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Lemos JF, Araújo LMC, Guimarães-do-Carmo VJ, Cardoso EJA, da Silva Ferreira AI, Barbosa KFDS, Raposo MCF, Melo RS. Sedentary behavior, increasing age, and overweight/obesity increase the presence and intensity of the chronic joint pain in individuals affected by Chikungunya fever. Clin Rheumatol 2024:10.1007/s10067-024-07073-5. [PMID: 39031292 DOI: 10.1007/s10067-024-07073-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Chikungunya fever (CF) is a viral disease, transmitted by alphavirus through Aedes aegypti, and albopictus mosquitoes, affecting several people, mainly in tropical countries, when its transmitter is not under control, and the main symptom of the chronic phase of CF is joint pain. OBJECTIVES The primary objective of this study was to observe the prevalence, most affected joints, and intensity of chronic joint pain in individuals affected by CF, and also identify the factors associated with chronic joint pain in these individuals. METHODS Cross-sectional study that evaluated one hundred and thirty volunteers, of both sexes, aged between 20-65 years, with a clinical and/or laboratory diagnosis of CF. The presence of joint pain was investigated using the Brazilian version of the Nordic Questionnaire of Musculoskeletal Symptoms and the intensity of pain using the Visual Analogue Scale. RESULTS Of the 130 volunteers evaluated, n = 112 (86%) reported currently experiencing chronic joint pain, persistent, for approximately 38.6 ± 1.73 months, with the greatest predominance in the morning (58%). The joints most affected by pain were: the ankles (65.5%), interphalangeal joints of the hands (59.2%), and knees (59.2%). The joints that presented the greatest intensity of pain were: the ankles (5.13 ± 0.34), interphalangeal joints of the hands (4.63 ± 0.34), and knees (4.33 ± 0.33). Sedentary behavior (p = 0.037), increasing age (p = 0.000), and overweight/obesity (p = 0.002) were factors associated with chronic joint pain. CONCLUSION A high prevalence of chronic, persistent joint pain was observed, with a greater prevalence in the morning. The joints most affected by chronic pain and with the greatest pain intensity were the ankles, and interphalangeal joints of the hands and knees. Sedentary behavior, increasing age, and overweight/obesity were the factors associated with chronic joint pain in individuals affected by CF in this study. Key Points • Individuals affected by CF had a high prevalence of chronic joint pain, persistent and more prevalent in the mornings • The ankles and interphalangeal joints of the hands and knees were the joints with the highest prevalence of pain • The ankles and interphalangeal joints of the hands and knees were the joints with the greatest pain intensity • Sedentary behavior, increasing age, and overweight/obesity were factors associated with chronic joint pain in individuals affected by CF.
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Affiliation(s)
- Joselanny F Lemos
- Department of Physical Therapy, Faculdade de Integração do Sertão (FIS), Serra Talhada, Pernambuco, Brazil
| | | | | | | | - Ana Isabel da Silva Ferreira
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Av. Jornalista Aníbal Fernandes, 173, Cidade Universitária, Recife, Pernambuco, 50740 - 560, Brazil
| | - Klarice Francisca Dos Santos Barbosa
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Av. Jornalista Aníbal Fernandes, 173, Cidade Universitária, Recife, Pernambuco, 50740 - 560, Brazil
| | | | - Renato S Melo
- Department of Physical Therapy, Universidade Federal de Pernambuco (UFPE), Av. Jornalista Aníbal Fernandes, 173, Cidade Universitária, Recife, Pernambuco, 50740 - 560, Brazil.
