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[Chikungunya: a challenge for the Dominican Republic's health services].[基孔肯雅热:对多米尼加共和国卫生服务的一项挑战]
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多米尼加共和国圣多明各大学教授和工作人员中基孔肯雅热的临床表现。

Clinical manifestations of chikungunya among university professors and staff in Santo Domingo, the Dominican Republic.

作者信息

Zingman Michael A, Paulino Amarilis Then, Payano Matilde Peguero

机构信息

Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America.

Facultad de Ciencias de Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic.

出版信息

Rev Panam Salud Publica. 2017 Aug 21;41:e64. doi: 10.26633/RPSP.2017.64.

DOI:10.26633/RPSP.2017.64
PMID:28902277
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6612746/
Abstract

OBJECTIVE

To further characterize chikungunya virus infection and its associated clinical manifestations, using a sample of university professors and staff in Santo Domingo, the Dominican Republic.

METHODS

A cross-sectional study with quota sampling by department was performed to obtain a convenience sample of professors (n = 736) and staff (n = 499) at the Universidad Autónoma de Santo Domingo. Surveys were used to collect demographic and infection data during the fall term of 2014. Univariate and bivariate analyses were carried out to quantify infection and clinical manifestation prevalence and to assess relationships of these outcomes with age, sex, and acute phase duration.

RESULTS

Of 1 236 participants, 49% reported infection (professors = 41%; staff = 61%). Of these, 53% also reported the presence of chronic effects, largely arthralgia (48%). Significant relationships were observed between reported infection and sex (P = 0.023), age (P < 0.001), and occupation (P < 0.001). More headache (P = 0.008) and edema (P < 0.001) in females, more headache (P = 0.005) in younger subjects, and more myalgia (P = 0.006) in those with longer acute symptoms were found. Additionally, more chronic arthralgia (P < 0.001; P = 0.003) and chronic edema (P < 0.001; P = 0.001) in females and older subjects, and more chronic myalgia (P = 0.041) and chronic edema (P = 0.037) in those with longer acute symptoms were observed.

CONCLUSIONS

To the authors knowledge, this is the first population-based chikungunya prevalence study in the Dominican Republic, and the first to explore clinical manifestations in a university setting. The findings reflect results from studies following the 2005 - 2006 Reunion Island outbreak: prevalence of infection and chronic arthralgia, as well as associations with sex, age, and acute intensity. Longitudinal research can provide further insight into these effects.

摘要

目的

利用多米尼加共和国圣多明各的大学教授和工作人员样本,进一步描述基孔肯雅病毒感染及其相关临床表现。

方法

采用按部门配额抽样的横断面研究,以获取圣多明各自治大学教授(n = 736)和工作人员(n = 499)的便利样本。在2014年秋季学期,通过调查收集人口统计学和感染数据。进行单变量和双变量分析,以量化感染和临床表现的患病率,并评估这些结果与年龄、性别和急性期持续时间的关系。

结果

在1236名参与者中,49%报告感染(教授 = 41%;工作人员 = 61%)。其中,53%还报告存在慢性影响,主要是关节痛(48%)。报告的感染与性别(P = 0.023)、年龄(P < 0.001)和职业(P < 0.001)之间存在显著关系。女性中头痛(P = 0.008)和水肿(P < 0.001)更多,年轻受试者中头痛(P = 0.005)更多,急性症状持续时间较长者中肌痛(P = 0.006)更多。此外,女性和老年受试者中慢性关节痛(P < 0.001;P = 0.003)和慢性水肿(P < 0.001;P = 0.001)更多,急性症状持续时间较长者中慢性肌痛(P = 0.041)和慢性水肿(P = 0.037)更多。

结论

据作者所知,这是多米尼加共和国第一项基于人群的基孔肯雅病毒患病率研究,也是第一项在大学环境中探索临床表现的研究。这些发现反映了2005 - 2006年留尼汪岛疫情后研究的结果:感染和慢性关节痛的患病率,以及与性别、年龄和急性严重程度的关联。纵向研究可以进一步深入了解这些影响。