Etiological spectrum of acute encephalitis syndrome in children in India: A systematic review and meta-analysis
Abstract
BACKGROUND: Acute encephalitis syndrome (AES) continues to be an important cause of illness and death among children in India. While Japanese encephalitis (JE) virus has traditionally been regarded as the leading cause, recent studies indicate that the range of causative organisms has widened considerably.
AIM: To estimate the pooled proportion of AES cases attributable to various common infectious etiologies among children aged 18 years or younger in India.
METHODS: A comprehensive search of PubMed/MEDLINE, EMBASE, and Scopus was conducted for studies published between January 2000 and December 2025. Studies conducted in India that included at least 25 children (≤ 18 years) with AES and reported laboratory-confirmed etiologies were considered eligible. Case reports and small case series were excluded. Quality assessment of included studies was performed using the Joanna Briggs Institute checklist. A random-effects model was used to obtain pooled estimates and their corresponding 95% confidence intervals (CI).
RESULTS: A total of 69 studies were included in the final analysis. Scrub typhus emerged as the most common cause, accounting for 20% (95%CI: 13%-27%) of AES cases, followed by JE at 13% (95%CI: 11%-15%). Enterovirus accounted for 6% of the cases (95%CI: 3%-9%). Dengue, herpes simplex virus and Epstein-Barr virus accounted for 5% of the cases each (95%CI: 3%-8%, 2%-9%, and 1%-11%, respectively). Mumps and chikungunya virus accounted for 4% each (95%CI: 1%-8%, and 2%-5%, respectively).
CONCLUSION: Scrub typhus and JE are the leading identifiable etiology of pediatric AES in India. Broader diagnostic methods, including molecular techniques, may improve the diagnostic yield and facilitate early targeted therapy in children with AES.
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BibTeX
@article{panda2026etiological,
title = {{Etiological spectrum of acute encephalitis syndrome in children in India: A systematic review and meta-analysis}},
author = {Prateek Kumar Panda and Pragnya Panda and Indar Kumar Sharawat and Dibya Prasanna Rana and Arnav Ranjan and Siddhant Govekar and Harikrishnan Kodamana and Deepak Kumar and Kalpana Panda},
journal = {World Journal of Clinical Pediatrics},
year = {2026},
month = nov,
doi = {10.5409/wjcp.121910},
url = {https://doi.org/10.5409/wjcp.121910},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Etiological spectrum of acute encephalitis syndrome in children in India: A systematic review and meta-analysis
AU - Prateek Kumar Panda
AU - Pragnya Panda
AU - Indar Kumar Sharawat
AU - Dibya Prasanna Rana
AU - Arnav Ranjan
AU - Siddhant Govekar
AU - Harikrishnan Kodamana
AU - Deepak Kumar
AU - Kalpana Panda
PY - 2026
DA - 2026/11/03
JO - World Journal of Clinical Pediatrics
DO - 10.5409/wjcp.121910
UR - https://doi.org/10.5409/wjcp.121910
AB - BACKGROUND: Acute encephalitis syndrome (AES) continues to be an important cause of illness and death among children in India. While Japanese encephalitis (JE) virus has traditionally been regarded as the leading cause, recent studies indicate that the range of causative organisms has widened considerably. AIM: To estimate the pooled proportion of AES cases attributable to various common infectious etiologies among children aged 18 years or younger in India. METHODS: A comprehensive search of PubMed/MEDLINE, EMBASE, and Scopus was conducted for studies published between January 2000 and December 2025. Studies conducted in India that included at least 25 children (≤ 18 years) with AES and reported laboratory-confirmed etiologies were considered eligible. Case reports and small case series were excluded. Quality assessment of included studies was performed using the Joanna Briggs Institute checklist. A random-effects model was used to obtain pooled estimates and their corresponding 95% confidence intervals (CI). RESULTS: A total of 69 studies were included in the final analysis. Scrub typhus emerged as the most common cause, accounting for 20% (95%CI: 13%-27%) of AES cases, followed by JE at 13% (95%CI: 11%-15%). Enterovirus accounted for 6% of the cases (95%CI: 3%-9%). Dengue, herpes simplex virus and Epstein-Barr virus accounted for 5% of the cases each (95%CI: 3%-8%, 2%-9%, and 1%-11%, respectively). Mumps and chikungunya virus accounted for 4% each (95%CI: 1%-8%, and 2%-5%, respectively). CONCLUSION: Scrub typhus and JE are the leading identifiable etiology of pediatric AES in India. Broader diagnostic methods, including molecular techniques, may improve the diagnostic yield and facilitate early targeted therapy in children with AES.
SN - 2219-2808
ER -