Viral etiology of encephalitis in children in southern Vietnam: results of a one-year prospective descriptive study.
BACKGROUND
Acute encephalitis is an important and severe disease in children in Vietnam. However, little is known about the etiology while such knowledge is essential for optimal prevention and treatment. To identify viral causes of encephalitis, in 2004 we conducted a one-year descriptive study at Children's Hospital Number One, a referral hospital for children in southern Vietnam including Ho Chi Minh City.


RESULTS
Children less than 16 years of age presenting with acute encephalitis of presumed viral etiology were enrolled. Diagnostic efforts included viral culture, serology and real time (RT)-PCRs. A confirmed or probable viral causative agent was established in 41% of 194 enrolled patients. The most commonly diagnosed causative agent was Japanese encephalitis virus (n = 50, 26%), followed by enteroviruses (n = 18, 9.3%), dengue virus (n = 9, 4.6%), herpes simplex virus (n = 1), cytomegalovirus (n = 1) and influenza A virus (n = 1). Fifty-seven (29%) children died acutely. Fatal outcome was independently associated with patient age and Glasgow Coma Scale (GCS) on admission.


CONCLUSIONS
Acute encephalitis in children in southern Vietnam is associated with high mortality. Although the etiology remains unknown in a majority of the patients, the result from the present study may be useful for future design of treatment and prevention strategies of the disease. The recognition of GCS and age as predictive factors may be helpful for clinicians in managing the patient.
Oxford University Clinical Research Unit, South East Asia Infectious Diseases Clinical Research Network, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. tanlv@oucru.org
Van Tan
VT
Le
Tu Qui
TQ
Phan
Quang Ha
QH
Do
Bach Hue
BH
Nguyen
Quoi Bao
QB
Lam
Van  Cam
V
Bach
Huu  Khanh
H
Truong
Tinh Hien
TH
Tran
Van  Vinh Chau
V
Nguyen
Tan  Tram
T
Tran
Minh  Hien
M
Vo
Vu Thieu  Nga
VT
Tran
Constance
C
Schultsz
Jeremy
J
Farrar
H Rogier
HR
van Doorn
Menno D
MD
de Jong
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000473:pathology; D018792:Encephalitis, Viral / Q000453:epidemiology* / Q000401:mortality / Q000821:virology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D014744:Vietnam / Q000453:epidemiology; D014773:Virology / Q000379:methods; D014780:Viruses / Q000145:classification* / Q000302:isolation & purification*