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Kang H, Auzenbergs M, Clapham H, Maure C, Kim JH, Salje H, Taylor CG, Lim A, Clark A, Edmunds WJ, Sahastrabuddhe S, Brady OJ, Abbas K. Chikungunya seroprevalence, force of infection, and prevalence of chronic disability after infection in endemic and epidemic settings: a systematic review, meta-analysis, and modelling study. THE LANCET. INFECTIOUS DISEASES 2024; 24:488-503. [PMID: 38342105 DOI: 10.1016/s1473-3099(23)00810-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Chikungunya is an arboviral disease transmitted by Aedes aegypti and Aedes albopictus mosquitoes with a growing global burden linked to climate change and globalisation. We aimed to estimate chikungunya seroprevalence, force of infection (FOI), and prevalence of related chronic disability and hospital admissions in endemic and epidemic settings. METHODS In this systematic review, meta-analysis, and modelling study, we searched PubMed, Ovid, and Web of Science for articles published from database inception until Sept 26, 2022, for prospective and retrospective cross-sectional studies that addressed serological chikungunya virus infection in any geographical region, age group, and population subgroup and for longitudinal prospective and retrospective cohort studies with data on chronic chikungunya or hospital admissions in people with chikungunya. We did a systematic review of studies on chikungunya seroprevalence and fitted catalytic models to each survey to estimate location-specific FOI (ie, the rate at which susceptible individuals acquire chikungunya infection). We performed a meta-analysis to estimate the proportion of symptomatic patients with laboratory-confirmed chikungunya who had chronic chikungunya or were admitted to hospital following infection. We used a random-effects model to assess the relationship between chronic sequelae and follow-up length using linear regression. The systematic review protocol is registered online on PROSPERO, CRD42022363102. FINDINGS We identified 60 studies with data on seroprevalence and chronic chikungunya symptoms done across 76 locations in 38 countries, and classified 17 (22%) of 76 locations as endemic settings and 59 (78%) as epidemic settings. The global long-term median annual FOI was 0·007 (95% uncertainty interval [UI] 0·003-0·010) and varied from 0·0001 (0·00004-0·0002) to 0·113 (0·07-0·20). The highest estimated median seroprevalence at age 10 years was in south Asia (8·0% [95% UI 6·5-9·6]), followed by Latin America and the Caribbean (7·8% [4·9-14·6]), whereas median seroprevalence was lowest in the Middle East (1·0% [0·5-1·9]). We estimated that 51% (95% CI 45-58) of people with laboratory-confirmed symptomatic chikungunya had chronic disability after infection and 4% (3-5) were admitted to hospital following infection. INTERPRETATION We inferred subnational heterogeneity in long-term average annual FOI and transmission dynamics and identified both endemic and epidemic settings across different countries. Brazil, Ethiopia, Malaysia, and India included both endemic and epidemic settings. Long-term average annual FOI was higher in epidemic settings than endemic settings. However, long-term cumulative incidence of chikungunya can be similar between large outbreaks in epidemic settings with a high FOI and endemic settings with a relatively low FOI. FUNDING International Vaccine Institute.
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Affiliation(s)
- Hyolim Kang
- London School of Hygiene and Tropical Medicine, London, UK; Seoul National University College of Medicine School, Seoul, South Korea.
| | | | - Hannah Clapham
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Clara Maure
- International Vaccine Institute, Seoul, South Korea
| | | | - Henrik Salje
- Department of Genetics, Cambridge University, Cambridge, UK
| | | | - Ahyoung Lim
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Clark
- London School of Hygiene and Tropical Medicine, London, UK
| | - W John Edmunds
- London School of Hygiene and Tropical Medicine, London, UK; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Sushant Sahastrabuddhe
- International Vaccine Institute, Seoul, South Korea; Centre International de Recherche en Infectiologie, Université Jean Monnet, Université Claude Bernard Lyon, INSERM, Saint-Etienne, France
| | - Oliver J Brady
- London School of Hygiene and Tropical Medicine, London, UK
| | - Kaja Abbas
- London School of Hygiene and Tropical Medicine, London, UK; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Skidmore AM, Bradfute SB. The life cycle of the alphaviruses: From an antiviral perspective. Antiviral Res 2023; 209:105476. [PMID: 36436722 PMCID: PMC9840710 DOI: 10.1016/j.antiviral.2022.105476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
The alphaviruses are a widely distributed group of positive-sense, single stranded, RNA viruses. These viruses are largely arthropod-borne and can be found on all populated continents. These viruses cause significant human disease, and recently have begun to spread into new populations, such as the expansion of Chikungunya virus into southern Europe and the Caribbean, where it has established itself as endemic. The study of alphaviruses is an active and expanding field, due to their impacts on human health, their effects on agriculture, and the threat that some pose as potential agents of biological warfare and terrorism. In this systematic review we will summarize both historic knowledge in the field as well as recently published data that has potential to shift current theories in how alphaviruses are able to function. This review is comprehensive, covering all parts of the alphaviral life cycle as well as a brief overview of their pathology and the current state of research in regards to vaccines and therapeutics for alphaviral disease.
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Affiliation(s)
- Andrew M Skidmore
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, 915 Camino de Salud, IDTC Room 3245, Albuquerque, NM, 87131, USA.
| | - Steven B Bradfute
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, 915 Camino de Salud, IDTC Room 3330A, Albuquerque, NM, 87131, USA.
