021.100310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Literature on potential anthropogenic drivers of zoonotic disease risk in the Indian subcontinent is sparse. We conducted a scoping review to identify primary sources, published 2000-2020, to clarify what research exists and on which areas future research should focus. We summarised findings thematically by disease. Of 80 sources included, 78 (98%) were original research articles and two were conference abstracts. Study designs and methods were not always clearly described, but 74 (93%) were quantitative (including one randomised trial), five (6%) were mixed-methods, and one was qualitative. Most sources reported research from India (39%) or Bangladesh (31%), followed by Pakistan (9%), Nepal (9%), Bhutan and Sri Lanka (6% each). Topically, most focused on rabies (18; 23%), Nipah virus (16; 20%) or leptospirosis (11; 14%), while 12 (15%) did not focus on a disease but instead on knowledge in communities. People generally did not seek post-exposure prophylaxis for rabies even when vaccination programmes were available and they understood that rabies was fatal, instead often relying on traditional medicines. Similarly, people did not take precautions to protect themselves from leptospirosis infection, even when they were aware of the link with rice cultivation. Nipah was correlated with presence of bats near human habitation. Official information on diseases, modes of transmission and prevention was lacking, or shared informally between friends, relatives, and neighbours. Behaviour did not correspond to disease knowledge. This review identifies various human behaviours which may drive zoonotic disease risk in the Indian subcontinent. Increasing community knowledge and awareness alone is unlikely to be sufficient to successfully change these behaviours. Further research, using interdisciplinary and participatory methods, would improve understanding of risks and risk perceptions and thus help in co-designing context-specific, relevant interventions.
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Affiliation(s)
- Anna Durrance-Bagale
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - James W. Rudge
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
- Mahidol University, Faculty of Public Health, 420/1 Rajvithi Road, Bangkok, Thailand
| | - Nanda Bahadur Singh
- Tribhuvan University, Central Department of Zoology, Kathmandu, Nepal
- Mid-Western University, Surkhet, Nepal
| | - Steven R. Belmain
- Natural Resources Institute, University of Greenwich, Chatham Maritime, Kent ME4 4TB, United Kingdom
| | - Natasha Howard
- London School of Hygiene and Tropical Medicine, Department of Global Health and Development, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore
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Abstract
African swine fever (ASF) is a highly contagious viral infection of domestic and wild pigs with high mortality. First reported in East Africa in the early 1900s, ASF was largely controlled in domestic pigs in many countries. However, in recent years ASF outbreaks have been reported in several countries in Europe and Asia. The occurrence of ASF in China, the largest pork producer in the world, in 2018 and in India, the country that surrounds and shares open borders with Nepal, has increased the risk of ASF transmission to Nepal. Lately, the pork industry has been growing in Nepal, overcoming traditional religious and cultural biases against it. However, the emergence of viral infections such as ASF could severely affect the industry’s growth and sustainability. Because there are no effective vaccines available to prevent ASF, the government should focus on preventing entry of the virus through strict quarantine measures at the borders, controls on illegal trade, and effective management practices, including biosecurity measures.
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Liu MD, Li CX, Huang Y, Dong YD, Nu W, Zhao TY. Spatial Distribution of Culex tritaeniorhynchus Giles, 1901 (Diptera: Culicidae) in Relation to Pigsties and Other Geo-environmental Features in Dao County, Hunan Province, China. JOURNAL OF MEDICAL ENTOMOLOGY 2019; 56:241-246. [PMID: 30169709 DOI: 10.1093/jme/tjy135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Indexed: 06/08/2023]
Abstract
In this study, we investigated the spatial distribution of Culex tritaeniorhynchus Giles, 1901 (Diptera: Culicidae) (the vector of Japanese B Encephalitis) and geo-environmental features (rice fields, forests, watercourses, and highways) correlated with their abundance in pigsties of Dao County, Hunan Province, China. First, light trapping in pigsties was carried out to determine vector density. Second, based on Advanced Land Observing Satellite remote-sensing datasets, spatial datasets of mosquito density and various geo-environmental features were constructed using Geography Information System. Finally, spatial statistical analysis and general linear regression were used to analyze the spatial distribution of vectors in relation to the geo-environmental features correlating with the abundance of mosquitoes in pigsties. As the results show, the distribution of mosquitoes in pigsties was not spatially autocorrelated, and several geo-environmental features that were either positively or negatively correlated with mosquito abundance in pigsties were identified. The application of these results to improve the control of vectors of Japanese B Encephalitis is also discussed.
