Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India
Abstract Background Advances in laboratory diagnostics have greatly enhanced the understanding of the infectious aetiologies of Acute Encephalitis Syndrome (AES) globally. However, these diagnostic tests are not widely utilized in many public-sector clinical settings in India. Significant gaps thus...
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2025-04-01
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| author | Anoop Velayudhan Harmanmeet Kaur Rahul Dhodapkar Labanya Mukhopadhyay Rizwan S. Abdulkader Sabarinathan R Valsan Philip Verghese Lalit Dar Rakesh Lodha Ravi V Sam Joy Pragya Yadav Amita Jain Ajanta Sharma Kaveri K Sayantan Banerjee Anitha PM Manjusree S Bharti Malhotra Baijayantimala Mishra Mala Chhabra Asim Sarfraz Bashir Fomda Mahima Mittal Manoj Murhekar Nivedita Gupta |
| author_facet | Anoop Velayudhan Harmanmeet Kaur Rahul Dhodapkar Labanya Mukhopadhyay Rizwan S. Abdulkader Sabarinathan R Valsan Philip Verghese Lalit Dar Rakesh Lodha Ravi V Sam Joy Pragya Yadav Amita Jain Ajanta Sharma Kaveri K Sayantan Banerjee Anitha PM Manjusree S Bharti Malhotra Baijayantimala Mishra Mala Chhabra Asim Sarfraz Bashir Fomda Mahima Mittal Manoj Murhekar Nivedita Gupta |
| author_sort | Anoop Velayudhan |
| collection | DOAJ |
| description | Abstract Background Advances in laboratory diagnostics have greatly enhanced the understanding of the infectious aetiologies of Acute Encephalitis Syndrome (AES) globally. However, these diagnostic tests are not widely utilized in many public-sector clinical settings in India. Significant gaps thus remain in the knowledge and understanding of the burden, etiological spectrum, and risk factors associated with AES occurring in India. Methods The current manuscript outlines a protocol designed to characterize the infectious causes of AES in affected regions of India through a network of 12 selected tertiary care hospitals and their associated Virus Research and Diagnostic Laboratories (VRDLs). A standardized tiered testing algorithm accounting for a wide range of possible etiological agents of infectious AES has been developed for use in the protocol, which aims to employ serological and molecular techniques to diagnose AES-causing priority pathogens. Pathogens of interest have been grouped in the testing algorithm into five levels (Levels 1–5) in decreasing order of priority based on their reported incidence. Clinical samples from each patient will be collected at presentation at respective sites, and relevant demographic and clinical data will be obtained from hospital records. Approximately 20% of samples which test negative for Level 1–4 pathogens will be subjected to Next-Generation Sequencing (NGS) to identify less well known/rare infectious causes of AES (Level 5 pathogens). De-identified clinical and laboratory data will be recorded into a web-based portal and managed by a designated nodal laboratory responsible for coordinating and overseeing the surveillance. The protocol ensures quality laboratory testing through an External Quality and Assessment Programme (EQAP). Discussion Results from this nationwide surveillance will yield crucial data to identify the causes of Acute Encephalitis Syndrome (AES) across India, supporting targeted public health interventions that could help reduce the disease burden. Additionally, this protocol serves as a model for a tiered laboratory algorithm for AES surveillance, providing a framework to guide similar initiatives in other regions. |
| format | Article |
| id | doaj-art-3e28f56f1fba47769fc01f5eb3cff2d3 |
| institution | OA Journals |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-3e28f56f1fba47769fc01f5eb3cff2d32025-08-20T01:47:33ZengBMCBMC Infectious Diseases1471-23342025-04-0125111310.1186/s12879-025-10963-xProtocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in IndiaAnoop Velayudhan0Harmanmeet Kaur1Rahul Dhodapkar2Labanya Mukhopadhyay3Rizwan S. Abdulkader4Sabarinathan R5Valsan Philip Verghese6Lalit Dar7Rakesh Lodha8Ravi V9Sam Joy10Pragya Yadav11Amita Jain12Ajanta Sharma13Kaveri K14Sayantan Banerjee15Anitha PM16Manjusree S17Bharti Malhotra18Baijayantimala Mishra19Mala Chhabra20Asim Sarfraz21Bashir Fomda22Mahima Mittal23Manoj Murhekar24Nivedita Gupta25Indian Council of Medical ResearchIndian Council of Medical ResearchJawaharlal Institute of Postgraduate Medical Education and ResearchIndian Council of Medical ResearchICMR-National Institute of EpidemiologyICMR-National Institute of EpidemiologyChristian