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Machado GLR, Castro RQ, Forechi L, Souza HDC, Fonseca DS, Garcia MAC. The impact of Chikungunya chronic arthralgia on women’s upper limbs motor function: a cross-sectional study. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22011229042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
ABSTRACT Post-Chikungunya chronic arthralgia (PCCA) may lead to musculoskeletal repercussions and functional loss. The objective was to assess the upper limb physical disability and symptoms during daily, work, and leisure activities of women presenting PCCA compared to healthy controls (HC). This was a cross-sectional study conducted with 52 women. The participants were divided into PCCA (37) and HC (15) groups. Handgrip strength, range of motion, level of pain (numerical rating scale), and participants’ physical disability and symptoms (Disabilities of the Arm, Shoulder, and Hand Questionnaire - DASH) were evaluated. Differences between groups were evaluated using the Students t-test and Pearson’s correlations. The chi-square test was applied for categorical variables. The significance was set at α=0.05. The disease duration was 19.5±13.1 months. We found no differences between groups for peak force (PCAA:23.6±7.4kgf; HC: 24.5±6.2kgf; p=0.676). The results showed a significant difference between groups regarding range of motion (PCCA: 63.5±17.3o; HC: 77.2±9.6o), level of hand pain (PCCA: 5.8±2.2; HC: 0.4±1.5), and upper limbs functional levels (PCCA: 44.5±17.4; HC: 16.2±20.5). Participants related severe difficulty or inability to perform tasks such as opening a jar (78.4%), placing objects above head height (48.7%), doing heavy household chores (56.8%), and gardening (51.4%). Impairment in the upper limb physical function in daily, work, and leisure activities shows the higher prevalence in the long-term.
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Bengue M, Pintong AR, Liegeois F, Nougairède A, Hamel R, Pompon J, de Lamballerie X, Roques P, Choumet V, Missé D. Favipiravir Inhibits Mayaro Virus Infection in Mice. Viruses 2021; 13:v13112213. [PMID: 34835018 PMCID: PMC8622800 DOI: 10.3390/v13112213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 01/10/2023] Open
Abstract
Mayaro virus (MAYV) is an emergent alphavirus that causes MAYV fever. It is often associated with debilitating symptoms, particularly arthralgia and myalgia. MAYV infection is becoming a considerable health issue that, unfortunately, lacks a specific antiviral treatment. Favipiravir, a broad-spectrum antiviral drug, has recently been shown to exert anti-MAYV activity in vitro. In the present study, the potential of Favipiravir to inhibit MAYV replication in an in vivo model was evaluated. Immunocompetent mice were orally administrated 300 mg/kg/dose of Favipiravir at pre-, concurrent-, or post-MAYV infection. The results showed a significant reduction in infectious viral particles and viral RNA transcripts in the tissues and blood of the pre- and concurrently treated infected mice. A significant reduction in the presence of both viral RNA transcript and infectious viral particles in the tissue and blood of pre- and concurrently treated infected mice was observed. By contrast, Favipiravir treatment post-MAYV infection did not result in a reduction in viral replication. Interestingly, Favipiravir strongly decreased the blood levels of the liver disease markers aspartate- and alanine aminotransferase in the pre- and concurrently treated MAYV-infected mice. Taken together, these results suggest that Favipiravir is a potent antiviral drug when administered in a timely manner.
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Affiliation(s)
- Michèle Bengue
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
| | - Ai-rada Pintong
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
| | - Florian Liegeois
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
| | - Antoine Nougairède
- Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement 190, IHU Méditerranée Infection, Institut National de la Santé et de la Recherche Médicale 1207, Aix Marseille Université, 13005 Marseille, France; (A.N.); (X.d.L.)
| | - Rodolphe Hamel
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
| | - Julien Pompon
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
| | - Xavier de Lamballerie
- Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement 190, IHU Méditerranée Infection, Institut National de la Santé et de la Recherche Médicale 1207, Aix Marseille Université, 13005 Marseille, France; (A.N.); (X.d.L.)
| | - Pierre Roques
- Unité de Virologie, Institut Pasteur de Guinée, Conakry BP4416, Guinea;
- Immunologie des Maladies Virales Auto-Immunes, Hématologiques et Bactériennes (IMVA-HB), Infectious Disease Models and Innovative Therapies (IDMIT): Commissariat a l’Energie Atomique et aux Energies Alternatives (CEA), Institut National de la Santé et de la Recherche Médicale U1184, Université Paris Saclay, 92265 Paris, France
| | - Valérie Choumet
- Unité Environnement et Risques Infectieux Groupe Arbovirus, Institut Pasteur, Université de Paris, 75724 Paris, France
- Correspondence: (V.C.); (D.M.)
| | - Dorothée Missé
- MIVEGEC, Univ. Montpellier, IRD, CNRS, 34394 Montpellier, France; (M.B.); (A.-r.P.); (F.L.); (R.H.); (J.P.)
- Correspondence: (V.C.); (D.M.)
