School of Medicine and Health Sciences Poster Presentations

Title

Prevalence of Chronic Joint Pain following Chikungunya Infection from a Colombian Cohort.

Document Type

Poster

Keywords

chikungunya arthritis; chronic joint pain; chikungunya

Publication Date

Spring 2017

Abstract

Introduction: Chikungunya fever is a viral illness spread by mosquitos. The infection presents with fever, headache, muscle pain, rash, and joint pain. Outbreaks have previously been restricted to Africa, Asia, Europe, and islands in the Indian and Pacific Oceans,1 causing chronic arthritis lasting months to years in these areas. In 2013, Chikungunya virus was found for the first time in the Americas, on islands in the Caribbean, and has now infected over 800,000 people. The primary objective of this study was to determine the prevalence of chronic arthritis after chikungunya infection in a Latin American cohort and define the clinical characteristics associated with chronic arthritis symptoms.

Methods: 494 Colombian patients with serologically confirmed Chikungunya were included in the study. Patients received a baseline symptom questionnaire and a 20-month telephonic follow-up symptom questionnaire. Comparisons of the reported symptoms were analyzed using chi-square or the Kruskal-Wallis.

Results: The baseline characteristics of the patients include mean age 49 +/- 17 years, 81% female, 94% Mestizo ethnicity, and 76% with high school or less education. Common comorbidities seen in the study sample were hypertension, diabetes, lung disease and depression. 25% of the patients reported current, persistent joint pain at 20-month follow-up, The patients with persistent joint pain in weeks had increased duration of initial joint pain (40.2 ± 37.7) compared to the no persistent joint pain group (11.4 ± 26.3) with p<0.0001. Of the 70 patients that missed work/school, 44 patients had persistent joint pain (p<0.001), and of the 32 patients that had symptoms impact their capacity to continue normal activity, 24 had chronic joint pain (p<0.001). Patients with persistent joint pain had increased disease activity of swollen joint count (0.5 ± 1.0) and tender joint count (3.0 ± 2.3) compared to the no persistent joint pain groups (0.04 ± 0.3, 0.2 ± 0.8, respectively) with p<0.0001.

Conclusion: Chikungunya caused significant debilitating chronic arthritis in quarter of the patients at 20-months post infection.

Future Analysis: The baseline cytokine profile of cases of chikungunya arthritis in comparison to age and gender matched controls from the same cohort without persistent arthritis will be evaluated to further understand the development chikungunya arthritis and the biomarkers that may predict persistent arthritis.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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Prevalence of Chronic Joint Pain following Chikungunya Infection from a Colombian Cohort.

Introduction: Chikungunya fever is a viral illness spread by mosquitos. The infection presents with fever, headache, muscle pain, rash, and joint pain. Outbreaks have previously been restricted to Africa, Asia, Europe, and islands in the Indian and Pacific Oceans,1 causing chronic arthritis lasting months to years in these areas. In 2013, Chikungunya virus was found for the first time in the Americas, on islands in the Caribbean, and has now infected over 800,000 people. The primary objective of this study was to determine the prevalence of chronic arthritis after chikungunya infection in a Latin American cohort and define the clinical characteristics associated with chronic arthritis symptoms.

Methods: 494 Colombian patients with serologically confirmed Chikungunya were included in the study. Patients received a baseline symptom questionnaire and a 20-month telephonic follow-up symptom questionnaire. Comparisons of the reported symptoms were analyzed using chi-square or the Kruskal-Wallis.

Results: The baseline characteristics of the patients include mean age 49 +/- 17 years, 81% female, 94% Mestizo ethnicity, and 76% with high school or less education. Common comorbidities seen in the study sample were hypertension, diabetes, lung disease and depression. 25% of the patients reported current, persistent joint pain at 20-month follow-up, The patients with persistent joint pain in weeks had increased duration of initial joint pain (40.2 ± 37.7) compared to the no persistent joint pain group (11.4 ± 26.3) with p<0.0001. Of the 70 patients that missed work/school, 44 patients had persistent joint pain (p<0.001), and of the 32 patients that had symptoms impact their capacity to continue normal activity, 24 had chronic joint pain (p<0.001). Patients with persistent joint pain had increased disease activity of swollen joint count (0.5 ± 1.0) and tender joint count (3.0 ± 2.3) compared to the no persistent joint pain groups (0.04 ± 0.3, 0.2 ± 0.8, respectively) with p<0.0001.

Conclusion: Chikungunya caused significant debilitating chronic arthritis in quarter of the patients at 20-months post infection.

Future Analysis: The baseline cytokine profile of cases of chikungunya arthritis in comparison to age and gender matched controls from the same cohort without persistent arthritis will be evaluated to further understand the development chikungunya arthritis and the biomarkers that may predict persistent arthritis.