Vijayakumar Krishna Pillai, Nair Anish Thekkumkara Surendran, George Biju, Lawrence Tony, Muthukkutty Sujina C, Ramachandran Reshmi
Department of Community Medicine, Government Medical College, Thiruvananthapuram, Calicut, Kerala, India.
J Glob Infect Dis. 2011 Jul;3(3):221-6. doi: 10.4103/0974-777X.83526.
The association of the present Chikungunya pandemic with a mutation in the Chik virus is already established in many parts of the world, including Kerala. Kerala was one of the worst-affected states of India in the Chikungunya epidemic of 2006-2007. It is important to discuss the clinical features of patients affected by Chikungunya fever in the context of this change in the epidemiology of the disease.
This study tries to analyze the clinical picture of the Chikungunya patients in Kerala during the epidemic of 2007.
A cross-sectional survey was carried out in five of the most affected districts in Kerala, India.
A two-stage cluster sampling technique was used to collect the information. Ten clusters each were selected from all the five districts, and the size of the clusters were 18 houses each. A structured interview schedule was used for data collection. Diagnosis based on clinical signs and symptoms was the major case-finding strategy.
Of the 3623 residents in the surveyed households, 1913 (52.8%) had Chikungunya clinically. Most of the affected were in the adult age group (73.4%). Swelling of the joints was seen in 69.9% of the patients, followed by headache (64.1%) and itching (50.3%). The knee joint was the most common joint affected (52%). The number of patients with persistence of any of the symptoms even after 1 month of illness was 1388 (72.6%). Taking bed rest till the relief of joint pain was found to be a protective factor for the persistence of the symptoms. Recurrence of symptoms with a period of disease-free interval was complained by 669 (35.0%) people. Older age (>40 years), a presentation of high-grade fever with shivering, involvement of the small joints of the hand, presence of rashes or joint swelling during the first week of fever and fever lasting for more than 1 week were the significant risk factors for recurrence of symptoms predicted by a binary logistic regression model. In conclusion, we found that there is substantial acute and chronic morbidity associated with the Chikungunya epidemic of 2007.
包括喀拉拉邦在内，基孔肯雅热目前在世界许多地区的大流行已被证实与基孔肯雅病毒的一种突变有关。喀拉拉邦是2006 - 2007年基孔肯雅热疫情中印度受影响最严重的邦之一。在该疾病流行病学发生这种变化的背景下，讨论受基孔肯雅热影响患者的临床特征很重要。
本研究试图分析2007年疫情期间喀拉拉邦基孔肯雅热患者的临床表现。
在印度喀拉拉邦受影响最严重的五个地区进行了横断面调查。
采用两阶段整群抽样技术收集信息。从所有五个地区各选取10个群组，每个群组规模为18户家庭。使用结构化访谈问卷进行数据收集。基于临床体征和症状的诊断是主要的病例发现策略。
在接受调查的家庭中的3623名居民中，有1913人（52.8%）临床上感染了基孔肯雅热。大多数受影响者为成年人（73.4%）。69.9%的患者出现关节肿胀，其次是头痛（64.1%）和瘙痒（50.3%）。膝关节是最常受影响的关节（52%）。即使在患病1个月后仍有任何症状持续的患者人数为1388人（72.6%）。发现卧床休息直至关节疼痛缓解是症状持续的一个保护因素。669人（35.0%）抱怨在无症状间隔期后症状复发。年龄较大（>40岁）、出现高热伴寒战、手部小关节受累、发热第一周出现皮疹或关节肿胀以及发热持续超过1周是二元逻辑回归模型预测的症状复发的显著危险因素。总之，我们发现2007年基孔肯雅热疫情存在大量急性和慢性发病情况。
