Estimation of the impact of a Japanese encephalitis immunization program with live, attenuated SA 14-14-2 vaccine in Nepal

Wider availability of the live, attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine has facilitated introduction or expansion of immunization programs in many countries. However, information on their impact is limited. In 2006, Nepal launched a JE immunization program, and by 2009, mass campaig...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2013-03, Vol.88 (3), p.464-468
Main Authors: Upreti, Shyam Raj, Janusz, Kristen B, Schluter, W William, Bichha, Ram Padarath, Shakya, Geeta, Biggerstaff, Brad J, Shrestha, Murari Man, Sedai, Tika Ram, Fischer, Marc, Gibbons, Robert V, Shrestha, Sanjaya K, Hills, Susan L
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Encephalitis, Japanese - prevention & control
Humans
Infant
Japanese Encephalitis Vaccines - classification
Japanese Encephalitis Vaccines - immunology
Nepal - epidemiology
Population Surveillance
Retrospective Studies
Vaccines, Attenuated - immunology
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Summary:Wider availability of the live, attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine has facilitated introduction or expansion of immunization programs in many countries. However, information on their impact is limited. In 2006, Nepal launched a JE immunization program, and by 2009, mass campaigns had been implemented in 23 districts. To describe the impact, we analyzed surveillance data from 2004 to 2009 on laboratory-confirmed JE and clinical acute encephalitis syndrome (AES) cases. The post-campaign JE incidence rate of 1.3 per 100,000 population was 72% lower than expected if no campaigns had occurred, and an estimated 891 JE cases were prevented. In addition, AES incidence was 58% lower, with an estimated 2,787 AES cases prevented, suggesting that three times as many disease cases may have been prevented than indicated by the laboratory-confirmed JE cases alone. These results provide useful information on preventable JE disease burden and the potential value of JE immunization programs.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.12-0196