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Fianu A, Doussiet É, Naty N, Porcherat S, Mussard C, Boussaïd K, Cogne M, Gérardin P, Favier F. Usefulness of Home Screening for Promoting Awareness of Impaired Glycemic Status and Utilization of Primary Care in a Low Socio-Economic Setting: A Follow-Up Study in Reunion Island. Int J Health Policy Manag 2022; 11:2208-2218. [PMID: 34634871 PMCID: PMC9808280 DOI: 10.34172/ijhpm.2021.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/21/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Low socio-economic settings are characterized by high prevalence of diabetes and difficulty in accessing healthcare. In these contexts, proximity health services could improve healthcare access for diabetes prevention. Our primary objective was to evaluate the usefulness of home screening for promoting awareness of impaired glycemic status and utilization of primary care among adults aged 18-79 in a low socio-economic setting. METHODS This follow-up study was conducted in 2015-2016 in Reunion Island, a French overseas department in the Indian Ocean. Enrollment and screening occurred on the same day at the home of participants (N=907). Impaired glycemic status was defined as [glycated hemoglobin (HbA1c) ≥5.7%] OR [fasting capillary blood glucose (FCBG) ≥1.10 g/L] OR [HbA1c=5.5-5.6% and FCBG=1.00-1.09 g/L]. Medical, socio-cultural, and socio-economic characteristics were collected via a face-to-face questionnaire. A one-month telephone follow-up survey was conducted to determine whether participants had consulted a general practitioner (GP) for confirmation of screening results. A multinomial polytomous logistic regression model was used to identify factors independently associated with non-use of GP consultation for confirmation of screening results and nonresponse to the telephone follow-up survey. RESULTS Prevalence of glycemic abnormalities was 46.0% (95% CI = 42.7-49.2%). Among participants with impaired glycemic status (N=417), 77.7% (95% CI=73.7-81.7%) consulted a GP for confirmation of screening results, 12.5% (95% CI=9.3-15.6%) did not, and 9.8% failed to respond to the follow-up survey. Factors independently associated with non-use of GP consultation for confirmation of screening results were self-reported unwillingness to consult a GP (adjusted odds ratio [OR]: 4.86, 95% CI=1.70-13.84), usual GP consultation frequency of less than once a year (adjusted OR: 4.13, 95% CI=1.56-10.97), and age 18-39 years (adjusted OR: 3.09, 95% CI=1.46-6.57). CONCLUSION Home screening for glycemic abnormalities is a useful proximity health service for diabetes prevention in low socio-economic settings. Further efforts, including health literacy interventions, are needed to increase utilization of primary care.
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Affiliation(s)
- Adrian Fianu
- INSERM CIC1410, CHU Réunion, Saint-Pierre, France
- CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Nadège Naty
- INSERM CIC1410, CHU Réunion, Saint-Pierre, France
| | | | | | | | - Muriel Cogne
- Service de Diabétologie - Site Sud, CHU de la Réunion, Saint-Pierre, France
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Godeluck A, Gérardin P, Lenclume V, Mussard C, Robillard PY, Sampériz S, Benhammou V, Truffert P, Ancel PY, Ramful D. Mortality and severe morbidity of very preterm infants: comparison of two French cohort studies. BMC Pediatr 2019; 19:360. [PMID: 31623604 PMCID: PMC6796444 DOI: 10.1186/s12887-019-1700-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/29/2019] [Indexed: 01/28/2023] Open
Abstract
Background In Reunion Island, a French overseas department, the burden of preterm birth and perinatal mortality exceed those observed in mainland France, despite similar access to standard perinatal care. The purpose of the study was to compare the outcome of two cohorts of NICU-admitted very preterm infants born between 24 and 31 weeks of gestation (WG): the registry-based OGP (Observatoire de la Grande Prématurité, Reunion Island, 2008–2013) cohort, and the nationwide EPIPAGE-2 (mainland France, 2011) observational cohort. Methods The primary outcome was adverse neonatal outcomes defined as a composite indicator of in-hospital mortality or any of three following severe morbidities: bronchopulmonary dysplasia (BPD), necrotising enterocolitis, or severe neurological injury (periventricular leukomalacia or grade III-IV intraventricular haemorrhages). Logistic regression modelling