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Segura-Charry JS, Parada-Martinez MA, Segura-Puello HR, Muñoz-Forero DM, Nieto-Mosquera DL, Villamil-Ballesteros AC, Cortés-Muñoz AJ. Musculoskeletal disorders due to chikungunya virus: A real experience in a rheumatology department in Neiva, Huila. ACTA ACUST UNITED AC 2021; 17:456-460. [PMID: 34625148 DOI: 10.1016/j.reumae.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/02/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chikungunya (CHIKV), is an endemic RNA virus in some regions of Asia and Africa. In Colombia in 2014, its spread started explosively and quickly. The presentation of CHIKV is a febrile condition, with musculoskeletal symptoms, which can progress to erosive arthropathy and polyarticular deformity. The purpose of this study is to evaluate symptomatic and serological behaviour in patients suffering from CHIKV infection in Neiva, Huila who attend the Rheumatology clinic, and to describe the comorbidities associated with the chronic phase of the disease. METHODS An observational, longitudinal and retrospective analysis of data collected in 410 patients afflicted with the CHIKV virus, with symptoms lasting more than 3 months, who persisted with musculoskeletal and joint symptoms. The patients were classified according to their commitment in post-viral arthralgias, polyarthritis post viral, Rheumatoid Arthritis (RA) post CHIKV, Spondyloarthritis postCHIKV, and soft tissue rheumatism. The statistical analysis was performed using SPSS software (version 24). A descriptive analysis was carried out to evaluate quantitative variables such as the mean (standard deviation), and categorical variables such as frequency (%). The categorical variables were compared using the Chi-square equation. As a statistical significance, a p less than .05 was considered. RESULTS Of the 410 patients, 89.23% were women, with polyarticular involvement in 92.26% of the cases. Of the patients, 49.83% had osteoarthritis. At the time of the evaluation in the Rheumatology clinic, 46.3% of the cases presented persistent non-inflammatory arthralgias, and 53.7% of the patients underwent arthritis on physical examination, of which, remarkably, 20.3% met the criteria for rheumatoid arthritis postCHIKV. CONCLUSIONS The development of musculoskeletal symptoms after CHIKV infection is a very serious public health problem, with persistent complications and long-term morbidity risk in real life. The presence of net postviral arthritis is noteworthy, however the development of postCHIKV rheumatoid arthritis usually requires more advanced pharmacological measures, including, in some cases, transition to biological therapy. The presence of symptoms of venous insufficiency in the lower limbs that developed with CHIKV infection was an incidental finding that requires a more precise study.
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Affiliation(s)
- Juan Sebastián Segura-Charry
- Servicio de Reumatología, Clinica Medilaser, Neiva, Huila, Colombia; Universidad Manuela Beltrán, Laboratorio de Investigación Humana (LIH), Bogotá, Colombia.
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Braga DADO, Barreto FKDA, Paiva CN, Ramalho ILC, Cavalcanti LPDG, Alencar CH. Seroepidemiological survey on chikungunya in endemic zones for arboviruses in Brazil, 2019. Zoonoses Public Health 2021; 68:955-964. [PMID: 34472209 DOI: 10.1111/zph.12888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to identify the seroprevalence of chikungunya and its associated factors in the city of Quixadá, Ceará, Brazil. We also aimed to identify the spatial distribution patterns of positive cases. A cross-sectional survey was conducted with a questionnaire about clinical symptoms, socioeconomic and demographic factors, and a 10 ml blood sample was collected and analysed by ELISA. For the bivariate analysis, we use the chi-square test, a prevalence ratio and its 95% confidence interval. A robust Poisson hierarchical regression was used to adjust for confounders. The Kernel density was performed for the spatial analysis. A total of 409 samples were analysed; of them, 70.7% were seropositive for previous exposure to chikungunya virus (CHIKV). High seropositivity for CHIKV was higher in female participants (75.5%; PR = 1.23; 95% CI: 1.06-1.43), those aged 31 years or more (74.3%; PR = 1.62; 95% CI: 1.04-2.52), and those with elementary education level (75.0%; PR = 1.30; 95% CI: 1.06-1.60). There were also high seroprevalence in those with less than a minimum wage per month (89.5%; PR = 1.59; 95% CI: 1.11-2.30), housewives (87.5%; PR = 1.64; 95% CI: 1.24-2.18) and unemployed (80.0%; PR = 1.50; 95% CI: 1.10-2.06). After adjusting for age, morning stiffness was the only chikungunya symptom that remained associated (PR = 1.20; 95% CI: 1.06-1.37; p < .001). There was an area of high density of cases in the downtown and two areas of medium density in nearby regions. Otherwise, the higher seroprevalence rates were in the peripherical neighbourhoods. There is a hyperendemicity of CHIKV in Quixadá, and most cases are spatially contiguous. The main associated clinical sign is morning stiffness, but other factors such as low income and spending a longer time at home were significantly associated with higher seroprevalence.