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Affiliation(s)
- M D Liu
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - C X Li
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - Y Huang
- Hunan Center for Disease Control and Prevention, Changsha, China
| | - Y D Dong
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
| | - W Nu
- Hunan Center for Disease Control and Prevention, Changsha, China
| | - T Y Zhao
- State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Beijing, China
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Wang H, Liang G. Epidemiology of Japanese encephalitis: past, present, and future prospects. Ther Clin Risk Manag 2015; 11:435-48. [PMID: 25848290 PMCID: PMC4373597 DOI: 10.2147/tcrm.s51168] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Japanese encephalitis (JE) is one of severe viral encephalitis that affects individuals in Asia, western Pacific countries, and northern Australia. Although 67,900 JE cases have been estimated among 24 JE epidemic countries annually, only 10,426 have been reported in 2011. With the establishment of JE surveillance and vaccine use in some countries, the JE incidence rate has decreased; however, serious outbreaks still occur. Understanding JE epidemics and identifying the circulating JE virus genotypes will improve JE prevention and control. This review summarizes the current epidemiology data in these countries.
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Affiliation(s)
- Huanyu Wang
- State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Department of Viral Encephalitis, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing People's Republic of China ; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
| | - Guodong Liang
- State Key Laboratory for Infectious Disease Prevention and Control (SKLID), Department of Viral Encephalitis, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing People's Republic of China ; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China
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Dhakal S, Joshi DD, Ale A, Sharma M, Dahal M, Shah Y, Pant DK, Stephen C. Regional variation in pig farmer awareness and actions regarding Japanese encephalitis in Nepal: implications for public health education. PLoS One 2014; 9:e85399. [PMID: 24416402 PMCID: PMC3887053 DOI: 10.1371/journal.pone.0085399] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/05/2013] [Indexed: 11/18/2022] Open
Abstract
Japanese encephalitis (JE) is a mosquito-borne zoonotic disease that has pigs as the major amplifying hosts. It is the most important cause of viral encephalitis in people in Nepal and is spreading in its geographic distribution in that country. Pig farming is increasing in Nepal due to reducing cultural biases against pigs and government programs to support pig farming for poverty alleviation. Major strategies for JE prevention and control include education, vector control, and immunization of people and pigs. This study used a survey of 400 pig farmers in 4 areas of Nepal with different JE and pig farming histories to explore regional variations in farmer awareness and actions towards JE, the association of awareness and actions with farm and farmer variables, and the implications of these associations for public health education. Exposure to JE risk factors was common across pig farms and pig farming districts but there were significant district level differences in knowledge and practices related to on-farm JE risk reduction. Social factors such as literacy, gender, and cultural practices were associated with farmer attitudes, knowledge and practices for JE control. JE vaccine uptake was almost non-existent and mosquito control steps were inconsistently applied across all 4 districts. Income was not a determining factor of the differences, but all farmers were very poor. The low uptake of vaccine and lack of infrastructure or financial capacity to house pigs indoors or away from people suggest that farmer personal protection should be a priority target for education in Nepal. This study re-enforces the need to attack root causes of people's personal disease prevention behaviours and take into account local variation in needs and capacities when designing health or agriculture education programs.
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Affiliation(s)
- Santosh Dhakal
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Durga Datt Joshi
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Anita Ale
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Minu Sharma
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Meena Dahal
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Yogendra Shah
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Dhan Kumar Pant
- National Zoonoses and Food Hygiene Research Centre, Kathmandu, Nepal
| | - Craig Stephen
- Centre for Coastal Health, Nanaimo British Columbia, Canada and Faculty of Veterinary Medicine and Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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Hecker K, El Kurdi S, Joshi D, Stephen C. Using network analysis to explore if professional opinions on Japanese encephalitis risk factors in Nepal reflect a socio-ecological system perspective. ECOHEALTH 2013; 10:415-422. [PMID: 24052266 DOI: 10.1007/s10393-013-0865-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 07/22/2013] [Accepted: 08/10/2013] [Indexed: 06/02/2023]
Abstract
Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia and a significant public health problem in Nepal. Its epidemiology is influenced by factors affecting its amplifying hosts (pigs), vectors (mosquitoes), and dead-end hosts (including people). While most control efforts target reduced susceptibility to infection either by vaccination of people or pigs or by reduced exposure to mosquitoes; the economic reality of Nepal makes it challenging to implement standard JE control measures. An ecohealth approach has been nominated as a way to assist in finding and prioritizing locally relevant strategies for JE control that may be viable, feasible, and acceptable. We sought to understand if Nepalese experts responsible for JE management conceived of its epidemiology in terms of a socio-ecological system to determine if they would consider ecohealth approaches. Network analysis suggested that they did not conceive JE risk as a product of a socio-ecological system. Traditional proximal risk factors of pigs, mosquitoes, and vaccination predominated experts' conception of JE risk. People seeking to encourage an ecohealth approach or social change models to JE management in Nepal may benefit from adopting social marketing concepts to encourage and empower local experts to examine JE from a socio-ecological perspective.
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Affiliation(s)
- Kent Hecker
- Veterinary Clinical and Diagnostic Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T3H 4N1, Canada,
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