Medical CollegeAll India Institute of Medical SciencesAll India Institute of Medical SciencesNational Institute of Mental Health and NeurosciencesIndian Council of Medical ResearchNational Institute of VirologyKing George’s Medical University, Uttar PradeshGauhati Medical College and HospitalKing Institute of Preventive Medicine and ResearchAll India Institute of Medical SciencesGovernment Medical CollegeGovernment Medical CollegeSawai Man Singh Medical CollegeAll India Institute of Medical SciencesABVIMS and Dr Ram Manohar Lohia HospitalAll India Institute of Medical SciencesSher-E-Kashmir Institute of Medical SciencesAll India Institute of Medical SciencesICMR-National Institute of EpidemiologyIndian Council of Medical ResearchAbstract Background Advances in laboratory diagnostics have greatly enhanced the understanding of the infectious aetiologies of Acute Encephalitis Syndrome (AES) globally. However, these diagnostic tests are not widely utilized in many public-sector clinical settings in India. Significant gaps thus remain in the knowledge and understanding of the burden, etiological spectrum, and risk factors associated with AES occurring in India. Methods The current manuscript outlines a protocol designed to characterize the infectious causes of AES in affected regions of India through a network of 12 selected tertiary care hospitals and their associated Virus Research and Diagnostic Laboratories (VRDLs). A standardized tiered testing algorithm accounting for a wide range of possible etiological agents of infectious AES has been developed for use in the protocol, which aims to employ serological and molecular techniques to diagnose AES-causing priority pathogens. Pathogens of interest have been grouped in the testing algorithm into five levels (Levels 1–5) in decreasing order of priority based on their reported incidence. Clinical samples from each patient will be collected at presentation at respective sites, and relevant demographic and clinical data will be obtained from hospital records. Approximately 20% of samples which test negative for Level 1–4 pathogens will be subjected to Next-Generation Sequencing (NGS) to identify less well known/rare infectious causes of AES (Level 5 pathogens). De-identified clinical and laboratory data will be recorded into a web-based portal and managed by a designated nodal laboratory responsible for coordinating and overseeing the surveillance. The protocol ensures quality laboratory testing through an External Quality and Assessment Programme (EQAP). Discussion Results from this nationwide surveillance will yield crucial data to identify the causes of Acute Encephalitis Syndrome (AES) across India, supporting targeted public health interventions that could help reduce the disease burden. Additionally, this protocol serves as a model for a tiered laboratory algorithm for AES surveillance, providing a framework to guide similar initiatives in other regions.https://doi.org/10.1186/s12879-025-10963-xAcute Encephalitis Syndrome (AES)SurveillanceEncephalitisNext-generation Sequencing (NGS)Testing algorithmUnknown/emerging novel pathogens |
| spellingShingle | Anoop Velayudhan Harmanmeet Kaur Rahul Dhodapkar Labanya Mukhopadhyay Rizwan S. Abdulkader Sabarinathan R Valsan Philip Verghese Lalit Dar Rakesh Lodha Ravi V Sam Joy Pragya Yadav Amita Jain Ajanta Sharma Kaveri K Sayantan Banerjee Anitha PM Manjusree S Bharti Malhotra Baijayantimala Mishra Mala Chhabra Asim Sarfraz Bashir Fomda Mahima Mittal Manoj Murhekar Nivedita Gupta Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India BMC Infectious Diseases Acute Encephalitis Syndrome (AES) Surveillance Encephalitis Next-generation Sequencing (NGS) Testing algorithm Unknown/emerging novel pathogens |
| title | Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India |
| title_full | Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India |
| title_fullStr | Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India |
| title_full_unstemmed | Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India |
| title_short | Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India |
| title_sort | protocol for nationwide surveillance of acute encephalitis syndrome aes in a network of tertiary care hospitals in india |
| topic | Acute Encephalitis Syndrome (AES) Surveillance Encephalitis Next-generation Sequencing (NGS) Testing algorithm Unknown/emerging novel pathogens |
| url | https://doi.org/10.1186/s12879-025-10963-x |
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