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Review
[Online ahead of print]

A Need to Raise the Bar - A Systematic Review of Temporal Trends in Diagnostics for Japanese Encephalitis Virus Infection, and Perspectives for Future Research

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Review

A Need to Raise the Bar - A Systematic Review of Temporal Trends in Diagnostics for Japanese Encephalitis Virus Infection, and Perspectives for Future Research

Tehmina Bharucha et al. Int J Infect Dis.

Abstract

Objective: Japanese encephalitis virus infection (JEV) remains a leading cause of neurological infection in Asia, largely involving individuals living in remote areas with limited access to treatment centres and diagnostic facilities. Laboratory confirmation is fundamental for the justification and implementation of vaccination programmes. We sought to review the literature on historical developments and current diagnostic capability worldwide, to identify knowledge gaps and instil urgency to address them.

Methods: Searches were performed in Web of Science and PubMed using the text word term 'Japanese encephalitis' up to 13th October 2019. Studies reporting laboratory-confirmed symptomatic JE cases in humans were included, and data on details of diagnostic tests were extracted. A JE case was classified according to confirmatory levels (1-4), where level 1 represented the highest level of confidence.

Findings: 20,212 published JE cases were identified from 205 studies. 15,167 (75%) of these positive cases were confirmed with the lowest confidence diagnostic test (level 3 or 4, or level 4). Only 109 (53%) of the studies reported contemporaneous testing for dengue-specific antibodies.

Conclusion: A fundamental pre-requisite for the control of JE is lacking --- that of a simple and specific diagnostic procedure that can be adapted for point-of-care tests and readily used throughout JE endemic regions of the world.

Keywords: Flavivirus; Japanese encephalitis; Neurological infection; Public Health; Vaccination.

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