Persistent arthralgia and related risks factors in laboratory-confirmed cases of Chikungunya virus infection in Mexico

• Main Authors: Efrén Murillo-Zamora, Oliver Mendoza-Cano, Benjamín Trujillo-Hernández, Ramón Alberto Sánchez-Piña, José Guzmán-Esquivel
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2017
• Subjects: Fiebre chikungunya; estudios de cohortes; grupos vulnerables; artralgia; dolor crónico; México; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/52ae16ef175449939404debe58efa0a2

ABSTRACT Objective To estimate the cumulative incidence of persistent arthralgia at 6 months from acute Chikungunya virus (CHIKV) infection and to evaluate the association of clinical markers with the risk of long-term arthralgia. Methods This multicenter retrospective cohort study was conducted in the Mexican state of Colima. A total of 136 individuals aged 15 years and older with serologically confirmed CHIKV infection were enrolled. Participants were interviewed at 6 months from the onset of symptoms, and self-reported persistent arthralgia (PA) was the main binary outcome. A self-report numeric rating scale (NRS) ranging from 0 to 10 was used to estimate the severity of articular pain. Results The cumulative incidence of PA was 41.9%. Severe pain (NRS ≥ 7) presented in 36.8% of participants with PA. In multiple analysis, individuals aged 40 years and older (risk ratio (RR) = 1.60; 95% confidence interval (CI), 1.03–2.48) and those with articular pain at 3 months post-infection (RR = 3.95; 95% CI, 1.95–8.01) had a significantly increased risk of PA at 6 months from CHIKV infection. Conclusions To the best of our knowledge, this is first report of a CHIKV-associated long-term outcome in Mexico, where the incidence of the infection has been high. This is also the first study in Latin America evaluating several factors associated with the risk of PA. Our findings may be useful in health care settings to stratify the risk of chronic arthralgia secondary to CHIKV infection and to identify patients who would benefit clinically from early medical intervention.