{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:11Z","timestamp":1791489671726,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T00:00:00Z","timestamp":1593043200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the proportion of scrub typhus meningoencephalitis among children with acute encephalitis syndrome and to outline its differentiating features. To develop a prediction rule for scrub typhus meningoencephalitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted at a tertiary care public hospital in Northern India. Consecutive patients of acute encephalitis syndrome who met our inclusion criteria were enrolled over 2 years. Standardized workup including serum IgM against Orientia tsutsugamushi was performed. Clinical and laboratory features were compared between IgM-positive and IgM-negative patients. The area under the receiver operating characteristic curve of the score derived from \u201cindependent predictors\u201d was measured. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated at different cut-offs of the score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Scrub typhus IgM enzyme-linked immunosorbent assay was positive in 66\/352 patients (18.8%). Longer duration of fever and prodromal stage along with eschar, hepatomegaly, lymphadenopathy, and pneumonia were significantly more prevalent in scrub typhus meningoencephalitis. However, petechiae were frequent in non\u2013scrub typhus patients. Leucocytosis, lymphocytosis, thrombocytopenia, hypoalbuminemia, and elevated levels of serum bilirubin, serum transaminases, and cerebrospinal fluid protein were associated with scrub typhus meningoencephalitis. Logistic regression revealed fever for &gt;8 days, pneumonia, absence of petechiae, cerebrospinal fluid protein &gt;1000 mg\/L, and serum glutamic oxaloacetic transaminase &gt;100 IU\/L as independent \u201cpredictors\u201d of scrub typhus meningoencephalitis. The area under the receiver operating characteristic curve (95% confidence interval) of the prediction score was 0.832 (0.78-0.89). Score at cutoff \u22651 had 91% sensitivity, 96.1% negative predictive value, and at cutoff \u22654 had 99.7% specificity, 88.9% positive predictive value, 83.1% negative predictive value, 40.3 positive likelihood ratio, 0.88 negative likelihood ratio for identifying scrub typhus meningoencephalitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Prediction score may help physicians in peripheral areas to identify and treat scrub typhus meningoencephalitis, an emerging cause of acute encephalitis syndrome in India.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0883073820933148","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T03:58:17Z","timestamp":1593057497000},"page":"820-827","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Prediction Rule for Scrub Typhus Meningoencephalitis in Children: Emerging Disease in North India"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8564-7051","authenticated-orcid":false,"given":"Areesha","family":"Alam","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Era\u2019s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranshi","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanti","family":"Prabha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj Kumar","family":"Kalyan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrakanta","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,25]]},"reference":[{"key":"bibr1-0883073820933148","unstructured":"National Vector disease control programme, annual report 2016-2017. https:\/\/mohfw.gov.in\/sites\/default\/files\/5201617.pdf."},{"key":"bibr2-0883073820933148","unstructured":"Ministry of Health & Family Welfare, Government of India. Operational guide for Japanese encephalitis vaccination in India. September 2010."},{"key":"bibr3-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1093\/jme\/tjy042"},{"key":"bibr4-0883073820933148","first-page":"11","volume":"16","author":"Mohod K","year":"2011","journal-title":"J Mahatma Gandhi Inst Med Sci"},{"key":"bibr5-0883073820933148","doi-asserted-by":"publisher","DOI":"10.3201\/eid2301.161038"},{"key":"bibr6-0883073820933148","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.136074"},{"key":"bibr7-0883073820933148","first-page":"538","volume":"135","author":"Mittal V","year":"2012","journal-title":"Indian J Med Res"},{"key":"bibr8-0883073820933148","doi-asserted-by":"publisher","DOI":"10.4103\/0976-3147.169769"},{"key":"bibr9-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0066595"},{"key":"bibr10-0883073820933148","first-page":"218","volume-title":"An Epidemiologic Approach","author":"Hulley SB","year":"1992","edition":"2"},{"key":"bibr11-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002099"},{"key":"bibr12-0883073820933148","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3291.ijcp20171698"},{"key":"bibr13-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmi096"},{"key":"bibr14-0883073820933148","doi-asserted-by":"publisher","DOI":"10.3201\/eid1610.100456"},{"key":"bibr15-0883073820933148","first-page":"2","volume":"12","author":"Digra SK","year":"2010","journal-title":"JK Sci"},{"key":"bibr16-0883073820933148","doi-asserted-by":"publisher","DOI":"10.4103\/2141-9248.157486"},{"key":"bibr17-0883073820933148","first-page":"167","volume":"63","author":"Zhao D","year":"2017","journal-title":"J Tropical Pediatr"},{"key":"bibr18-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmv097"},{"key":"bibr19-0883073820933148","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.107919"},{"issue":"4","key":"bibr20-0883073820933148","first-page":"95","volume":"12","author":"Khandelwal S","year":"2015","journal-title":"Pediatr Oncall J"},{"key":"bibr21-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2016.03.003"},{"key":"bibr22-0883073820933148","doi-asserted-by":"publisher","DOI":"10.3126\/ajms.v8i4.17163"},{"key":"bibr23-0883073820933148","first-page":"24","volume":"58","author":"Vivekanandan M","year":"2010","journal-title":"J Assoc Phys India"},{"key":"bibr24-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-018-3143-9"},{"key":"bibr25-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-018-2612-5"},{"key":"bibr26-0883073820933148","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3291.ijcp20164585"},{"key":"bibr27-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-108"},{"key":"bibr28-0883073820933148","doi-asserted-by":"publisher","DOI":"10.18203\/2320-6012.ijrms20160794"},{"key":"bibr29-0883073820933148","doi-asserted-by":"publisher","DOI":"10.5530\/ijmedph.2.2011.8"},{"key":"bibr30-0883073820933148","first-page":"388","volume":"7","author":"Rakholia R","year":"2017","journal-title":"Ann Med Health Sci Res"},{"key":"bibr31-0883073820933148","first-page":"2366","volume":"90","author":"Chanta C","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"bibr32-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-017-2403-4"},{"key":"bibr33-0883073820933148","volume":"84","author":"Eswaradass PV","year":"2015","journal-title":"Neurology"},{"key":"bibr34-0883073820933148","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5916.159279"},{"key":"bibr35-0883073820933148","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2013.05.017"}],"container-title":["Journal of Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0883073820933148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0883073820933148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0883073820933148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:39:36Z","timestamp":1777495176000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0883073820933148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,25]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1177\/0883073820933148"],"URL":"https:\/\/doi.org\/10.1177\/0883073820933148","relation":{},"ISSN":["0883-0738","1708-8283"],"issn-type":[{"value":"0883-0738","type":"print"},{"value":"1708-8283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,25]]}}}