adjusting for confounders was performed. Results A total of 1272 very preterm infants from the Reunionese OGP cohort and 3669 peers from the mainland EPIPAGE-2 cohort were compared. Adverse neonatal outcomes were more likely observed in the OGP cohort (32.6% versus 26.6%, p < 0.001), as result of both increased in-hospital mortality across all gestational age strata and increased BPD among the survivors of the 29–31 WG stratum. After adjusting for gestational age, gender and multiple perinatal factors, the risk of adverse neonatal outcomes was higher in the OGP cohort than in the EPIPAGE-2 cohort across all gestational age strata. Conclusions Despite similar guidelines for standard perinatal care, very preterm infants born in Reunion Island have a higher risk for death or severe morbidity compared with those born in mainland France. Electronic supplementary material The online version of this article (10.1186/s12887-019-1700-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Patrick Gérardin
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Victorine Lenclume
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Corinne Mussard
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Pierre-Yves Robillard
- CHU de la Réunion, Saint Pierre, Réunion.,Centre d'Etudes Périnatales de l'Océan Indien (CEPOI), Université de la Réunion, EA 7388, Saint-Denis, France
| | | | | | - Patrick Truffert
- CHU Lille, EA 2694 Public Health, Epidemiology and Quality of Care unit, F-59000, Lille, France
| | - Pierre-Yves Ancel
- INSERM U 1153, CHU Cochin Hôtel Dieu, Paris, France.,Université Paris Descartes, Paris, France.,URC - CIC1419 Plurithématique, Cochin Hôtel Dieu, Paris, France
| | - Duksha Ramful
- CHU de la Réunion, Saint Denis, Réunion. .,INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion. .,Postal address: Neonatal and pediatric intensive care unit, Félix Guyon Hospital, CHU de La Réunion, Allée des Topazes, CS 11021, 97400, Saint-Denis Cedex, La Réunion, France.
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Gérardin P, Zemali N, Bactora M, Camuset G, Balleydier E, Pascalis H, Guernier V, Mussard C, Bertolotti A, Koumar Y, Naze F, Picot S, Filleul L, Pages F, Tortosa P, Jaubert J. Seroprevalence of typhus group and spotted fever group Rickettsia exposures on Reunion island. BMC Res Notes 2019; 12:387. [PMID: 31288833 PMCID: PMC6617902 DOI: 10.1186/s13104-019-4416-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/29/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Murine typhus has been increasingly reported on Reunion island, Indian ocean, following documentation of eight autochthonous infections in 2012–2013. We conducted a serosurvey to assess the magnitude of the seroprevalence of rickettsioses in the population. Two hundred and forty-one stored frozen sera taken from the 2009 Copanflu-RUN cohort were analysed using an immunofluorescence assay allowing to distinguish typhus group (TGR) and spotted fever group Rickesttsiae (SFGR). Seropositivity was defined for a dilution titre of Rickettsia IgG antibodies ≥ 1:64. Seroprevalence was weighted to account for the discrepancy between the Copanflu-RUN subset and the general population, as to infer prevalence at community level. Prevalence proportion ratios (PPR) were measured using log-binomial models. Results The weighted seroprevalences of typhus group rickettsioses and spotted fever group rickettsioses were of 12.71% (95% CI 8.84–16.58%) and 17.68% (95% CI 13.25–22.11%), respectively. Pooled together, data suggested that a fifth of the population had been exposed at least to one Rickettsia group. Youths (< 20 years) were less likely seropositive than adults (adjusted PPR 0.13, 95% CI 0.01–0.91). People living in the western dryer part of the island were more exposed (adjusted PPR 2.53, 95% CI 1.07–5.97). Rickettsioses are endemic on Reunion island and circulated before their first identification as murine typhus in year 2011. Surprisingly, since isolation of Rickettsia africae from Amblyomma variegatum in year 2004 or isolation of Rickettsia felis from Amblyomma loculosum, no autochthonous cases of African tick-bite fever or flea-borne spotted fever has yet been diagnosed. Electronic supplementary material The online version of this article (10.1186/s13104-019-4416-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Gérardin
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France. .,UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France.
