Deciphering Clinical Predictors in Japanese Encephalitis: A Systematic Review and Meta-Analysis of Effective Diagnosis and Prognosis Indicators

Abstract Japanese encephalitis (JE) is a neurotropic flavivirus that causes brain inflammation and is transmitted by bites from infected mosquitoes of the Culex species. The disease can range from mild to severe, with initial symptoms such as fever, headache, vomiting, and fatigue. As the infection progresses, patients may develop more severe neurological symptoms, including seizures, confusion, and paralysis. A systematic review process using established reporting guidelines such as PRISMA was used to analyze 1477 studies, resulting in 880 unique investigations imported into Zotero for further analysis. In this review, 307 research articles were excluded due to lack of relevance. Eventually, this review synthesized findings from 38 investigations that met the criteria for inclusion. The review investigated clinical predictors for Japanese encephalitis diagnosis and prognosis, finding potential risk factors in seizures and muscle rigidity but no significant correlation at the 95% confidence level. Fever and vomiting were significant predictors, but headache was not due to heterogeneity among studies. A large dataset is needed to confirm associations, and not all infected individuals will show all symptoms.