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. 2018 Jan 3;5(1):ofx234.
doi: 10.1093/ofid/ofx234. eCollection 2018 Jan.

The Identification of Risk Factors for Chronic Chikungunya Arthralgia in Grenada, West Indies: A Cross-Sectional Cohort Study

Claire J Heath  1   2 , Jason Lowther  2   3 , Trevor P Noël  2   3 , Idis Mark-George  2 , Derek B Boothroyd  1 , George Mitchell  4 , Calum MacPherson  2   3 , A Desiree LaBeaud  1
Affiliations

The Identification of Risk Factors for Chronic Chikungunya Arthralgia in Grenada, West Indies: A Cross-Sectional Cohort Study

Claire J Heath et al. Open Forum Infect Dis. .

Abstract

Background: Chikungunya virus (CHIKV) is a re-emerging arboviral pathogen. In 2014, an explosive CHIKV outbreak occurred in Grenada, West Indies, infecting approximately 60% of the population. In approximately 50% of cases, CHIKV infection transitions to painful arthralgia that can persist for years. Elucidation of the risk factors for chronic disease is imperative to the development of effective risk management strategies and specific therapeutics.

Methods: We conducted a cross-sectional study of 240 people who were tested for CHIKV during the outbreak. We administered questionnaires to examine demographic, behavioral, psychological, social, and environmental factors to identify associations with chronic disease. Physical examinations were performed and persistent symptoms were recorded.

Results: Ethnicity and socioeconomic status were not associated with risk of chronic joint pain. Female sex increased risk, and age was demonstrated to be predictive of chronic CHIKV sequelae. Mosquito avoidance behaviors did not reduce risk. Patients suffering joint pains, generalized body ache, and weakness in the extremities during acute infection were more likely to develop chronic arthralgia, and an increased duration of acute disease also increased risk.

Conclusions: These data demonstrate that chronic CHIKV affects people across the ethnic and socioeconomic spectrum, and it is not reduced by vector avoidance activity. Increased duration of acute symptoms, in particular acute joint pain, was strongly correlated with the risk of persistent arthralgia, thus effective clinical management of acute CHIKV disease could reduce burden of chronic CHIKV.

Keywords: Caribbean; Chikungunya; Grenada; arthralgia; arthritis.

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Figures

Figure 1.
Figure 1.
Analysis of the association of mosquito vector avoidance behaviors and the risk of chronic Chikungunya virus arthralgia.
Figure 2.
Figure 2.
Arthritis impact scores in subjects with Chikungunya virus-related persistent arthritis and arthralgia in each distinct life domain.
Figure 3.
Figure 3.
Correlation of duration of acute symptoms and initial joint pain with each life domain in arthritis impact quality-of-life assessment.
See this image and copyright information in PMC

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