Estimates of the global burden of Japanese Encephalitis and the impact of vaccination from 2000-2015

  1. Tran Minh Quan
  2. Tran Thi Nhu Thao
  3. Nguyen Manh Duy
  4. Tran Minh Nhat
  5. Hannah Clapham  Is a corresponding author
  1. University of Notre Dame, United States
  2. Oxford University Clinical Research Unit, Wellcome Trust Asia Program, Viet Nam

Abstract

Japanese encephalitis (JE) is a mosquito-borne disease, known for its high mortality and disability rate among symptomatic cases. Many effective vaccines are available for JE, and the use of a recently developed and inexpensive vaccine, SA 14-14-2, has been increasing over the recent years particularly with Gavi support. Estimates of the local burden and the past impact of vaccination are therefore increasingly needed, but difficult due to the limitations of JE surveillance. In this study, we implemented a mathematical modelling method (catalytic model) combined with age-stratifed case data from our systematic review which can overcome some of these limitations. We estimate in 2015 JEV infections caused 100,308 JE cases (95%CI: 61,720 - 157,522) and 25,125 deaths (95%CI: 14,550 - 46,031) globally, and that between 2000 and 2015 307,774 JE cases (95%CI: 167,442- 509,583) were averted due to vaccination globally. Our results highlight areas that could have the greatest benefit from starting vaccination or from scaling up existing programs and will be of use to support local and international policymakers in making vaccine allocation decisions.

Data availability

This study conducted a literature review and collated all data on age-stratified JE cases from these papers. The full list of these papers and the data extracted is available in the supplement.The code and data is available here: https://github.com/tranquanc123/JE_burden_estimates.

Article and author information

Author details

  1. Tran Minh Quan

    Biological Science Department, University of Notre Dame, South Bend, United States
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-3337-161X
  2. Tran Thi Nhu Thao

    Oxford University Clinical Research Unit, Wellcome Trust Asia Program, Ho Chi Minh City, Viet Nam
    Competing interests
    The authors declare that no competing interests exist.
  3. Nguyen Manh Duy

    Oxford University Clinical Research Unit, Wellcome Trust Asia Program, Ho Chi Minh City, Viet Nam
    Competing interests
    The authors declare that no competing interests exist.
  4. Tran Minh Nhat

    Oxford University Clinical Research Unit, Wellcome Trust Asia Program, Ho Chi Minh City, Viet Nam
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-9500-8341
  5. Hannah Clapham

    Oxford University Clinical Research Unit, Wellcome Trust Asia Program, Ho Chi Minh City, Viet Nam
    For correspondence
    hannah.clapham@nus.edu.sg
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-2531-161X

Funding

Bill and Melinda Gates Foundation and Gavi (Vaccine Impact Modelling Consortium)

  • Tran Minh Quan
  • Tran Thi Nhu Thao
  • Nguyen Manh Duy
  • Tran Minh Nhat

Wellcome Trust (089276/B/09/7)

  • Hannah Clapham

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Eduardo Franco, McGill University, Canada

Version history

  1. Received: August 12, 2019
  2. Accepted: May 17, 2020
  3. Accepted Manuscript published: May 26, 2020 (version 1)
  4. Version of Record published: June 9, 2020 (version 2)

Copyright

© 2020, Quan et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Tran Minh Quan
  2. Tran Thi Nhu Thao
  3. Nguyen Manh Duy
  4. Tran Minh Nhat
  5. Hannah Clapham
(2020)
Estimates of the global burden of Japanese Encephalitis and the impact of vaccination from 2000-2015
eLife 9:e51027.
https://doi.org/10.7554/eLife.51027

Further reading

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    In most of the world, the mammography screening programmes were paused at the start of the pandemic, whilst mammography screening continued in Denmark. We examined the mammography screening participation during the COVID-19 pandemic in Denmark.

    Methods:

    The study population comprised all women aged 50–69 years old invited to participate in mammography screening from 2016 to 2021 in Denmark based on data from the Danish Quality Database for Mammography Screening in combination with population-based registries. Using a generalised linear model, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) of mammography screening participation within 90, 180, and 365 d since invitation during the pandemic in comparison with the previous years adjusting for age, year and month of invitation.

    Results:

    The study comprised 1,828,791 invitations among 847,766 women. Before the pandemic, 80.2% of invitations resulted in participation in mammography screening within 90 d, 82.7% within 180 d, and 83.1% within 365 d. At the start of the pandemic, the participation in screening within 90 d was reduced to 69.9% for those invited in pre-lockdown and to 76.5% for those invited in first lockdown. Extending the length of follow-up time to 365 d only a minor overall reduction was observed (PR = 0.94; 95% CI: 0.93–0.95 in pre-lockdown and PR = 0.97; 95% CI: 0.96–0.97 in first lockdown). A lower participation was, however, seen among immigrants and among women with a low income.

    Conclusions:

    The short-term participation in mammography screening was reduced at the start of the pandemic, whilst only a minor reduction in the overall participation was observed with longer follow-up time, indicating that women postponed screening. Some groups of women, nonetheless, had a lower participation, indicating that the social inequity in screening participation was exacerbated during the pandemic.

    Funding:

    The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.

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    Research Article

    Accurate inference of who infected whom in an infectious disease outbreak is critical for the delivery of effective infection prevention and control. The increased resolution of pathogen whole-genome sequencing has significantly improved our ability to infer transmission events. Despite this, transmission inference often remains limited by the lack of genomic variation between the source case and infected contacts. Although within-host genetic diversity is common among a wide variety of pathogens, conventional whole-genome sequencing phylogenetic approaches exclusively use consensus sequences, which consider only the most prevalent nucleotide at each position and therefore fail to capture low frequency variation within samples. We hypothesized that including within-sample variation in a phylogenetic model would help to identify who infected whom in instances in which this was previously impossible. Using whole-genome sequences from SARS-CoV-2 multi-institutional outbreaks as an example, we show how within-sample diversity is partially maintained among repeated serial samples from the same host, it can transmitted between those cases with known epidemiological links, and how this improves phylogenetic inference and our understanding of who infected whom. Our technique is applicable to other infectious diseases and has immediate clinical utility in infection prevention and control.