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. 2018 Jun 6;12(6):e0006561.
doi: 10.1371/journal.pntd.0006561. eCollection 2018 Jun.

Chikungunya outbreak (2017) in Bangladesh: Clinical profile, economic impact and quality of life during the acute phase of the disease

Mohammad Sorowar Hossain  1   2   3 , Md Mahbub Hasan  1   4 , Muhammad Sougatul Islam  1 , Salequl Islam  1   5 , Miliva Mozaffor  1   6 , Md Abdullah Saeed Khan  1   7 , Nova Ahmed  1 , Waheed Akhtar  1   8 , Shahanaz Chowdhury  3 , S M Yasir Arafat  1   9 , Md Abdul Khaleque  2 , Zohora Jameela Khan  1   10 , Tashmim Farhana Dipta  1   11 , Shah Md Zahurul Haque Asna  3 , Md Akram Hossain  12 , Km Sultanul Aziz  1 , Abdullah Al Mosabbir  1   13 , Enayetur Raheem  1   14
Affiliations

Chikungunya outbreak (2017) in Bangladesh: Clinical profile, economic impact and quality of life during the acute phase of the disease

Mohammad Sorowar Hossain et al. PLoS Negl Trop Dis. .

Abstract

Background: Chikungunya virus causes mosquito-transmitted infection that leads to extensive morbidity affecting substantial quality of life. Disease associated morbidity, quality of life, and financial loss are seldom reported in resources limited countries, such as Bangladesh. We reported the acute clinical profile, quality of life and consequent economic burden of the affected individuals in the recent chikungunya outbreak (May to September 2017) in Dhaka city, Bangladesh.

Methods: We conducted a cross-sectional study during the peak of chikungunya outbreak (July 24 to August 5, 2017) to document the clinical profiles of confirmed cases (laboratory test positive) and probable cases diagnosed by medical practitioners. Data related to clinical symptoms, treatment cost, loss of productivity due to missing work days, and quality of life during their first two-weeks of symptom onset were collected via face to face interview using a structured questionnaire. World Health Organization endorsed questionnaire was used to assess the quality of life.

Results: A total of 1,326 chikungunya cases were investigated. Multivariate analysis of major clinical variables showed no statistically significant differences between confirmed and probable cases. All the patients reported joint pain and fever. Other more frequently reported symptoms include headache, loss of appetite, rash, myalgia, and itching. Arthralgia was polyarticular in 56.3% of the patients. Notably, more than 70% patients reported joint pain as the first presenting symptom. About 83% of the patients reported low to very low overall quality of life. Nearly 30% of the patients lost more than 10 days of productivity due to severe arthropathy.

Conclusions: This study represents one of the largest samples studied so far around the world describing the clinical profile of chikungunya infection. Our findings would contribute to establish an effective syndromic surveillance system for early detection and timely public health intervention of future chikungunya outbreaks in resource-limited settings like Bangladesh.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Spatial distribution of 855 patients out of 1326 CHIKV infected patients in Dhaka city.
The remaining 471 patents were not interested to disclose their address during the interview. Data presented in this Figure as % of total patients had no reservation to share their residential address (n = 855).
Fig 2
Fig 2
The economic impact of chikungunya infection on days misses from work (A) and rating versus income ranges as 100% staked column (B). Respondents were asked to rate the chikungunya healthcare expenditure on their economic conditions on a numeric rating scale of 1 to 10. Rating 8–10, 5–7, 2–4 and 1 is considered as extreme, moderate, mild and no impact on economic conditions of respondents, respectively. One column in B illustrates the relative percentage of cases from different income ranges. The exchange rate of 1 USD is about 82 BDT.
Fig 3
Fig 3. Impact of chikungunya infection on overall quality of life (Q1 of WHOQOL-BREF) among different socio-demographic status and pain rating.
See this image and copyright information in PMC

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