西方工业化国家和热带国家急性脑炎综合征的发病率。
The incidence of acute encephalitis syndrome in Western industrialised and tropical countries.
作者信息
Jmor Fidan, Emsley Hedley C A, Fischer Marc, Solomon Tom, Lewthwaite Penny
机构信息
Division of Neuroscience, University of Liverpool, Clinical Sciences Centre, Lower Lane, Liverpool L97LJ, UK.
出版信息
Virol J. 2008 Oct 30;5:134. doi: 10.1186/1743-422X-5-134.
BACKGROUND
As part of efforts to control Japanese encephalitis (JE), the World Health Organization is producing a set of standards for JE surveillance, which require the identification of patients with acute encephalitis syndrome (AES). This review aims to provide information to determine what minimum annual incidence of AES should be reported to show that the surveillance programme is active.
METHODS
A total of 12,436 articles were retrieved from 3 databases; these were screened by title search and duplicates removed to give 1,083 papers which were screened by abstract (or full paper if no abstract available) to give 87 papers. These 87 were reviewed and 25 papers identified which met the inclusion criteria.
RESULTS
Case definitions and diagnostic criteria, aetiologies, study types and reliability varied among the studies reviewed. Amongst prospective studies reviewed from Western industrialised settings, the range of incidences of AES one can expect was 10.5-13.8 per 100,000 for children. For adults only, the minimum incidence from the most robust prospective study from a Western setting gave an incidence of 2.2 per 100,000. The incidence from the two prospective studies for all age groups was 6.34 and 7.4 per 100,000 from a tropical and a Western setting, respectively. However, both studies included arboviral encephalitis, which may have given higher rather than given higher] incidence levels.
CONCLUSION
In the most robust, prospective studies conducted in Western industrialised countries, a minimum incidence of 10.5 per 100,000 AES cases was reported for children and 2.2 per 100,000 for adults. The minimum incidence for all ages was 6.34 per 100,000 from a tropical setting. On this basis, for ease of use in protocols and for future WHO surveillance standards, a minimum incidence of 10 per 100,000 AES cases is suggested as an appropriate target for studies of children alone and 2 per 100,000 for adults and 6 per 100,000 for all age groups.
背景
作为控制日本脑炎（乙脑）工作的一部分，世界卫生组织正在制定一套乙脑监测标准，其中要求识别急性脑炎综合征（AES）患者。本综述旨在提供信息，以确定应报告的AES最低年发病率，以表明监测计划正在发挥作用。
方法
从3个数据库中检索到总共12436篇文章；通过标题搜索进行筛选并去除重复项，得到1083篇论文，再通过摘要（若没有摘要则通过全文）进行筛选，得到87篇论文。对这87篇论文进行评审，确定25篇符合纳入标准的论文。
结果
在所评审的研究中，病例定义和诊断标准、病因、研究类型及可靠性各不相同。在从西方工业化环境中进行的前瞻性研究中，儿童AES的发病率范围预计为每10万人10.5 - 13.8例。仅针对成年人，来自西方环境的最可靠前瞻性研究给出的最低发病率为每10万人2.2例。两项针对所有年龄组的前瞻性研究中，热带地区和西方地区的发病率分别为每10万人6.34例和7.4例。然而，这两项研究都包括虫媒病毒性脑炎，这可能导致发病率高于实际水平。
结论
在西方工业化国家进行的最可靠的前瞻性研究中，儿童AES的最低发病率报告为每10万人10.5例，成人为每10万人2.2例。热带地区所有年龄组的最低发病率为每10万人6.34例。在此基础上，为便于在方案中使用以及符合未来世界卫生组织的监测标准，建议将每10万人10例AES病例的最低发病率作为仅针对儿童研究的合适目标，每10万人2例作为成人的目标，每10万人6例作为所有年龄组的目标。
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