Marimoutou Catherine, Vivier Elodie, Oliver Manuela, Boutin Jean-Paul, Simon Fabrice
From the Clinical Research Unit (CM), Department of Infectious Diseases and Tropical Medicine (EV, FS), and Department of Medical Biochemistry (MO), Laveran Military Teaching Hospital, Marseille; Center for Epidemiology and Public Health for the French Army (CM, J-PB), Marseille; and URMITE, Université de la Méditerranée (FS), Marseille, France.
Medicine (Baltimore). 2012 Jul;91(4):212-219. doi: 10.1097/MD.0b013e318260b604.
We compared the morbidity and quality of life of military policemen ("gendarmes") infected with chikungunya virus (CHIKV+) 30 months after contamination. We categorized the subjects in 3 groups: healed patients (n = 48), non-healed patients (n = 37, 44% of CHIKV+), and uninfected subjects (CHIKV-, n = 297). Data were self-recorded in this retrospective cohort study; they included sociodemographic information, clinical symptoms, and the Medical Outcome Study 36-item short-form health survey (MOS-SF36) quality of life questionnaire. The study population was mostly men (92%), with a median age of 42.8 years, regardless of CHIKV status. The main complaints were rheumatic symptoms (pain, stiffness, and swelling), reported 5 times more often by non-healed CHIKV+ subjects and 2-3 times more often by healed CHIKV+ subjects than by CHIKV- subjects, and fatigue. The CHIKV+ patients reported more use of health care services. Thirty months after infection, all rheumatic symptoms were more frequent and intense among CHIKV+ than among CHIKV- subjects, with a gradient of severity between healed and non-healed CHIKV+ subjects. Non-healed CHIKV+ subjects reported subsequent limitation in their activities. All dimensions of MOS-SF36 as well as physical and mental component summaries were impaired in CHIKV+ compared to CHIKV- subjects, with a decreasing gradient of impairment from non-healed to healed CHIKV+ subjects, then to CHIKV- subjects. These observations confirm the long-term impact of CHIKV infection on both physical and mental health. Questions persist regarding the duration of this impairment and the possibility of a return to "before CHIKV" health status for infected patients.
我们比较了感染基孔肯雅病毒（CHIKV+）30个月后的宪兵（“宪警”）的发病率和生活质量。我们将受试者分为3组：已治愈患者（n = 48）、未治愈患者（n = 37，占CHIKV+患者的44%）和未感染受试者（CHIKV-，n = 297）。在这项回顾性队列研究中，数据由受试者自行记录；包括社会人口学信息、临床症状以及医学结局研究简明健康调查问卷（MOS-SF36）生活质量问卷。无论CHIKV状态如何，研究人群大多为男性（92%），中位年龄为42.8岁。主要症状为风湿症状（疼痛、僵硬和肿胀），未治愈的CHIKV+受试者报告的频率比CHIKV-受试者高5倍，治愈的CHIKV+受试者报告的频率比CHIKV-受试者高2至3倍，还有疲劳。CHIKV+患者报告使用医疗服务的频率更高。感染30个月后，CHIKV+受试者中所有风湿症状都比CHIKV-受试者更频繁、更严重，且在治愈和未治愈的CHIKV+受试者之间存在严重程度梯度。未治愈的CHIKV+受试者报告随后活动受限。与CHIKV-受试者相比，CHIKV+受试者的MOS-SF36所有维度以及身体和心理成分总结均受损，且从未治愈到治愈的CHIKV+受试者再到CHIKV-受试者，受损程度呈递减梯度。这些观察结果证实了CHIKV感染对身心健康的长期影响。关于这种损害的持续时间以及感染患者恢复到“感染基孔肯雅病毒之前”健康状态的可能性，问题依然存在。
