Understanding the Diagnosis of Viral Meningo-Encephalitis in India: A Systematic Review

Abstract

Background and Objectives: Diagnosis of viral meningoencephalitis is very crucial for recognizing the occurrence of epidemics and for instituting appropriate treatment. The diagnostic capability of the country can be ascertained by studying the published reports of viral meningoencephalitis in our country from reputed scientific literature. Hence, we aimed to study the diagnostic methods used for viral meningo encephalitis from Indian studies indexed in PubMed database. Methods: The data was gathered from human studies of actual cases of viral meningitis, encephalitis or meningoencephalitis in India up to 8th August 2016 [earliest study found was from the year 1988] indexed in PubMed database. Results: A total of 186 articles were included from 1548 studies screened. Clinical diagnosis over arched all the methods of diagnosis of viral meningoencephalitis in all the studies. Only 23.1% studies reported definitive confirmation of the infectious agent by PCR. Only 34.3% studies reported any microbiological tests for viral etiology. SGPGI, NIV AND NIMHANS were the three major centers reporting molecular diagnosis. Over three decades PCR has superseded antibody testing for viral meningoencephalitis diagnosis. Interpretation and Conclusion: Our analysis shows that the diagnosis of viral meningo encephalitis in India is mainly based on clinical diagnosis. Definitive diagnosis by molecular diagnostic methods can be achieved with the establishment of a greater number of molecular viral diagnostic and research labs.