Aetiology of acute meningoencephalitis in Cambodian children, 2010–2013

Paul Horwood (1) , Veasna Duong (1) , Denis Laurent (2) , Channa Mey (1) , Heng Sothy (2) , Ky Santy (2) , Beat Richner (2) , Seiha Heng (3) , Sopheak Hem (3) , Justine J. Cheval (4) , Christopher Gorman (1) , Philippe Dussart (1) , Menno de Jong (5) , Alexandra Kerleguer (3) , Bertrand Guillard (3) , Bernadette Murgue (6) , Marc Lecuit (7) , Xavier de Lamballerie (8, 9) , Jeremy Farrar (10) , Arnaud Tarantola (11) , Marc Eloit (4, 7) , Philippe Buchy (1, 12)

1 Unité de Virologie / Virology Unit [Phnom Penh]
2 Kantha Bopha Hospitals Foundation
3 Institut Pasteur du Cambodge
4 PathoQuest
5 UvA - University of Amsterdam [Amsterdam]
6 OMS / WHO - Organisation Mondiale de la Santé / World Health Organization Office
7 Biologie des Infections - Biology of Infection
8 IRD - Institut de Recherche pour le Développement
9 EHESP - École des Hautes Études en Santé Publique [EHESP]
10 OUCRU - Oxford University Clinical Research Unit [Ho Chi Minh City]
11 Unité d'Épidémiologie et de Santé Publique [Phnom Penh]
12 GlaxoSmithKline

Acute meningoencephalitis (AME) is associated with considerable morbidity and mortality in children in developing countries. Clinical specimens were collected from children presenting with AME at two Cambodian paediatric hospitals to determine the major aetiologies associated with AME in the country. Cerebrospinal fluid (CSF) and blood samples were screened by molecular and cell culture methods for a range of pathogens previously associated with AME in the region. CSF and serum (acute and convalescent) were screened for antibodies to arboviruses such as Japanese encephalitis virus (JEV), dengue virus (DENV), and chikungunya virus (CHIKV). From July 2010 through December 2013, 1160 children (one month to 15 years of age) presenting with AME to two major paediatric hospitals were enroled into the study. Pathogens associated with AME were identified using molecular diagnostics, cell culture and serology. According to a diagnostic algorithm, a confirmed or highly probable aetiologic agent was detected in 35.0% (n=406) of AME cases, with a further 9.2% (total: 44.2%, n=513) aetiologies defined as suspected. JEV (24.4%, n=283) was the most commonly identified pathogen followed by Orientia tsutsugamushi (4.7%, n=55), DENV (4.6%, n=53), enteroviruses (3.5%, n=41), CHIKV (2.0%, n=23) and Streptococcus pneumoniae (1.6%, n=19). The majority of aetiologies identified for paediatric AME in Cambodia were vaccine preventable and/or treatable with appropriate antimicrobials.

Keywords: chikungunya virus; dengue virus; encephalitis; Japanese encephalitis virus; meningoencephalitis; meningitis; paediatric; scrub typhus

Domains: Infectious diseases

Paul Horwood, Veasna Duong, Denis Laurent, Channa Mey, Heng Sothy, et al.. Aetiology of acute meningoencephalitis in Cambodian children, 2010–2013. Emerging microbes & infections, 2017, 6 (5), pp.e35. ⟨10.1038/emi.2017.15⟩. ⟨pasteur-01739350⟩