| | - Naël Zemali
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Marie Bactora
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Guillaume Camuset
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Elsa Balleydier
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Hervé Pascalis
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France
| | - Vanina Guernier
- Geelong Centre for Emerging Infectious Diseases, Deakin University, Geelong, VIC, Australia
| | - Corinne Mussard
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France
| | - Antoine Bertolotti
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France.,Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Yatrika Koumar
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Laurent Filleul
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Frédéric Pages
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Pablo Tortosa
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France
| | - Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
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Gérardin P, Rollot O, Maillard O, Mussard C, Porcherat S, Lenclume V, Fianu A, Bertolotti A, Huiart L, Marimoutou C. Qualité de vie à 10–11 ans d’une épidémie de Chikungunya : étude en population générale. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mas C, Gérardin P, Chirpaz E, Carbonnier M, Mussard C, Samperiz S, Ramful D. Follow-up at two years of age and early predictors of non-compliance in a cohort of very preterm infants. Early Hum Dev 2017; 108:1-7. [PMID: 28342385 DOI: 10.1016/j.earlhumdev.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/12/2017] [Accepted: 03/03/2017] [Indexed: 11/17/2022]
Abstract
AIM To examine the rates of follow-up at two years of age and perinatal factors associated with non-compliance in an observational population-based cohort of very preterm children enrolled in a routine follow-up program. METHOD Data review of infants born between 2008 and 2012 in the Observatoire de La Grande Prématurité, Reunion Island cohort. All singletons born alive before 33weeks of gestational age and resident on the island at two years of age were included. Patients were considered compliant if they were timely evaluated between 20-28months of age, or non-compliant if they were not evaluated or evaluated after 28months of age. RESULTS Of the 802 survivors (mean gestational age of 30.3±2.0months, mean birthweight of 1364±396g), 468 (58.4%) were examined between 20-28months, 119 (14.8%) after 28months of age, and 215 (26.8%) were never evaluated, respectively. In multivariate analysis, factors associated with non-compliance were higher parity (>2), past history of preterm delivery, maternal diabetes (preexisting or gestational), appropriate for gestational status, and centre of birth. CONCLUSION Sustainable follow-up of vulnerable neonates remains a challenge in clinical practice. Early predictors of non-compliance can be used to define individualized and local follow-up strategies in these infants at high risk for developmental disabilities.
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Affiliation(s)
- Claire Mas
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
| | - Patrick Gérardin
- Pôle Femme Mère Enfant, CHU Réunion, Saint Pierre, Reunion, France ; Centre d'Investigation Clinique (INSERM CIC1410) Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France.
| | - Emmanuel Chirpaz
- Unité de Soutien Méthodologique, Centre Hospitalier Félix Guyon, 97405 Saint Denis Cedex, La Réunion, France.
| | - Magali Carbonnier
- Neonatal Intensive Care Unit, CHU Réunion, 97448 Saint Pierre Cedex, Réunion Island, France.
| | - Corinne Mussard
- Pôle Femme Mère Enfant, CHU Réunion, Saint Pierre, Reunion, France ; Centre d'Investigation Clinique (INSERM CIC1410) Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France.
| | - Sylvain Samperiz
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
| | - Duksha Ramful
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
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Richard M, Ramful D, Robillard PY, Mussard C, Loumouamou Y, Ogier M, Tasset C, N'guyen AD, Alessandri JL, Sampériz S, Gérardin P. [Prevalence, severity, and predictors of bronchopulmonary dysplasia in a cohort of very preterm infants]. Arch Pediatr 2013; 20:928-37. [PMID: 23829969 DOI: 10.1016/j.arcped.2013.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 02/21/2013] [Accepted: 05/15/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this retrospective cohort study was to determine the prevalence and severity of BPD and its predictors in a regional cohort of very preterm (VP) infants in Reunion Island. METHODS All autochthonous VP infants, live-born before the 33rd week of gestation (WG) between 1st January 2008 and 31st December 2009, were eligible for the study. Only VP infants surviving at least 28 days, for whom the parameters were known from birth, were included in the case-control study of predictors of moderate to severe BPD (BPDmo/s). RESULTS In VP infants less than 33 WG, the rate of overall BPD (3 grades of severity) was 30.7%. Among those who survived 28 days or more, the rate of BPDmo/s was 13.1% (95%CI: 10.2-15.9%). In VP infants less than 32 WG that survived at 36 WG, the prevalence of BPDmo/s was 18.2% (95% CI: 14.2-22.1%). In a fixed-effect logistic model, adjusted for gestational age, postnatal growth, and the mode of ventilation at 24h, 4 key factors were predictive of BDPmo/s: small for gestational age, surfactant, delayed energy intake, and late-onset neonatal infection. In a mixed-effect logistic model adjusted for these same cofactors, the site was associated with BPDmo/s, in line with a center-effect. CONCLUSION The prevalence of BPDmo/s in the mixed-race population of Reunion Island is consistent with those observed in Europe but were site-specific. In our setting, predictors of individual BPDmo/s are similar to those already identified.
