Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017—January 2018

Bumburidi, Yekaterina; Utepbergenova, Gulmira; Yerezhepov, Bakhtygali; Berdiyarova, Nursulu; Kulzhanova, Kaldikul; Head, Jennifer R.; Moffett, Daphne B.; Singer, Daniel; Angra, Pawan; Whistler, Toni; Sejvar, James J.

doi:10.1371/journal.pone.0251494

Cited by 6 publications

(6 citation statements)

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“…These data do not re ect the true picture of the spread of enterovirus HA in Kazakhstan, since the classic mild course of herpangina may remain unreported due to home or local hospital treatment. The high number of cases of aseptic meningitis in our study correlates with previous study data, in which enteroviruses were identi ed as etiological agent in 73% of cases of encephalitis and meningitis in Kazakhstan, with the average incidence of 14 per 100,000 population, and for children under 15 years of age the incidence is 35.9 per 100,000 children (Bumburidi et al, 2021). Despite the high incidence rate, information on circulating serotypes is limited.…”

Section: Discussionsupporting

confidence: 86%

Genetic diversity of enteroviral meningitis, herpangina and hand, foot, and mouth disease in Kazakhstan

Dinara,

Assel,

Asylulan

et al. 2023

Preprint

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Enteroviral infection is a common cause of aseptic meningitis, herpangina, and hand, foot, and mouth disease in children. Limited data are available on the enteroviral subtypes associated with hospitalization for these conditions in Kazakhstan. We collected cerebrospinal fluid (CSF) and nasopharyngeal swabs (NSW) from children (N=152, median age=8 years) hospitalized with symptoms of aseptic meningitis (AM, N=139) or herpangina (HA, N=13) disease. We then genotyped enteroviral subtypes associated with AM (n=50) and HA (n=9) using next-generation sequencing (NGS) on the viral protein 1 (VP1), followed up by whole-genome sequencing of the isolated viral species. All identified EVs were species B EV, consisting of five echovirus (E6, E9, E11, E21 and E25) and three coxsackievirus (CVA9, CVB3 and CVB5) serotypes within the cohort. The most abundant EVs were CVA9 (38.5%), CVB5 (21.5%) and E6 (13.8%). Most HA samples (6/9) were genotyped with coxsackievirus CVA9, while AM was associated with a variety of both echovirus and coxsackievirus serotypes. The results suggest that coxsackievirus CVA9 may be the dominant serotype circulating in the HA population, while AM is more diverse in terms of circulating echovirus and coxsackievirus serotypes. Further studies are needed to determine the clinical implications of these findings and to investigate potential differences in disease severity or outcomes associated with different EV serotypes.

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Section: Discussionsupporting

confidence: 86%

Genetic diversity of enteroviral meningitis, herpangina and hand, foot, and mouth disease in Kazakhstan

Dinara,

Assel,

Asylulan

et al. 2023

Preprint

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“…L monocytogenes was among the most frequent pathogens in adults (70 of 630 studies [11%]; 77 of 733 study periods [11%]; 1829 of 314 454 episodes [0.6%]) (eTable 20 and eFigure 37 in Supplement 1). The overall CFR was 27% (95% CI, 24% to 31%) (eFigure 38 in Supplement 1); CFR was 35% (95% CI, 24% to 47%) before 1961 and 25% (95% CI, 20% to 30%) in the 2000s. An insufficient number of studies were available to analyze the CFR in adults of low-income countries (eTable 21 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…N meningitidis was among the most frequent pathogens in children and adults (250 studies; 274 study periods; 123 830 episodes) (eTable 16 and eFigure 27 in Supplement 1). This sample was dominated by a Nigerian study describing an outbreak in 2009 with more than 50 000 patients . The overall CFR was 8.8% (95% CI, 8.0% to 9.7%) (eFigure 28 in Supplement 1); CFR was 11% (95% CI, 8% to 16%) before 1961 and 7.2% (95% CI, 5.8.% to 8.7%) i...…”

