RT Journal Article
SR Electronic
T1 Chikungunya in Colombia: a description of an epidemic within the framework of a COPCORD study
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 389981
DO 10.1101/389981
A1 Juan C. Rueda
A1 Ana M. Santos
A1 Jose-Ignacio Angarita
A1 Rodrigo B. Giraldo
A1 Eugenia-Lucia Saldarriaga
A1 Jesús Giovanny Ballesteros Muñoz
A1 Elías Forero
A1 Hugo Valencia
A1 Francisco Somoza
A1 Ingris Peláez-Ballestas
A1 Mario H. Cardiel
A1 Paula X. Pavía
A1 John Londono
YR 2018
UL http://biorxiv.org/content/early/2018/08/15/389981.abstract
AB During 2014 and 2015 the chikungunya virus reached Colombia unleashing an epidemic that spread throughout the whole territory. Concurrently, the Colombian Rheumatology Association was conducting a Community Oriented Program for Control of Rheumatic Diseases (COPCORD) to establish rheumatic disease prevalence in the country. Chikungunya infected patients were identified within the COPCORD population. The aim of this study was to describe the demographics, clinical characteristics and disability of patients with clinical suspicion of chikungunya infection. To confirm chikungunya infection, ELISA IgM and IgG serology was performed. From the 6528-surveyed people of the COPCORD study, 548 where included in the study because of clinical suspicion of chikungunya virus infection. Of those, 295 were positive for IgG or IgM chikungunya serology with 151 patients fulfilling WHO clinical criteria for chikungunya infection (true positives). Most patients were > 45 years (57.7%), and females (69.7%). Patients with low income and low socio-economic strata had increased risk of chikungunya infection (p = 0.00; OR: 2.36, CI: 1.47-3.77 and p = 0.00; OR: 2.81, CI: 1.90-4.17 respectively). True positive patients were associated with symmetric arthritis (p = 0.00; OR: 22.49, CI: 12.71-39.80) of ankles (p = 0.00; OR: 16.06, CI: 7.57-34.08), hands (p = 0.00; OR: 16.12, CI: 8.25-39.79), feet (p = 0.00; OR: 16.35, CI: 7.41-36.05) and elbows (p = 0.00; OR: 14.00, CI: 3.03-64.70). Most patients developed mild to moderate disability (95.2 to 100%). Our study showed that poverty and low socioeconomic status are associated with increased risk of chikungunya infection. Also, we found two distinctive phenotypes of chikungunya infection; those with positive chikungunya serology and typical clinical symptoms (true positives) and those with positive serology without clinical symptoms (false negatives). Finally, a distinctive clinical picture presented by chikungunya infected patients was found which should be considered as the hallmark for diagnostic clinical criteria.