Long - term sequelae in children with Japanese Encephalitis treated at National Children's Hospital, 2017 - 2023

Abstract

The National Children’s Hospital, a tertiary pediatric speciality healthcare facility, treats nearly half of all Japanese encephalitis (JE) cases nationwide. However, no studies have been to date evaluating the long-term sequelae in children with JE treated at this hospital. This cross - sectional descriptive study collected data from 360 JE patients treated at the National Children’s Hospital from 2017 to 2023. The results showed that most patients were male (61.9%) and Kinh ethnicity (76.4%). The median age at onset was seven years, ranging from 1.5 months to 15.7 years. 21.4% of all patients were completely unvaccinated against JE, and 53.1% had unknown vaccination histories. The rate of long-term sequelae and death due to JE sequelae was significant (42.2%), with 29 deaths (8.2%) and 41 cases (11.6%) of severe sequelae. The remaining cases included 56 children (15.9%) with moderate sequelae, 23 children (6.5%) with mild sequelae, and 204 children (57.8%) with complete recovery. Neuro-motor sequelae were the most common (21.0%), followed by neurological sequelae (11.3%) and motor sequelae (1.7%). Notably, there were 12 cases (0.3%) of cerebral palsy with quadriplegia and inability to communicate, including three children who required continued mechanical ventilation. Associated factors that help predict long-term sequelae and death in children with JE include the need for mechanical ventilation during treatment, tracheostomy, and inpatient stay exceeding two weeks.