1
|
Tandale BV, Deshmukh PS, Tomar SJ, Narang R, Qazi MS, Goteti Venkata P, Jain M, Jain D, Guduru VK, Jain J, Gosavi RV, Valupadas CS, Deshmukh PR, Raut AV, Narlawar UW, Jha PK, Bondre VP, Sapkal GN, Damle RG, Khude PM, Niswade AK, Talapalliwar M, Rathod P, Balla PS, Muttineni PK, Kalepally Janakiram KK, Rajderkar SS. Incidence of Japanese Encephalitis and Acute Encephalitis Syndrome Hospitalizations in the Medium-Endemic Region in Central India. J Epidemiol Glob Health 2023; 13:173-179. [PMID: 37162636 PMCID: PMC10271976 DOI: 10.1007/s44197-023-00110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/17/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND We estimated the incidence of Japanese encephalitis (JE) and acute encephalitis syndrome (AES) following routine immunization with the live-attenuated SA 14-14-2 JE vaccine. METHODS We implemented enhanced surveillance of AES and JE hospitalizations in endemic districts in Maharashtra and Telangana States during 2015-2016 and 2018-2020. We estimated incidence and compared differences in the incidence of JE and AES between two states, and vaccinated and unvaccinated districts during two study periods. We also considered secondary data from public health services to understand long-term trends from 2007 to 2020. RESULTS The annual AES incidence rate of 2.25 cases per 100,000 children in Maharashtra during 2018-2020 was significantly lower than 3.36 cases per 100,000 children during 2015-2016. The six JE-vaccinated districts in Maharashtra had significantly lower incidence rates during 2018-2020 (2.03, 95% CI 1.73-2.37) than in 2015-16 (3.26, 2.86-3.70). In addition, the incidence of both JE and AES in two unvaccinated districts was higher than in the vaccinated districts in Maharashtra. Telangana had a lower incidence of both JE and AES than Maharashtra. The AES incidence rate of 0.95 (0.77-1.17) during 2018-2020 in Telangana was significantly lower than 1.67 (1.41-1.97) during 2015-2016. CONCLUSIONS The annual incidence rate of Japanese encephalitis was < 1 case per 100,000 children. It indicated accelerated control of Japanese encephalitis after routine immunization. However, the annual incidence of acute encephalitis syndrome was still > 1 case per 100,000 children. It highlights the need for improving surveillance and evaluating the impacts of vaccination.
Collapse
Affiliation(s)
- Babasaheb V Tandale
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India.
| | - Pravin S Deshmukh
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | - Shilpa J Tomar
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | - Rahul Narang
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | | | | | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Dipty Jain
- Government Medical College, Nagpur, Maharashtra, India
| | | | - Jyoti Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | - Pradeep R Deshmukh
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
- All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Abhishek V Raut
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | - Vijay P Bondre
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | - Gajanan N Sapkal
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | - Rekha G Damle
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | - Poornima M Khude
- Epidemiology Group, ICMR-National Institute of Virology, 130/1, Sus Road, Pashan, Pune, Maharashtra, 411021, India
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Tandale BV, Khude PM, Deshmukh PS, Narang R, Qazi MS, Padmaja GV, Jain M, Jain D, Guduru VK, Deshmukh PR, Raut AV, Narlawar UW, Jha PK, Rajderkar SS. Effectiveness of Japanese encephalitis vaccination among children in central India. J Med Virol 2023; 95:e28399. [PMID: 36512338 DOI: 10.1002/jmv.28399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/19/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Japanese encephalitis (JE) disease among children continues in central India despite vaccination implemented in the routine immunization program. Therefore, we planned to estimate the JE vaccination effectiveness among children by undertaking a 1:2 individually-matched population-based case-control study from August 2018 to October 2020. The laboratory-confirmed JE cases aged 1-15 years were enrolled along with neighborhood controls without fever and encephalitis matched on the residence area, age and sex. The JE vaccination history was enquired from parents and verified independently from the vaccination cards available at home and records at health facilities. We enrolled 35 JE cases and 70 matched controls. The vaccination effectiveness of 86.7% (95% confidence interval [CI]: 30.8-94.7) was estimated on the per-protocol analysis of 31 case-control sets. The screening method provided an effectiveness of 89.5% (CI: 78.9-94.7) on using the population vaccination coverage of 90% reported earlier in the same area. In conclusion, JE vaccination offered a moderate level of protection among children in JE medium-endemic central India, similar to reports from high-endemic areas in India. The operational aspects of vaccination program implementation need to be evaluated to assess the impact of vaccination on the disease burden of JE in medium-endemic regions of India.
Collapse
Affiliation(s)
- Babasaheb V Tandale
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Poornima M Khude
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Pravin S Deshmukh
- Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Rahul Narang
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Mohiuddin S Qazi
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Goteti V Padmaja
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Manish Jain
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Dipty Jain
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Vijay Kumar Guduru
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Pradeep R Deshmukh
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Abhishek V Raut
- Microbiology Department, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Uday W Narlawar
- Microbiology Department, Government Medical College, Nagpur, Maharashtra, India
| | - Punam Kumari Jha
- Microbiology Department, Kakatiya Medical College, Warangal, Telangana, India
| | - Shekhar S Rajderkar
- Community Medicine Deaprtment, Government Medical College, Miraj, Maharashtra, India
| | | |
Collapse
|
3
|
Tandale BV, Deshmukh PS, Narang R, Qazi MS, Padmaja GV, Deshmukh PR, Raut AV, Narlawar UW, Jha PK, Rajderkar SS. Coverage of Japanese encephalitis routine vaccination among children in central India. J Med Virol 2023; 95:e28155. [PMID: 36114690 DOI: 10.1002/jmv.28155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/08/2022]
Abstract
We aimed to estimate the coverage of Japanese encephalitis (JE) vaccination in central India to help explain the continued occurrence of JE disease despite routine vaccination. We implemented a 30-cluster survey for estimating the coverage of JE vaccination in the medium-endemic areas implemented with JE vaccination in central India. The parents were enquired about the uptake of the JE vaccine by their children aged 2-6 years, followed by verification of the immunization cards at home along with reasons for non-vaccination. Vaccination coverage was reported as a percentage with 95% confidence intervals (CI). We estimated high coverage of live-attenuated SA 14-14-2 JE vaccination in Maharashtra (94.8%, 95% CI: 92.7-96.3) and Telangana (92.8%, 95% CI: 90.0-94.9). The vaccination card retention was 90.3% in Maharashtra and 70.4% in Telangana state. There were no gender differences in coverage in both states. A similar level of JE vaccination coverage was observed during the year 2013-2021 in both states. In Maharashtra, the maximum age-wise coverage was 96.6% in the >60 months age category, whereas in Telangana it was in the <24 months age category (97.2%). The timeliness of JE vaccination was appropriate and similar in both states. We found a very good agreement between JE and measles-rubella vaccinations administered simultaneously. The reasons for non-vaccination were the shortage of vaccines and the parental migration for work. The coverage of JE vaccination was high in medium-endemic regions in central India. Vaccination effectiveness studies may help further explain the continued incidence of JE.
Collapse
Affiliation(s)
| | | | - Rahul Narang
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | - Pradeep R Deshmukh
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | - Abhishek V Raut
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India
| | | | | | | |
Collapse
|