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Affiliation(s)
- M Richard
- Service de réanimation néonatale et pédiatrique, pôle Femme-Mère-Enfant, groupe hospitalier Sud-Réunion, centre hospitalier universitaire de Saint-Pierre, BP 350, 97448 Saint-Pierre cedex, Réunion
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Gérardin P, Fianu A, Michault A, Mussard C, Boussaïd K, Rollot O, Grivard P, Kassab S, Bouquillard E, Borgherini G, Gaüzère BA, Malvy D, Bréart G, Favier F. Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study. Arthritis Res Ther 2013; 15:R9. [PMID: 23302155 PMCID: PMC3672753 DOI: 10.1186/ar4137] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 01/04/2013] [Indexed: 05/03/2023] Open
Abstract
Introduction Long-lasting relapsing or lingering rheumatic musculoskeletal pain (RMSP) is the hallmark of Chikungunya virus (CHIKV) rheumatism (CHIK-R). Little is known on their prognostic factors. The aim of this prognostic study was to search the determinants of lingering or relapsing RMSP indicative of CHIK-R. Methods Three hundred and forty-six infected adults (age ≥ 15 years) having declared RMSP at disease onset were extracted from the TELECHIK cohort study, Reunion island, and analyzed using a multinomial logistic regression model. We also searched for the predictors of CHIKV-specific IgG titres, assessed at the time of a serosurvey, using multiple linear regression analysis. Results Of these, 111 (32.1%) reported relapsing RMSP, 150 (43.3%) lingering RMSP, and 85 (24.6%) had fully recovered (reference group) on average two years after acute infection. In the final model controlling for gender, the determinants of relapsing RMSP were the age 45-59 years (adjusted OR: 2.9, 95% CI: 1.0, 8.6) or greater or equal than 60 years (adjusted OR: 10.4, 95% CI: 3.5, 31.1), severe rheumatic involvement (fever, at least six joints plus four other symptoms) at presentation (adjusted OR: 3.6, 95% CI: 1.5, 8.2), and CHIKV-specific IgG titres (adjusted OR: 3.2, 95% CI: 1.8, 5.5, per one unit increase). Prognostic factors for lingering RMSP were age 45-59 years (adjusted OR: 6.4, 95% CI: 1.8, 22.1) or greater or equal than 60 years (adjusted OR: 22.3, 95% CI: 6.3, 78.1), severe initial rheumatic involvement (adjusted OR: 5.5, 95% CI: 2.2, 13.8) and CHIKV-specific IgG titres (adjusted OR: 6.2, 95% CI: 2.8, 13.2, per one unit increase). CHIKV specific IgG titres were positively correlated with age, female gender and the severity of initial rheumatic symptoms. Conclusions Our data support the roles of age, severity at presentation and CHIKV specific IgG titres for predicting CHIK-R. By identifying the prognostic value of the humoral immune response of the host, this work also suggest a significant contribution of the adaptive immune response to the physiopathology of CHIK-R and should help to reconsider the paradigm of this chronic infection primarily shifted towards the involvement of the innate immune response.