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Affiliation(s)
| | | | | | | | - Luciano Pamplona de Góes Cavalcanti
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, Brazil.,Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brazil
| | - Carlos Henrique Alencar
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, Brazil.,Programa de Pós-graduação em Saúde Pública, Universidade Federal do Ceará, Fortaleza, Brazil
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Medina-Cintrón N, Martínez I, Pérez-Ríos N, Berríos-López Y, Vilá LM. Clinical Manifestations and Outcomes in Disease-Modifying Antirheumatic Drug-Naive Adult Patients with Chronic Chikungunya Arthritis. Am J Trop Med Hyg 2021; 104:1741-1746. [PMID: 33684065 PMCID: PMC8103441 DOI: 10.4269/ajtmh.20-1573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/22/2021] [Indexed: 11/07/2022] Open
Abstract
Most studies on chronic chikungunya virus (CHIKV) arthritis include patients treated with disease-modifying antirheumatic drugs (DMARDs), likely altering the expression of clinical manifestations and outcome. Therefore, we sought to evaluate the clinical features and correlates in DMARD-naive patients with chronic CHIKV arthritis. We conducted a case-control study in adult patients with serologically confirmed CHIKV infection in Puerto Rico. Demographic features, clinical manifestations, comorbidities, disease activity (per Clinical Disease Activity Index [CDAI]), functional status (per Health Assessment Questionnaire Disability Index [HAQ-DI]), and pharmacologic treatment were ascertained. Patients with and without chronic CHIKV arthritis were compared. Furthermore, a sub-analysis was performed among patients with chronic CHIKV who presented with mild disease activity versus moderate-to-high disease activity at study visit. In total, 61 patients were studied; 33 patients had chronic arthritis and 28 had resolved arthritis. Patients with chronic arthritis had significantly more diabetes mellitus, chronic back pain, and fever, tiredness, and myalgias on the acute phase. The mean (SD) HAQ score was 0.95 (0.56), and 57.6% had moderate-to-high disease activity. Patients with moderate-to-high disease activity had higher scores in overall HAQ-DI and HAQ-DI categories (dressing and grooming, arising, hygiene, reaching, and activities) than in those with mild activity. In conclusion, in this group of DMARD-naive patients with chronic CHIKV arthritis, nearly 58% had moderate-to-high disease activity and had substantial functional disability. Diabetes mellitus, chronic back pain, and some manifestations on acute infection were associated with chronic CHIKV arthritis.
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Affiliation(s)
- Nicolle Medina-Cintrón
- Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Idali Martínez
- Department of Microbiology and Medical Zoology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Naydi Pérez-Ríos
- Hispanic Alliance for Clinical and Translational Research, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Yaritza Berríos-López
- Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Luis M. Vilá
- Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico;,Address correspondence to Luis M. Vilá, Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan PR 00936-5067, Puerto Rico. E-mail:
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Quantifying Media Effects, Its Content, and Role in Promoting Community Awareness of Chikungunya Epidemic in Bangladesh. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:84-94. [PMID: 36417192 PMCID: PMC9620935 DOI: 10.3390/epidemiologia2010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chikungunya is a vector-borne disease, mostly present in tropical and subtropical regions. The virus is spread by Ae. aegypti and Ae. albopictus mosquitos and symptoms include high fever to severe joint pain. Dhaka, Bangladesh, suffered an outbreak of chikungunya in 2017 lasting from April to September. With the goal of reducing cases, social media was at the forefront during this outbreak and educated the public about symptoms, prevention, and control of the virus. Popular web-based sources such as the top dailies in Bangladesh, local news outlets, and Facebook spread awareness of the outbreak. OBJECTIVE This study sought to investigate the role of social and mainstream media during the chikungunya epidemic. The study objective was to determine if social media can improve awareness of and practice associated with reducing cases of chikungunya. METHODS We collected chikungunya-related information circulated from the top nine television channels in Dhaka, Bangladesh, airing from 1st April-20th August 2017. All the news published in the top six dailies in Bangladesh were also compiled. The 50 most viewed chikungunya-related Bengali videos were manually coded and analyzed. Other social media outlets, such as Facebook, were also analyzed to determine the number of chikungunya-related posts and responses to these posts. RESULTS Our study showed that media outlets were associated with reducing cases of chikungunya, indicating that media has the potential to impact future outbreaks of these alpha viruses. Each media outlet (e.g., web, television) had an impact on the human response to an individual's healthcare during this outbreak. CONCLUSIONS To prevent future outbreaks of chikungunya, media outlets and social media can be used to educate the public regarding prevention strategies such as encouraging safe travel, removing stagnant water sources, and assisting with tracking cases globally to determine where future outbreaks may occur.
