Murillo-Zamora Efrén, Mendoza-Cano Oliver, Trujillo-Hernández Benjamín, Alberto Sánchez-Piña Ramón, Guzmán-Esquivel José
University of Colima, School of Medicine, Doctorate in Health Science program, Colima, Colima, Mexico.
University of Colima, School of Civil Engineering, Coquimatlán, Colima, Mexico.
Rev Panam Salud Publica. 2017 Jun 8;41:e72. doi: 10.26633/RPSP.2017.72.
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.
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.
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.
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.
评估急性基孔肯雅病毒（CHIKV）感染6个月后持续性关节痛的累积发病率，并评估临床指标与长期关节痛风险之间的关联。
这项多中心回顾性队列研究在墨西哥科利马州进行。共纳入136名15岁及以上血清学确诊为CHIKV感染的个体。在症状出现6个月时对参与者进行访谈，自我报告的持续性关节痛（PA）是主要的二元结局。使用0至10的自我报告数字评定量表（NRS）来评估关节疼痛的严重程度。
PA的累积发病率为41.9%。PA患者中36.8%出现严重疼痛（NRS≥7）。在多因素分析中，40岁及以上的个体（风险比（RR）=1.60；95%置信区间（CI），1.03 - 2.48）以及感染后3个月出现关节痛的个体（RR = 3.95；95%CI，1.95 - 8.01）在CHIKV感染6个月时发生PA的风险显著增加。
据我们所知，这是墨西哥关于CHIKV相关长期结局的首次报告，该国感染发病率一直很高。这也是拉丁美洲第一项评估与PA风险相关的多个因素的研究。我们的研究结果可能有助于医疗机构对CHIKV感染继发慢性关节痛的风险进行分层，并识别可能从早期医疗干预中临床获益的患者。
