Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.

<h4>Objective</h4>To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).<h4>Methods</h4>This study utilized two nationwide datasets in Taiwan: the Notifiable Disease...

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Autores principales:	Hsuan-Ying Chen, Chen-Yi Yang, Cheng-Yang Hsieh, Chun-Yin Yeh, Chang-Chun Chen, Yen-Chin Chen, Chung-Chih Lai, Rebecca Claire Harris, Huang-Tz Ou, Nai-Ying Ko, Wen-Chien Ko
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/ac08c06f61d64a2d87b37c5a25a3e193
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spelling	oai:doaj.org-article:ac08c06f61d64a2d87b37c5a25a3e1932021-12-02T20:24:07ZLong-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.1935-27271935-273510.1371/journal.pntd.0009703https://doaj.org/article/ac08c06f61d64a2d87b37c5a25a3e1932021-09-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009703https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Objective</h4>To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).<h4>Methods</h4>This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.<h4>Results</h4>This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).<h4>Conclusion</h4>A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.Hsuan-Ying ChenChen-Yi YangCheng-Yang HsiehChun-Yin YehChang-Chun ChenYen-Chin ChenChung-Chih LaiRebecca Claire HarrisHuang-Tz OuNai-Ying KoWen-Chien KoPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 9, p e0009703 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Hsuan-Ying Chen Chen-Yi Yang Cheng-Yang Hsieh Chun-Yin Yeh Chang-Chun Chen Yen-Chin Chen Chung-Chih Lai Rebecca Claire Harris Huang-Tz Ou Nai-Ying Ko Wen-Chien Ko Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
description	<h4>Objective</h4>To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE).<h4>Methods</h4>This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients' healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients.<h4>Results</h4>This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (p<0.05). Having a four-dose JE vaccination (i.e., born after 1976) versus no JE vaccination history (i.e., born before 1963) was significantly associated with lower all-cause mortality (hazard ratio: 0.221 [95% confidence interval: 0.067, 0.725]). Comorbid diabetes and incident epilepsy/convulsion events significantly increased the mortality risk by 2.47- and 1.85-fold, respectively (p<0.05).<h4>Conclusion</h4>A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.
format	article
author	Hsuan-Ying Chen Chen-Yi Yang Cheng-Yang Hsieh Chun-Yin Yeh Chang-Chun Chen Yen-Chin Chen Chung-Chih Lai Rebecca Claire Harris Huang-Tz Ou Nai-Ying Ko Wen-Chien Ko
author_facet	Hsuan-Ying Chen Chen-Yi Yang Cheng-Yang Hsieh Chun-Yin Yeh Chang-Chun Chen Yen-Chin Chen Chung-Chih Lai Rebecca Claire Harris Huang-Tz Ou Nai-Ying Ko Wen-Chien Ko
author_sort	Hsuan-Ying Chen
title	Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
title_short	Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
title_full	Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
title_fullStr	Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
title_full_unstemmed	Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.
title_sort	long-term neurological and healthcare burden of adults with japanese encephalitis: a nationwide study 2000-2015.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ac08c06f61d64a2d87b37c5a25a3e193
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Long-term neurological and healthcare burden of adults with Japanese encephalitis: A nationwide study 2000-2015.

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