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Barreto FKDA, Alencar CH, Araújo FMDC, Oliveira RDMAB, Cavalcante JW, Lemos DRQ, Farias LABG, Boriz ILF, Medeiros LQ, Melo MNP, Miyajima F, Siqueira AM, Freitas ARR, Cavalcanti LPDG. Seroprevalence, spatial dispersion and factors associated with flavivirus and chikungunha infection in a risk area: a population-based seroprevalence study in Brazil. BMC Infect Dis 2020; 20:881. [PMID: 33234110 PMCID: PMC7685300 DOI: 10.1186/s12879-020-05611-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/11/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The State of Ceará, in Northeastern Brazil, suffers from a triple burden of arboviruses (dengue, Zika and chikungunya). We measured the seroprevalence of chikungunya, dengue and Zika and its associated factors in the population of Juazeiro do Norte, Southern Ceará State, Brazil. METHODS A cross-sectional study of analytical and spatial analysis was performed to estimate the seroprevalence of dengue, Zika and chikungunya, in the year 2018. Participants were tested for IgM and IgG against these three viruses. Those with IgM and/or IgG positive tests results were considered positive. Poisson regression was used to analyze the factors associated with positive cases, in the same way that the spatial analysis of positive cases was performed to verify whether the cases were grouped. RESULTS Of the 404 participants, 25.0% (103/404) were positive for CHIKV, 92.0% (373/404) for flavivirus (dengue or Zika) and of these, 37.9% (153/404) samples were classified as probable dengue infection. Of those who reported having had an arbovirus in the past, positive CHIKV cases had 58.7% arthralgia (PR = 4.31; 95% CI: 2.06-9.03; p = 0.000) mainly in the hands, ankles and feet. Age over 60 years had a positive association with cases of flavivirus (PR = 1.29; 95% CI: 1.09-1.54; p = 0.000). Fever, muscle pain, joint pain and skin rash were the most reported symptoms (46.1, 41.0, 38.3 and 28.41%, respectively). The positive cases of chikungunya and dengue or Zika were grouped in space and the city center was most affected area. CONCLUSIONS Four years after the introduction of CHIKV, where DENV has been in circulation for over 30 years, 1/4 of the population has already been exposed, showing the extent of the epidemic. The measured prevalence was much higher than that reported by local epidemiological surveillance.
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Affiliation(s)
| | - Carlos Henrique Alencar
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | | | - John Washington Cavalcante
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Serviço de Verificação de Óbitos Dr Rocha Furtado, Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brazil
| | | | - Luís Arthur Brasil Gadelha Farias
- Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Hospital São José de Doenças infecciosas, Fortaleza, CE, Brazil
| | - Isac Lucca Frota Boriz
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Leticia Queiroz Medeiros
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | | | - André Machado Siqueira
- Fundação Oswaldo Cruz, Presidência da Fiocruz, Instituto de Pesquisa Clínica Evandro Chagas (INI/Fiocruz), Rio de Janeiro, Brazil
| | | | - Luciano Pamplona de Góes Cavalcanti
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Abstract
Alphaviruses, members of the enveloped, positive-sense, single-stranded RNA Togaviridae family, represent a reemerging public health threat as mosquito vectors expand into new geographic territories. The Old World alphaviruses, which include chikungunya virus, Ross River virus, and Sindbis virus, tend to cause a clinical syndrome characterized by fever, rash, and arthritis, whereas the New World alphaviruses, which consist of Venezuelan equine encephalitis virus, eastern equine encephalitis virus, and western equine encephalitis virus, induce encephalomyelitis. Following recovery from the acute phase of infection, many patients are left with debilitating persistent joint and neurological complications that can last for years. Clues from human cases and studies using animal models strongly suggest that much of the disease and pathology induced by alphavirus infection, particularly atypical and chronic manifestations, is mediated by the immune system rather than directly by the virus. This review discusses the current understanding of the immunopathogenesis of the arthritogenic and neurotropic alphaviruses accumulated through both natural infection of humans and experimental infection of animals, particularly mice. As treatment following alphavirus infection is currently limited to supportive care, understanding the contribution of the immune system to the disease process is critical to developing safe and effective therapies.
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Affiliation(s)
- Victoria K Baxter
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mark T Heise
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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Segura-Charry JS, Parada-Martinez MA, Segura-Puello HR, Muñoz-Forero DM, Nieto-Mosquera DL, Villamil-Ballesteros AC, Cortés-Muñoz AJ. Musculoskeletal Disorders due to Chikungunya Virus: A Real Experience in a Rheumatology Department in Neiva, Huila. REUMATOLOGIA CLINICA 2020; 17:S1699-258X(20)30073-5. [PMID: 32576537 DOI: 10.1016/j.reuma.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/13/2020] [Accepted: 04/02/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Chikungunya (CHIKV), is an endemic RNA virus in some regions of Asia and Africa. In Colombia in 2014, its spread starts explosively and quickly. The presentation of CHIKV is a febrile condition, with musculoskeletal symptoms, which can progress to erosive arthropathy and polyarticular deformity. The purpose of this study is to evaluate in patients suffering from CHIKV infection in Neiva, Huila who attend the Rheumatology clinic, the symptomatic and serological behavior, and to describe comorbidities associated to the chronic phase of the disease. METHODS An observational, longitudinal and retrospective analysis of data collected in 410 patients afflicted with the CHIKV virus, with symptoms lasting more than 3 months, who persisted with musculoskeletal and joint symptoms. The patients were classified according to their commitment in post-viral arthralgias, polyarthritis post viral, Rheumatoid Arthritis (RA) post CHIKV, Spondyloarthritis postCHIKV, and soft tissue rheumatism. The statistical analysis was performed using SPSS software (version 24). A descriptive analysis was carried out to evaluate quantitative variables such as the mean (standard deviation), and categorical variables such as frequency (%). The categorical variables were compared using the Chi-square equation. As a statistical significance, a p less than .05 was considered. RESULTS Of the 410 patients, 89.23% were women, with polyarticular involvement in 92.26% of the cases. Of the patients, 49.83% had osteoarthritis. At the time of the evaluation in the Rheumatology clinic, 46.3% of the cases presented persistent non-inflammatory arthralgias, and 53.7% of the patients underwent arthritis on physical examination, of which, remarkably, 20.3% met the criteria for rheumatoid arthritis postCHIKV. CONCLUSIONS The development of musculoskeletal symptoms after CHIKV infection is a very serious public health problem, with persistent complications and long-term morbidity risk in real life. The presence of net postviral arthritis is noteworthy, however the development of postCHIKV rheumatoid arthritis usually requires more advanced pharmacological measures, including, in some cases, transition to biological therapy. The presence of symptoms of venous insufficiency in the lower limbs that developed with CHIKV infection was an incidental finding that requires a more precise study.
