Search

Objective To develop a simple tool for assessing the severity of disability resulting from Japanese encephalitis and whether, as a result, a child is likely to be dependent. Methods A new outcome score based on a 15-item questionnaire was developed after a literature review, examination of current assessment tools, discussion with experts and a pilot study. The score was used to evaluate 100 children in Malaysia (56 Japanese encephalitis patients, 2 patients with encephalitis of unknown etiology and 42 controls) and 95 in India (36 Japanese encephalitis patients, 41 patients with encephalitis of unknown etiology and 18 controls). Inter- and intra-observer variability in the outcome score was determined and the score was compared with full clinical assessment. Findings There was good inter-observer agreement on using the new score to identify likely dependency (K = 0.942 for Malaysian children; K = 0.786 for Indian children)and good intra-observer agreement (K = 1.000 and 0.902, respectively). In addition, agreement between the new score and clinical assessment was also good (K = 0.906 and 0.762, respectively). The sensitivity and specificity of the new score for identifying children likely to be dependent were 100% and 98.4% in Malaysia and 100% and 93.8% in India. Positive and negative predictive values were 84.2% and 100% in Malaysia and 65.6% and 100% in India. Conclusion The new tool for assessing disability in children after Japanese encephalitis was simple to use and scores correlated well with clinical assessment. Objectif Developper un outil simple pour evaluer la gravite de l'invalidite resultant de l'encephalite japonaise et, en consequence, la probabilite de dependance de l'enfant. Methodes Une nouvelle echelle d'evaluation basee sur un questionnaire de 15 questions a ete developpee apres une analyse de la litterature, l'examen des outils d'evaluation actueis, une discussion avec les experts et une etude pilote. L'echelle a ete utilisee pour evaluer 100 enfants en Malaisie (56 patients atteints d'encephalite japonaise, 2 patients atteints d'encephalite d'etiologie inconnue et 42 controles) et 95 en Inde (36 patients atteints d'encephalite, 41 patients atteints d'encephalite d'etiologie inconnue et 18 controles). La variabilite inter et intra-observateurs dans l'echelle d'evaluation a ete determinee et l'echelle a ete comparee avec une evaluation clinique complete. Resulfats II a ete observe une bonne correspondance inter-observateurs dans l'utilisation de la nouvelle echelle pour identifier la dependance probable (K = 0,942 pour les enfants malais; K = 0,786 pour les enfants indiens), ainsi qu'une bonne correspondance intra-observateurs (K = 1,000 et 0,902, respectivement). De plus, la correspondance entre la nouvelle echelle et l'evaluation clinique a ete bonne (K = 0,906 et 0,762, respectivement). La sensibilite et la specificite de la nouvelle echelle d'evaluation de la probabilite de dependance des enfants ont ete de 100 % et de 98,4 % en Malaisie et de 100 % et de 93,8 % en Inde. Les valeurs predictives positives et negatives ont ete de 84,2 % et de 100 % en Malaisie et de 65,6 % et de 100 % en Inde. Conclusion Le nouvel outil pour l'evaluation de l'invalidite des enfants apres encephalite japonaise a ete simple a utiliser et les resultats presentent une bonne correlation avec l'evaluation clinique. Objetivos Disenar una herramienta sencilla para valorar la gravedad de la incapacidad causada por la encefalitis japonesa y la posibilidad de que un nino sea dependiente como consecuencia de la misma. Metodos Se ha elaborado una nueva escala de resultados, basada en un cuestionario de 15 puntos, realizado tras una revision bibliografica, en el estudio de las herramientas de valoracion actuales, en el debate con expertos y en un estudio preliminar. La escala se empleo para evaluar a 100 ninos en Malasia (56 pacientes con encefalitis japonesa, 2 pacientes con encefalitis de etiologIa desconocida y 42 controles) y 95 en India (36 pacientes con encefalitis japonesa, 41 pacientes con encefalitis de etiologia desconocida y 18 controles). Se determino la variabilidad interobservador e intraobservador en la escala de resultados y se comparo la escala con una valoracion clinica completa. Resultados Hubo un consenso interobservador tavorable respecto a la utilizacion de la nueva escala para identificar la posible dependencia K = 0,942 en el caso de los hinos malasios; K = 0,786 para los ninos indios) y un consenso intraobservador favorable (K = 1,000 y 0,902, respectivamente). Ademas, el consenso entre la nueva escala y la valoracion clinica tambien fue bueno (K = 0,906 y 0,762, respectivamente). La sensibilidad y la especificidad de la nueva escala para identificar a los ninos que pueden ser dependientes fue del 100% y del 98,4% en Malasia, y del 100% y dei 93,8% en India. Los valores predictivos positivos y negativos fueron dei 84,2% y dei 100% en Malasia, y dei 65,6% y dei 100% en India. Conclusiones La nueva herramienta de valoracion de la incapacidad infantil tras la encefalitis japonesa fue facil de usar y los resultados estaban relacionados con la valoracion clinica., Introduction Neurological disability is a major problem among children in resource-poor countries but the true burden of disability is unknown because there is no simple and reliable way of measuring [...]