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Gérardin P, Fianu A, Malvy D, Mussard C, Boussaïd K, Rollot O, Michault A, Gaüzere BA, Bréart G, Favier F. [Perceived morbidity and community burden of chikungunya in La Reunion]. Med Trop (Mars) 2012; 72 Spec No:76-82. [PMID: 22693934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Persistence of clinical manifestations, especially polyarthralgia and fatigue, is a characteristic feature of chikungunya virus (CHIK-v) infection. The purpose of this study was to measure the impact of prolonged or late-onset manifestations of CHIK-v infection on the self-perceived health of people on Reunion Island. METHODS This retrospective cohort survey, dubbed TELECHIK survey, was conducted eighteen months after the end of the chikungunya outbreak on a representative random sample from the SEROCHIK population-based survey conducted on Reunion Island. A total of 1094 subjects whose CHIK-v specific IgG antibody status had been documented were interviewed about current symptoms. RESULTS Analysis of data showed 45% of CHIK+ vs 14% of CHIK- subjects reporting musculoskeletal pain (P < 0.001), 56% vs. 44% reporting fatigue (P = 0.003), 77% vs. 53% reporting cerebral manifestations (P < 0.001), 51% vs. 34% reporting sensorineural impairments (P < 0.001), 18% vs. 13% reporting digestive complaints (P = 0.06), and 38% vs. 32% reporting skin involvement (P = 0.13). The mean delay between infection and interview was two years (range, 15-34 months). Analysis of data after correction for age, gender, body mass index and comorbidity indicated that rheumatic pain, fatigue, cerebral manifestations and sensorineural impairments were more likely in CHIK+ than CHIK- subjects but the likelihood of digestive and skin manifestations was the same. CONCLUSION With a mean delay of two years after infection, 45% to 77% of CHIK+ subjects reported prolonged or late-onset symptoms attributable to CHIK-v. These results indicate that persistent manifestations of chikungunya infection have a heavy impact on rheumatologic, neurological and sensorineural health.
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Affiliation(s)
- P Gérardin
- Centre d'Investigation Clinique - Epidémiologie Clinique (CIC-EC) de La Réunion (INSERM/CHR/URML-OI), Saint Pierre, La Réunion, France.
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Gérardin P, Fianu A, Malvy D, Mussard C, Boussaïd K, Rollot O, Michault A, Gaüzere BA, Bréart G, Favier F. Perceived morbidity and community burden after a Chikungunya outbreak: the TELECHIK survey, a population-based cohort study. BMC Med 2011; 9:5. [PMID: 21235760 PMCID: PMC3029216 DOI: 10.1186/1741-7015-9-5] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 01/14/2011] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Persistent disabilities are key manifestations of Chikungunya virus (CHIKV) infection, especially incapacitating polyarthralgia and fatigue. So far, little is known about their impact on health status. The present study aimed at describing the burden of CHIKV prolonged or late-onset symptoms on the self-perceived health of La Réunion islanders. METHODS At 18 months after an outbreak of Chikungunya virus, we implemented the TELECHIK survey; a retrospective cohort study conducted on a random sample of the representative SEROCHIK population-based survey. A total of 1,094 subjects sampled for CHIKV-specific IgG antibodies in the setting of La Réunion island in the Indian Ocean, between August 2006 and October 2006, were interviewed about current symptoms divided into musculoskeletal/rheumatic, fatigue, cerebral, sensorineural, digestive and dermatological categories. RESULTS At the time of interview, 43% of seropositive (CHIK+) subjects reported musculoskeletal pain (vs 17% of seronegative (CHIK-) subjects, P < 0.001), 54% fatigue (vs 46%, P = 0.04), 75% cerebral disorders (vs 57%, P < 0.001), 49% sensorineural impairments (vs 37%, P = 0.001), 18% digestive complaints (vs 15%, P = 0.21), and 36% skin involvement (vs 34%, P = 0.20) on average 2 years after infection (range: 15-34 months). After controlling for confounders such as age, gender, body mass index or major comorbidities in different Poisson regression models, 33% of joint pains were attributable to CHIKV, 10% of cerebral disorders and 7.5% of sensorineural impairments, while Chikungunya did not enhance fatigue states, digestive and skin disorders. CONCLUSIONS On average, 2 years after infection 43% to 75% of infected people reported prolonged or late-onset symptoms highly attributable to CHIKV. These manifestations carry a significant burden in the community in the fields of rheumatology, neurology and sensorineural health.
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Affiliation(s)
- Patrick Gérardin
- Centre for Clinical Investigation-Clinical Epidemiology (CIC-EC) of La Réunion (INSERM/CHR/URMLR), Saint Pierre, La Réunion, France.
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