Ramachandran V, Kaur P, Kanagasabai K, Vadivoo S, Murhekar M V
National Institute of Epidemiology (ICMR), R-127, Tamil Nadu Housing Board, Ayapakkam, Chennai, Tamil Nadu, India.
J Postgrad Med. 2014 Jan-Mar;60(1):3-6. doi: 10.4103/0022-3859.128795.
Chikungunya (CHIK) fever is viral disease characterized by joint pain for prolonged duration in various settings. However, there are no reports of long-term follow-up of the CHIK patients from India.
We conducted a cohort study to describe the clinical manifestations, incidence of persistent arthralgia, and the associated risk factors among patients with CHIK identified during an outbreak in a suburb of Chennai, India.
We conducted a retrospective cum prospective cohort study in Gowripet, Avadi, Chennai. We included all adult CHIK case patients identified during the outbreak. We conducted a nested case-control study to identify the risk factors for persistent arthralgia defined as a CHIK case experiencing arthralgia for more than 15 days from the date of onset of illness. We included all 81 patients and 81 randomly selected controls.
All 403 case patients had joint pain. Approximately 40% suffered joint pain for up to 1 month and 7% had it beyond 1 year. The most commonly affected types of joints were knee (96%), wrist (80%), and ankle (77%) joints. Regarding the number of types of joints affected, 36% had six types of joints, 23% had five types of joints, and 14% had three types of joints affected. The overall incidence of persistent arthralgia was 80%. High-grade fever, involvement of four or more types of joints, and joint swelling were significantly associated with persistent arthralgia.
High prevalence of persistent arthralgia indicates the need for appropriate treatment strategies to reduce the severity and duration of joint pain.
基孔肯雅热是一种病毒性疾病，其特征是在不同情况下会出现长时间的关节疼痛。然而，尚无来自印度的基孔肯雅热患者长期随访的报告。
我们开展了一项队列研究，以描述在印度钦奈郊区一次疫情中确诊的基孔肯雅热患者的临床表现、持续性关节痛的发病率及相关危险因素。
我们在钦奈的戈里佩特、阿瓦迪进行了一项回顾性兼前瞻性队列研究。我们纳入了疫情期间确诊的所有成年基孔肯雅热病例患者。我们开展了一项巢式病例对照研究，以确定持续性关节痛的危险因素，持续性关节痛定义为从发病之日起关节疼痛超过15天的基孔肯雅热病例。我们纳入了所有81例患者以及81例随机选取的对照。
所有403例病例患者均有关节疼痛。约40%的患者关节疼痛持续长达1个月，7%的患者关节疼痛持续超过1年。最常受累的关节类型是膝关节（96%）、腕关节（80%）和踝关节（77%）。就受累关节类型的数量而言，36%的患者有六种关节类型受累，23%的患者有五种关节类型受累，14%的患者有三种关节类型受累。持续性关节痛的总体发病率为80%。高热、四种或更多类型关节受累以及关节肿胀与持续性关节痛显著相关。
持续性关节痛的高患病率表明需要采取适当的治疗策略以减轻关节疼痛的严重程度和持续时间。