During 2005, 764 children were brought to a large children's hospital in Ho Chi Minh City, Vietnam, with a diagnosis of hand, foot, and mouth disease. All enrolled children had [...]

This study provides a comprehensive overview of the molecular epidemiology of human enterovirus 71 (HEV71) in the Asia-Pacific region from 1997 through 2002. Phylogenetic analysis of the VP4 and VP1 [...]

Sequences of enterovirus 75 (EV75) were first identified in cerebrospinal fluid (CSF), stool samples, and throat samples obtained during 1974-2000 in Ethiopia, Oman, Bangladesh, and the United States; the new [...]

Background: The search for the dengue virus receptor has generated many candidates often identified only by molecular mass. The wide host range of the viruses in vitro combined with multiple approaches to identifying the receptor(s) has led to the notion that many receptors or attachment proteins may be involved and that the different dengue virus serotypes may utilize different receptors on the same cells as well as on different cell types. Results: In this study we used sequential extraction of PS Clone D cell monolayers with the detergent β-octylglucopyranoside followed by sodium deoxycholate to prepare a cell membrane-rich fraction. We then used 2 dimensional (2D) gel electrophoresis to separate the membrane proteins and applied a modified virus overlay protein binding assay (VOPBA) to show that dengue virus serotypes 1, 2 and 3 all interact with the 37 kDa/67 kDa laminin receptor (LAMR1), a common non-integrin surface protein on many cell types. Conclusion: At least 3 of the 4 dengue serotypes interact with the 37 kDa/67 kDa laminin receptor, LAMR1, which may be a common player in dengue virus-cell surface interaction. [ABSTRACT FROM AUTHOR]

Background: In Southeast Asia, dengue viruses often co-circulate with other flaviviruses such as Japanese encephalitis virus, and due to the presence of shared antigenic epitopes it is often difficult to use serological methods to distinguish between previous infections by these flaviviruses. Results: Convalescent sera from 69 individuals who were known to have had dengue or Japanese encephalitis virus infection were tested by western blotting against dengue, Japanese encephalitis and West Nile virus antigens. We determined that individuals who had been infected with dengue viruses had IgG responses against the premembrane protein of dengue viruses but not Japanese encephalitis, whereas individuals who had been infected with Japanese encephalitis had IgG specific for the premembrane protein of Japanese encephalitis virus but not the dengue viruses. None reacted with the premembrane protein of West Nile virus. Using the Pearson Chi Square test, it was determined that the difference between the two groups was highly significant with a p value of <0.001. Conclusion: The use of flavivirus premembrane protein in seroepidemiological studies will be useful in determining what flaviviruses have circulated in a community. [ABSTRACT FROM AUTHOR]

Enterovirus 71 (EV71) causes childhood hand, foot, and mouth disease and neurological complications, and no vaccines or therapeutic drugs are currently available. Formaldehyde-inactivated whole-virus vaccines derived from EV71 clinical isolates and a mouse-adapted virus (MAV) were tested in a mouse model of EV71 encephalomyelitis. After only two immunizations, given to mice at 1 and 7 days of age, the MAV vaccine protected mice at 14 days of age from disease. Tissues from immunized mice were negative for virus by viral culture, reverse transcriptase PCR, immunohistochemistry analysis, and in situ hybridization. Cross-neutralizing EV71 antibodies to strains with genotypes B3, B4, and C1 to C5 generated in immunized adult mice were able to passively protect 14-day-old mice from disease. [ABSTRACT FROM AUTHOR]

Objective To develop a simple tool for assessing the severity of disability resulting from Japanese encephalitis and whether, as a result, a child is likely to be dependent. Methods A new outcome score based on a 15-item questionnaire was developed after a literature review, examination of current assessment tools, discussion with experts and a pilot study. The score was used to evaluate 100 children in Malaysia (56 Japanese encephalitis patients, 2 patients with encephalitis of unknown etiology and 42 controls) and 95 in India (36 Japanese encephalitis patients, 41 patients with encephalitis of unknown etiology and 18 controls). Inter- and intra-observer variability in the outcome score was determined and the score was compared with full clinical assessment. Findings There was good inter-observer agreement on using the new score to identify likely dependency (Ê = 0.942 for Malaysian children; Ê = 0.786 for Indian children) and good intra-observer agreement (Ê = 1.000 and 0.902, respectively). In addition, agreement between the new score and clinical assessment was also good (Ê = 0.906 and 0.762, respectively). The sensitivity and specificity of the new score for identifying children likely to be dependent were 100% and 98.4% in Malaysia and 100% and 93.8% in India. Positive and negative predictive values were 84.2% and 100% in Malaysia and 65.6% and 100% in India. Conclusion The new tool for assessing disability in children after Japanese encephalitis was simple to use and scores correlated well with clinical assessment. [ABSTRACT FROM AUTHOR]