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    Demograpghic and Epidemiological Characteristics of Subacute Sclerosing Panencephalitis Patients in Pediatric Intensive Care Unit and Attitudes of Their Parents About Home Care
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    Research Article
    VOLUME: 5 ISSUE: 3
    P: 107-112
    December 2018

    Demograpghic and Epidemiological Characteristics of Subacute Sclerosing Panencephalitis Patients in Pediatric Intensive Care Unit and Attitudes of Their Parents About Home Care

    J Pediatr Emerg Intensive Care Med 2018;5(3):107-112
    DOI: 10.4274/cayd.15807
    Çağlar Ödek 1
    Mehmet Erol 1
    Remezan Demir 1
    Melek Tunç 1
    Ahmet Aydınalp 1
    Funda Feryal Taş 1
    Muhammet Köşker 2
    Serhat Samancı 3
    1. Diyarbakır Çocuk Hastalıkları Hastanesi, Çocuk Yoğun Bakım Ünitesi, Diyarbakır, Türkiye
    2. Diyarbakır Çocuk Hastalıkları Hastanesi, Çocuk Enfeksiyon Hastalıkları Kliniği, Diyarbakır, Türkiye
    3. Diyarbakır Çocuk Hastalıkları Hastanesi, Çocuk Sağlığı ve Hastalıkları Kliniği, Diyarbakır, Türkiye
    No information available.
    No information available
    Received Date: 16.05.2018
    Accepted Date: 16.07.2018
    Publish Date: 04.12.2018
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    ABSTRACT

    Introduction:

    Subacute sclerosing panencephalitis (SSPE) is a chronic, progressive, and degenerative infection of the central nervous system caused by measles virus. The first aim of this study was to assess the demographic and epidemiological characteristics of SSPE patients admitted to pediatric intensive care unit (PICU). The second aim was to determine the thoughts of their parents about home care.

    Methods:

    Patients with SSPE, who were admitted to our PICU between January 1, 2015 and June 30, 2015, were evaluated retrospectively.

    Results:

    Fourteen patients were admitted to the PICU for a total of 16 episodes. Ten (71%) patients were male and 4 (29%) were female. Male-to-female ratio was 2.5. The mean age of the patients was 16.25±1.14 years. Thirteen patients had received their first measles vaccine at the age of 9 months. Ten (71.4%) patients had measles infection at a later time after the vaccination and one (7.1%) patient had measles before vaccination. The mean age at the time of measles infection was 23.81±15.67 months. The mean age at the time of first symptoms was 8.64±3.33 years and the mean duration of latent period was 5.72±2.96 years. Thirteen (81.3%) patients were admitted to the PICU with pneumonia and respiratory failure, 1 (6.2%) was admitted with sepsis, and 2 (12.5%) patients were admitted with neurological problems. None of the parents accepted home care in the study period. Frequent power cuts (80%), poor housing and home conditions (70%), poverty (60%), worries of the parents about home care (60%), and household crowding (50%) were their reasons for not accepting home care.

    Conclusion:

    Patients with SSPE may require PICU admission and long PICU stays for respiratory failure and neurologic problems. Palliative care units may be an option when home care is not possible for these patients.

    Keywords: Pediatric intensive care unit, measles, subacute sclerosing panencephalitis

