Case fatality rate and risk factors for Nipah virus encephalitis: A systematic review and meta-analysis

Sebastien Kenmoe; Maurice Demanou; Jean Joel Bigna; Cyprien Nde Kengne; Abdou Fatawou Modiyinji; Fredy Brice N Simo; Sara Eyangoh; Serge Alain Sadeuh-Mba; Richard Njouom

doi:10.1016/j.jcv.2019.05.009

Case fatality rate and risk factors for Nipah virus encephalitis: A systematic review and meta-analysis

J Clin Virol. 2019 Aug:117:19-26. doi: 10.1016/j.jcv.2019.05.009. Epub 2019 May 21.

Authors

Sebastien Kenmoe¹, Maurice Demanou¹, Jean Joel Bigna², Cyprien Nde Kengne³, Abdou Fatawou Modiyinji⁴, Fredy Brice N Simo⁵, Sara Eyangoh⁶, Serge Alain Sadeuh-Mba¹, Richard Njouom⁷

Affiliations

¹ Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274 Yaoundé, Cameroon.
² Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
³ National AIDS Control Committee, Cameroon.
⁴ Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274 Yaoundé, Cameroon; Department of Animals Biology and Physiology, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon.
⁵ Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274 Yaoundé, Cameroon; Department of Biochemistry, Faculty of Sciences, University of Yaoundé I, Yaoundé, Cameroon.
⁶ Department of Mycobacteriology, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
⁷ Department of Virology, Centre Pasteur of Cameroon, 451 Rue 2005, P.O. Box 1274 Yaoundé, Cameroon. Electronic address: njouom@pasteur-yaounde.org.

PMID: 31132674
DOI: 10.1016/j.jcv.2019.05.009

Abstract

Background: A wide range of Nipah virus (NiV) encephalitis case fatality rates (CFR) have been reported. Data on the involvement of several potential risk factors in Nipah virus transmission remain controversial. We performed a systematic review and meta-analysis to estimate the pooled CFR of NiV encephalitis and to assess the risk factors for NiV infection.

Methods: Articles published up to the 27^thof November 2018 in MedLine, Embase and Web of knowledge databases were considered for this study. We included cross-sectional, cohort, and case-control studies that have reported NiV CFR and/or risk factors. Data were pooled with random-effects model. This review was registered in the PROSPERO, CRD42018116242.

Findings: This global review included 22 citations (25 studies) including 2156, 1682, and 474 suspected, probable, and confirmed cases of NiV encephalitis, respectively. We determined a pooled CFR for NiV encephalitis at 61.0% (95% CI, 45.7-75.4; I² = 96.8%). Climbing trees (OR = 1.4; 95% CI; 1.0-1.9), male gender (OR = 1.5; 95% CI; 1.1-2.0), travel outside their own sub-district (OR = 2.0; 95% CI; 1.4-2.9), and exposure to date palm sap (DPS) (OR = 5.7; 95% CI; 3.8-8.6) or pigs (OR = 7.6; 95% CI; 1.2-45.4) were significantly associated with NiV infection.

Conclusion: Findings from this study suggest that NiV Encephalitis is associated with a high CFR and that male gender, travel outside their sub-district, climbing trees, and exposure to pigs and DPS are associated with an increased risk of NiV encephalitis.

Keywords: Case fatality rate; Encephalitis; Nipah virus; Risk factors.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Animals
Encephalitis, Viral / mortality*
Female
Henipavirus Infections / mortality*
Humans
Male
Mortality
Nipah Virus / pathogenicity*
Risk Factors
Sex Characteristics
Zoonoses / epidemiology
Zoonoses / mortality