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Affiliation(s)
- Juan Sebastián Segura-Charry
- Servicio de Reumatología, Clinica Medilaser, Neiva, Huila, Colombia; Universidad Manuela Beltrán, Laboratorio de Investigación Humana (LIH), Bogotá, Colombia.
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Noor FM, Hossain MB, Islam QT. Prevalence of and risk factors for long-term disabilities following chikungunya virus disease: A meta-analysis. Travel Med Infect Dis 2020; 35:101618. [PMID: 32160972 DOI: 10.1016/j.tmaid.2020.101618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main aim of this study was to investigate the percentage of individuals who developed long-term disabilities after chikungunya virus (CHIKV) disease on the basis of follow up time interval and its associated risk factors. METHOD In this meta-analysis, electronic databases PubMed, Science Direct and Google Scholar were searched to identify cohort studies of CHIKV disease from January 2000 to June 2018. Total 28 eligible studies were selected for analysis. The pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures were calculated using a random effects model. RESULT Among 28 studies, 24 studies were used for PR calculation and the PR for the long-term disabilities of CHIKV disease patients were found 39.70%, [95% CI: (31.77-47.64), p < 0.01] for follow up time between 6 and 12 months, 35.85%, [95% CI: (24.09-47.61), p < 0.01] for follow up time between 12 and 18 months and 28.20%, [95% CI: (19.74-36.66), p < 0.01] for greater than 18 months respectively. Eighteen studies were used for RR calculation and significant association were found between long-term disabilities after CHIKV disease and gender [RR: 1.46, p < 0.01], age [RR: 1.61, p < 0.01], diabetes [RR: 1.40, p < 0.01], hypertension [RR: 1.37, p < 0.01], severity of pain at acute stage [RR: 2.02, p < 0.01]. CONCLUSION Approximately 40% patients developed long-term disabilities after 6 months of CHIKV disease and 28% patients still suffer from this disease after 18 months of acute infection.
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Affiliation(s)
| | - Md Belal Hossain
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
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Figueiredo CM, Neris RLDS, Gavino-Leopoldino D, da Silva MOL, Almeida JS, Dos-Santos JS, Figueiredo CP, Bellio M, Bozza MT, Assunção-Miranda I. Mayaro Virus Replication Restriction and Induction of Muscular Inflammation in Mice Are Dependent on Age, Type-I Interferon Response, and Adaptive Immunity. Front Microbiol 2019; 10:2246. [PMID: 31632368 PMCID: PMC6779782 DOI: 10.3389/fmicb.2019.02246] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/13/2019] [Indexed: 12/24/2022] Open
Abstract
Mayaro virus (MAYV) is an emergent arbovirus first described in forest regions of the American continent, with recent and increasing notification of urban area circulation. Similar to Chikungunya (CHIKV) and other arthritogenic Alphavirus, MAYV-induced disease shows a high prevalence of persistent arthralgia, and myalgia. Despite this, knowledge regarding pathogenesis and characteristics of host immune response of MAYV infections are still limited. Here, using different ages of wild-type (WT), adult Type I Interferon receptor deficient (IFNAR-/-), and adult recombination activation gene-1 deficient (RAG-/-) mice, we have investigated the dependence of age, innate and adaptive immunity for the control of MAYV replication, tissue damage, and inflammation in mice. We have found that MAYV induces clinical signal and replicates in young WT mice, which gain the ability to restrict MAYV replication with aging. In addition, we observed that mice age and type I interferon response are related to restriction of MAYV infection and muscular inflammation in mice. Moreover, MAYV continues to replicate persistently in RAG-/- mice, being detected at blood and tissues 40 days post infection, indicating that adaptive immunity is essential to MAYV clearance. Despite chronic replication, infected adult RAG-/- mice did not develop an apparent signal of muscle damage in early and late infection. On the other hand, MAYV infection in young WT and adult IFNAR-/- mice triggers an increase in the expression of pro-inflammatory mediators, such as TNF, IL-6, KC, IL-1β, MCP-1, and RANTES, in muscle tissue, and decreases TGF-β expression, that were not significantly modulated in adult WT and RAG-/- mice. Taken together, our data demonstrated that age, innate and adaptive immunity are important to restrict MAYV replication and that adaptive immunity is also involved in MAYV-induced tissue damage. These results contribute to the comprehension of MAYV pathogenesis, and describe translational mice models for further studies of MAYV infection, vaccine tests, and therapeutic strategies against this virus.