    References

    1
    Campbell C, Levin S, Humphreys P, Walop W, Brannan R. Subacute sclerosing panencephalitis: results of the Canadian Paediatric Surveillance Program and review of the literature. BMC Pediatr. 2005;5:47.
    2
    Gadoth N. Subacute sclerosing panencephalitis (SSPE) the story of a vanishing disease. Brain Dev. 2012;34:705-11.
    3
    Gutierrez J, Issacson RS, Koppel BS. Subacute sclerosing panencephalitis: an update. Dev Med Child Neurol. 2010;52:901-7.
    4
    Bellini WJ, Rota JS, Lowe LE, Katz RS, Dyken PR, et al. Subacute sclerosing panencephalitis: more cases of this fatal disease are prevented by measles immunization than was previously recognized. J Infect Dis. 2005;192:1686-93.
    5
    Schönberger K, Ludwig MS, Wildner M, Weissbrich B. Epidemiology of subacute sclerosing panencephalitis (SSPE) in Germany from 2003 to 2009: a risk estimation. PLoS One. 2013;8:e68909.
    6
    Cece H, Tokay L, Yıldız S, Karakaş O, İşcan A. Epidemiological findings and clinical and magnetic resonance presentations in subacute sclerosing panencephalitis. J Int Med Res. 2011;39:594-602.
    7
    Güler S, Küçükkoç M, İşcan A. Prognosis and demographic characteristics of SSPE patients in İstanbul, Turkey. Brain Dev. 2015;37:612-7.
    8
    Halsey NA, Modlin JF, Jabbour JT, Dubey L, Eddins DL, et al. Risk factors in subacute sclerosing panencephalitis: a case-control study. Am J Epidemol. 1980;111:415-24.
    9
    Zilber N, Kahana E. Environmental risk factors for subacute sclerosing panencephalitis (SSPE). Acta Neurol Scand. 1998;98:49-54.
    10
    İrdem A, Ecer S, Özbek MN, Yaramış A, Devecioğlu C. Subakut sklerozan panensefalit hastalarının epidemiyolojik özellikleri. Dicle Tıp Dergisi 2004;31:31-35.
    11
    Aaby P, Bukh J, Lisse IM, Smits AJ. Risk factors in subacute sclerosing panencephalitis: age- and sex-dependent host reactions or intensive exposure? Rev Infect Dis. 1984;6:239-50.
    12
    Campbell H, Andrews N, Brown KE, Miller E. Review of the effect of measles vaccination on the epidemiology of SSPE. Int J Epidemiol. 2007;36:1334-48.
    13
    Abe Y, Hashimoto K, Iinuma K, Ohtsuka Y, Ichiyama T, et al. Survey of subacute sclerosing panencephalitis in Japan. J Child Neurol. 2012;27:1529-33.
    14
    Onal AE, Gürses C, Direşkeneli GS, Yılmaz G, Demirbilek V, et al. Subacute sclerosing panencephalitis surveillance study in İstanbul. Brain Dev. 2006;28:183-9.
    15
    Egemen A. Fundamentals of immunizing. In: Egemen A, Aksit S, editors. Repuclic of Turkey, Ministry of Health, Basic Health Services general directorate, Repuclic of Turkey, Ministry of Health, Health Project General Coordinatorship. Ankara: Bizim Büro Basımevi; 2001.p. 161-88.
    16
    Argüelles MH, Orellana ML, Castello AA, Villegas GA, Masini M, et al. Measles virus-specific antibody levels in individuals in Argentina who received a one-dose vaccine. J Clin Microbiol. 2006;44:2733-8.
    17
    Malik MA, Saeed M, Qureshi AU, Ahmed N, Akram M. Predictors of clinical course of subacute sclerosing panencephalitis: experience at the Children's Hospital Lahore. J Coll Physicians Surg Pak. 2010;20:671-4.
    18
    Ceyhan M, Kanra G, Erdem G, Kanra B. Immunogenicity and efficacy of one dose measles-mumps-rubella (MMR) vaccine at twelve months of age as compared to monovalent measles vaccination at nine months followed by MMR revaccination at fifteen months of age. Vaccine. 2001;19:4473-8.
    19
    Beersma MFC, Galama JMD, Van Druten HAM, Reiner WO, Lucas CJ, et al. Subacute sclerosing panencephalitis in the Netherlands--1976-1990. Int J Epidemiol. 1992;21:583-8.
    20
    Dyken PR, Cunningham SC, Ward LC. Changing character of subacute sclerosing panencephalitis in the United States. Pediatr Neurol. 1989;5:339-41.
    21
    Fukuyama Y, Nihei K, Matsumoto S, Ebina T, Kamoshita S, et al. Clinical effects of MND-19 (Inosiplex) on subacute sclerosing panencephalitis – a multi-institutional collaborative study – the Inosiplex-SSPE Research Committee. Brain Dev. 1987;9:270-82.
    22
    Jones CE, Dyken PR, Huttenlocher PR, Jabbour JT, Maxwell KW. Inosiplex therapy in subacute sclerosing panencephalitis. A multicentre, non-randomised study in 98 patients. Lancet 1982;1:1034-7.
    23
    Anlar B. Subacute sclerosing panencephalitis and chronic viral encephalitis. Handb Clin Neurol. 2013;112:1183-9.
    24
    Dünya Sağlık Örgütü Web sayfası. www.who.int/cancer/palliative/definition/en/
    25
    Algıer L. Çocuklarda palyatif bakım. Ankara Üniversitesi Tıp Fakültesi Mecmuası 2005;58:132-5.
    26
    Abu-Saad HH. Palliative care: An international view. Patient Educ Couns. 2000;41:15-22.
    27
    TC Sağlık Bakanlığı Kamu Hastaneleri Genel Müdürlüğü Web sayfası. https://khgmozellikli.saglik.gov.tr/svg/palyatif.php
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