Aetiology of acute meningoencephalitis in Cambodian children, 2010–2013

Figures & data

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Table 1 Demographic characteristics of the study participants

Characteristics	Siem Reap	Phnom Penh	Total
Number of patients	931	229	1160
Date range	July 2010–September 2013	February–December 2013	July 2010–December 2013
Age
Range	1 month–15 years	2 months–15 years	1 month–15 years
Median	6 years	5 years	6 years
1–11 months	36 (3.9%)	10 (4.5%)	46 (4.0%)
1–5 years	422 (45.3%)	107 (46.7%)	529 (45.6%)
6–10 years	255 (27.4%)	67 (29.3%)	322 (27.8%)
11–15 years	217 (23.3%)	40 (17.5%)	257 (22.2%)
Unknown	1 (0.1%)	5 (2.2%)	6 (0.5%)
Sex
Female	381 (40.9%)	102 (44.5%)	483 (41.6%)
Male	550 (59.1%)	126 (55.0%)	676 (58.3%)
Unknown	0	1 (0.4%)	1 (0.09%)

Table 2 Laboratory results to determine the aetiology of acute meningoencephalitis in Cambodian children

Pathogen^a	CSF-PCR or Culture	Confirmed Blood-PCR or Culture	Confirmed	Highly probable CSF IgM or PCR detection of CMV or EBV in CSF	Suspected Blood IgM or EV71 throat and rectal PCR	Total (n=1,160)
	CSF—PCR or Culture	Blood—PCR or Culture	Total
Japanese encephalitis virus	3	0	3 (0.3%)	233 (20.1%)	47 (4.1%)	283 (24.4%)
Dengue virus 1	10^b	6^b	16 (4.4%)
Dengue virus 2	3^c	2^c	5 (0.4%)	5 (0.4%)	25 (2.2%)	53 (4.6%)
Dengue virus 3	0	1	1 (0.09%)
Dengue virus 4	0	1	1 (0.09%)
Flavivirus	0	0	0	8 (0.7%)	20 (1.7%)	28 (2.4%)
Chikungunya virus	7^d	4^d	11 (0.9%)	6 (0.5%)	6 (0.5%)	23 (2.0%)
Enterovirus	22	0	22 (1.9%)	NA	NA	22 (1.9%)
Enterovirus 71	9	0	9 (0.8%)	NA	10 (0.9%)	19 (1.6%)
Herpes simplex virus	11	NA	11 (0.9%)	NA	NA	11 (0.9%)
Epstein-Barr virus	NA	NA	NA	10 (0.9%)	NA	10 (0.9%)
Cytomegalovirus	NA	NA	NA	5 (0.4%)	NA	5 (0.4%)
Streptococcus pneumoniae	19	0	19 (1.6%)	NA	NA	19 (1.6%)
Haemophilus influenzae	8	0	8 (0.7%)	NA	NA	8 (0.7%)
Neisseria meningitidis	2	0	2 (0.2%)	NA	NA	2 (0.2%)
Orientia tsutsugamushi	4^e	51^e	55 (4.7%)	NA	NA	55 (4.7%)
Total^f	NA	NA	141 (12.2%)	265 (22.8%)	107 (9.2%)	513 (44.2%)

Abbreviations: cytomegalovirus, CMV; cerebrospinal fluid, CSF; Epstein-Barr virus, EBV; immunoglobulin, IgM; not applicable, NA.

a Only pathogens detected in the study are included in the table.

b 2 cases were positive in both CSF and blood, 8 cases were positive in CSF only, 6 cases were positive in blood only.

c 1 case was positive in both CSF and blood, 2 cases were positive in CSF only, 2 cases were positive in blood only.

d 6 cases were positive in both CSF and blood, 1 case was positive in CSF only, 4 cases were positive in blood only.

e 4 cases were positive in both CSF and blood, 0 cases were positive in CSF only, 51 cases were positive in blood only.

f Only the number of patients were included in the total amounts (i.e. a coinfection with two pathogens was not counted twice).

Table 3 Age and gender characteristics for patients in which the main pathogens were detected

Pathogen detected^a	Gender ratio (M:F)	Median age (years)	Age groups (% of total number in age group)
			1–11 months	1–5 years	6–10 years	11–15 years
JEV	1.6 (144:92)	5	1 (2.2%)	119 (22.5%)	85 (26.4%)	30 (11.7%)
DENV1-4	1.5 (17:11)	6	2 (4.3%)	12 (2.3%)	9 (2.8%)	5 (1.9%)
CHIKV	16 (16:1)	7	0	8 (1.5%)	4 (1.2%)	5 (1.9%)
Enterovirus^b	1.8 (20:11)	4	0	19 (3.6%)	9 (2.8%)	3 (1.2%)
S. pneumoniae	1.4 (11:8)	4	0	12 (2.3%)	4 (1.2%)	3 (1.2%)
O. tsutsugamushi	1.4 (32:23)	8	1 (2.2%)	18 (3.4%)	11 (3.4%)	25 (9.7%)
Baseline	1.4 (676:483)	6	n=46	n=529	n=322	n=257

Abbreviations: chikungunya virus, CHIKV; dengue virus, DENV; Japanese encephalitis virus, JEV.

a Confirmed and highly probable aetiologies.

b Including EV-A71.

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