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Affiliation(s)
- Camila Menezes Figueiredo
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Romulo Leão da Silva Neris
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Gavino-Leopoldino
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Juliana Silva Almeida
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julio Souza Dos-Santos
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Maria Bellio
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Torres Bozza
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Iranaia Assunção-Miranda
- Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Murillo-Zamora E, Mendoza-Cano O, Trujillo-Hernández B, Guzmán-Esquivel J, Lugo-Radillo A, Higareda-Almaraz MA, Evangelista-Salazar JJ, Higareda-Almaraz E, Benítes-Godínez V. Development of a concise clinical index for predicting chronic chikungunya arthritis. Int J Infect Dis 2019; 86:1-4. [DOI: 10.1016/j.ijid.2019.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022] Open
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Rodríguez-Morales AJ, Bonilla-Aldana DK, Bonilla-Aldana JC, Mondragón-Cardona Á. Chikungunya and Zika in Huila: Mapping their Incidence in a Neglected Area of Colombia. Arch Med Res 2019; 49:512-513. [PMID: 30799053 DOI: 10.1016/j.arcmed.2019.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 01/21/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Alfonso J Rodríguez-Morales
- Public Health and Infection Research and Incubator Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
| | - D Katterine Bonilla-Aldana
- Public Health and Infection Research and Incubator Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación Sanidad Animal, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | | | - Álvaro Mondragón-Cardona
- Department of Internal Medicine, Hospital Universitario Hernando Moncaleano Perdomo, Universidad Surcolombiana, Neiva, Huila, Colombia
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Escalera-Antezana JP, Murillo-García DR, Rodriguez-Morales AJ. Chikungunya in Bolivia: Still a Neglected Disease? Arch Med Res 2018; 49:288. [PMID: 30269966 DOI: 10.1016/j.arcmed.2018.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/14/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Juan Pablo Escalera-Antezana
- Medical School, Faculty of Health Sciences, UniFranz, Cochabamba, Bolivia; Tongji Hospital & Medical College, Huazhong University of Science &Technology, Wuhan, P.R. China
| | - David R Murillo-García
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - Alfonso J Rodriguez-Morales
- Medical School, Faculty of Health Sciences, UniFranz, Cochabamba, Bolivia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
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Prevalence and risk factors of post chikungunya rheumatic musculoskeletal disorders: a prospective follow-up study in French Guiana. Eur J Clin Microbiol Infect Dis 2018; 37:2159-2164. [PMID: 30120648 DOI: 10.1007/s10096-018-3353-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/08/2018] [Indexed: 12/22/2022]
Abstract
The estimated seroprevalence in the general population after chikungunya virus (CHIKV) epidemics ranged from 38 to 63%. Despite a low case fatality, subacute and chronic rheumatic forms of CHIKV infection generate significant morbidity and have a socioeconomic impact. The objective of the study was to estimate the prevalence of chronic post-CHIKV rheumatic or musculoskeletal pain (pCHIK-RMSP) at 3 and 6 months after the initial symptoms. An observational study was conducted at Cayenne General Hospital in French Guiana between April 1 and June 30, 2014. All patients seen for CHIKV infection confirmed by RT-PCR were prospectively included. Pregnant women and children under 15 were excluded from the study. All patients were called by phone at 3 and 6 months to enquire about the presence of pCHIK-RMSP. Out of a total of 254 eligible patients, 168 were selected. The mean age was 45.3 years (SD ± 1.4 yo) and the sex ratio (M/F) was 0.75. No death was reported. At 3 months, 40.2% (95% CI 31.1-49.3) of patients (n = 45/112) had pCHIK-RMSP and 31.3% (95% CI 22.2-40.4) of patients (n = 31/99) at 6 months. The median time of end to pain was 2 weeks after the date of onset of signs. The present study provides succinct but informative data about pCHIK-RMSP, which represents the real burden of the disease. There are few studies on that subject in the Amazonian region, but our study shows a lower impact than in the Indian Ocean islands where the population is older.
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