The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

Win, Aung Ye Naung; Wai, Khin Thet; Harries, Anthony; Kyaw, Nang Thu Thu; Oo, Tin; Than, Wint Phyo; Lin, Htar Htar; Lin, Zaw

doi:10.1186/s41182-020-00200-3

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…In endemic areas, there are more studies on disease burden (i.e. morbidity and mortality) instead of studies on economic burden [37][38][39][40][41][42]. We estimated the DALYs of JE in Zhejiang Province during 2013-2018 was 80.01 per million population (53.67 YLDs, 26.34 YLLs) when EF = 3 was applied using GBD 2010 methodology.…”

Section: Discussionmentioning

confidence: 99%

Economic and disease burden of Japanese encephalitis in Zhejiang Province, 2013–2018

Deng

Yan

et al. 2021

PLoS Negl Trop Dis

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Background Japanese encephalitis (JE) is a mosquito-borne disease and associated with high mortality and disability rate among symptomatic cases. In the absence of local data, this study estimated the economic burden and the disability-adjusted life years (DALYs) due to JE in Zhejiang Province, China during 2013–2018, to increase disease awareness and provide evidence for effective health policy. Methodology/Principle findings We merged multiple data sources, including National Notifiable Disease Registry System (NNDRS), patient interviews and medical records from corresponding hospitals for JE cases which occurred during 2013–2018 in Zhejiang Province. Direct costs were extracted from hospitals’ billing systems and patient interviews. Indirect costs and disease burden were calculated based on questionnaire survey from patient interviews and follow-up assessment by general practitioners. Given under-reporting, an expansion factor (EF) was applied to extrapolate the JE burden to the provincial level. The total economic burden of JE during 2013–2018 was estimated at US $12.01 million with an EF = 3. Of this, $8.32 million was due to direct economic cost and $3.69 million to indirect cost. The disease burden of JE was 42.75 DALYs per million population (28.44 YLD, 14.28 YLL) according to the 1990 Global Burden of Disease (GBD 1990) methodology and 80.01 DALYs (53.67YLD, 26.34YLL) according to the GBD 2010 methodology. Sensitivity analysis demonstrated that the overall economic burden varied from US$ 1.73–36.42 million. The greatest variation was due to the prognosis of illness (-85.57%-203.17%), followed by occupation (-34.07%-134.12%) and age (-72.97%-47.69%). Conclusions/Significance JE imposes a heavy burden for families and society in Zhejiang Province. This study provides comprehensive empirical estimates of JE burden to increase awareness and strengthen knowledge of the public. These data may support provincial level public health decision making for prevention and control of JE. Ongoing surveillance for acute meningitis and encephalitis syndrome (AEMS) in sentinel hospitals, is needed to further refine estimates of JE burden.

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Section: Discussionmentioning

confidence: 99%

Economic and disease burden of Japanese encephalitis in Zhejiang Province, 2013–2018

Deng

Yan

et al. 2021

PLoS Negl Trop Dis

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“…However, widespread outbreaks began in 2014 and continue to pose a significant public health problem. After gradual increases, the number of detected cases reached 404 in 2016 [6]. At present, JE cases have been detected in all states and regions of Myanmar, primarily affecting children aged nine months to 15 years old [7].…”

Section: Introductionmentioning

confidence: 97%

Effectiveness of the SA 14-14-2 Live-Attenuated Japanese Encephalitis Vaccine in Myanmar

et al. 2021

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Myanmar is an endemic country for the Japanese encephalitis virus (JEV), and the SA-14-14-2 live-attenuated JEV vaccine was first introduced as a catch-up vaccination campaign in 2017. To determine the effectiveness of vaccination by means of neutralizing antibody titers against JEV, a cross-sectional descriptive study was conducted among five to 15-year-old monastic school children in Mandalay, Myanmar. A total of 198 students who had received vaccines were recruited, and single-time investigation of anti-JEV IgG and neutralizing antibodies against wild-type JEV were determined using anti-JEV IgG ELISA and plaque reduction neutralization tests (PRNT50). All students 100% (198/198) showed positive results on the anti-JEV IgG ELISA, and 87% (172/198) of the students had neutralizing antibodies against JEV six months after immunization. The geometric mean titers of both IgG antibodies and neutralizing antibodies increased with the participants’ age groups, and statistically significant differences in anti-JEV IgG titers were noted across age groups. In this study, we could not investigate the persistence of neutralizing antibodies as only single-time blood collection was done. This study, which is the first report of JEV vaccination among children in Myanmar, showed similar neutralizing antibody production rates among vaccinated individuals as did studies in other countries.

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“…Vaccines are available only for JEV, YFV, and tick-borne encephalitis virus (TBEV). However, due to poor vaccination coverage and genotypic shift, the number of cases for these viruses remains quite high [ 14 , 15 ]. The world’s first approved dengue vaccine, tetravalent dengue vaccine CYD-TDV (Dengvaxia, Sanofi Pasteur, Lyon France), has been suspended in the Philippines due to its enhanced risk of severe dengue in seronegative individuals, a phenomenon associated with the occurrence of antibody-dependent enhancement (ADE) [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Finding a chink in the armor: Update, limitations, and challenges toward successful antivirals against flaviviruses

et al. 2022

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Flaviviruses have caused large epidemics and ongoing outbreaks for centuries. They are now distributed in every continent infecting up to millions of people annually and may emerge to cause future epidemics. Some of the viruses from this group cause severe illnesses ranging from hemorrhagic to neurological manifestations. Despite decades of research, there are currently no approved antiviral drugs against flaviviruses, urging for new strategies and antiviral targets. In recent years, integrated omics data-based drug repurposing paired with novel drug validation methodologies and appropriate animal models has substantially aided in the discovery of new antiviral medicines. Here, we aim to review the latest progress in the development of both new and repurposed (i) direct-acting antivirals; (ii) host-targeting antivirals; and (iii) multitarget antivirals against flaviviruses, which have been evaluated both in vitro and in vivo, with an emphasis on their targets and mechanisms. The search yielded 37 compounds that have been evaluated for their efficacy against flaviviruses in animal models; 20 of them are repurposed drugs, and the majority of them exhibit broad-spectrum antiviral activity. The review also highlighted the major limitations and challenges faced in the current in vitro and in vivo evaluations that hamper the development of successful antiviral drugs for flaviviruses. We provided an analysis of what can be learned from some of the approved antiviral drugs as well as drugs that failed clinical trials. Potent in vitro and in vivo antiviral efficacy alone does not warrant successful antiviral drugs; current gaps in studies need to be addressed to improve efficacy and safety in clinical trials.

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The burden of Japanese encephalitis, the catch-up vaccination campaign, and health service providers’ perceptions in Myanmar: 2012–2017

Cited by 6 publications

References 26 publications

Economic and disease burden of Japanese encephalitis in Zhejiang Province, 2013–2018

Economic and disease burden of Japanese encephalitis in Zhejiang Province, 2013–2018

Effectiveness of the SA 14-14-2 Live-Attenuated Japanese Encephalitis Vaccine in Myanmar

Finding a chink in the armor: Update, limitations, and challenges toward successful antivirals against flaviviruses

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