Section: Resultsmentioning

confidence: 99%

“…H influenzae was among the most frequent pathogens in children (226 of 630 studies [36%]; 249 of 733 study periods [34%]; 49 539 of 314 454 episodes [16%]) (eTable 18 and eFigure 32 in Supplement 1). The overall CFR was 11% (95% CI, 10% to 13%) (eFigure 33 in Supplement 1); CFR was 13% (95% CI, 10% to 18%) before 1961 and 10% (95% CI, 7% to 16%) after 2010. CFR was higher in low-income countries (23%; 95% CI, 19% to 29%) compared with high-income countries (7%; 95% CI, 5% to 9%) (eTable 19 in Supplement 1) and did not decrease substantially during the period (0.7% per year; 95% CI, −0.3% to 1.7% per year; P = .17) (eFigures 34 to 36 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

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Global Case Fatality of Bacterial Meningitis During an 80-Year Period

van Ettekoven,

Liechti,

Brouwer

et al. 2024

JAMA Netw Open

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ImportanceThe impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain.ObjectiveTo describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis.Data SourcesGoogle Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality.Study SelectionIncluded studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care–associated meningitis, tuberculous meningitis, or missing outcome were excluded.Data Extraction and SynthesisData were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period’s year as an estimator variable were used.Main Outcome and MeasureCase fatality ratios of bacterial meningitis.ResultsThis review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients’ sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P &lt; .001).Conclusions and RelevanceIn this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

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“…But the national epidemiological situation of meningitis in Kazakhstan is unknown. With the exception of a surveillance study for meningitis and encephalitis in a high-endemic area of South Kazakhstan ( 13 ), there were no studies conducted related to VM both in adults and children at a country level. Generally, epidemiological studies are critical in understanding disease trends and relationships, which may contribute to disease control ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics and climatic variability of viral meningitis in Kazakhstan, 2014–2019

Yerdessov

Zhunussova

Imanova³

et al. 2023

Front. Public Health

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BackgroundThe comprehensive epidemiology and impact of climate on viral meningitis (VM) in Kazakhstan are unknown. We aimed to study the incidence, in-hospital mortality and influence of climatic indicators on VM from 2014 to 2019.MethodsNationwide electronic healthcare records were used to explore this study. ICD-10 codes of VM, demographics, and hospital outcomes were evaluated using descriptive statistics and survival analysis.ResultsDuring the 2014–2019 period, 10,251 patients with VM were admitted to the hospital. 51.35% of them were children, 57.85% were males, and 85.9% were from the urban population. Enteroviral meningitis was the main cause of VM in children. The incidence rate was 13 and 18 cases per 100,000 population in 2014 and 2019, respectively. Case fatality rate was higher in 2015 (2.3%) and 2017 (2.0%). The regression model showed 1°C increment in the daily average temperature might be associated with a 1.05-fold (95% CI 1.047–1.051) increase in the daily rate of VM cases, 1hPa increment in the average air pressure and 1% increment in the daily average humidity might contribute to a decrease in the daily rate of VM cases with IRRs of 0.997 (95% CI 0.995–0.998) and 0.982 (95% CI 0.981–0.983), respectively. In-hospital mortality was 35% higher in males compared to females. Patients residing in rural locations had a 2-fold higher risk of in-hospital death, compared to city residents. Elderly patients had a 14-fold higher risk of in-hospital mortality, compared to younger patients.ConclusionThis is the first study in Kazakhstan investigating the epidemiology and impact of climate on VM using nationwide healthcare data. There was a tendency to decrease the incidence with outbreaks every 5 years, and mortality rates were higher for Russians and other ethnicities compared to Kazakhs, for males compared to females, for elder patients compared to younger patients, and for patients living in rural areas compared to city residents. The climatic parameters and the days of delay indicated a moderate interaction with the VM cases.

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Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017—January 2018

Cited by 6 publications

References 45 publications

Genetic diversity of enteroviral meningitis, herpangina and hand, foot, and mouth disease in Kazakhstan

Genetic diversity of enteroviral meningitis, herpangina and hand, foot, and mouth disease in Kazakhstan

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

Epidemiological characteristics and climatic variability of viral meningitis in Kazakhstan, 2014–2019

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