Hospital Universitario Japonés, Santa Cruz, Bolivia.
Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panamá, Panamá.
J Clin Rheumatol. 2019 Mar;25(2):101-107. doi: 10.1097/RHU.0000000000000868.
BACKGROUND/OBJECTIVE: Although mortality rates related with chikungunya (CHIK) outbreaks in Latin America's (LA's) dengue-endemic rural and new urban regions are low, dealing with symptoms and sequelae can both produce a significant burden of disease and diminish quality of life-from many months to years-after the acute phase of the infection, with a significant impact on public and individual health.The aim of this work was to establish Pan-American League of Associations for Rheumatology-Central American, Caribbean and Andean Rheumatology Association (ACCAR) consensus-conference endorsements and recommendations on the diagnosis and treatment of CHIK-related inflammatory arthropathies transmitted by Aedes aegypti and Aedes albopictus in LA.
Based on the Consensus Development Conference format, a panel of ACCAR rheumatologist voting members (n = 10) took part in this Pan-American League of Associations for Rheumatology initiative. Experts voted from a previous content analysis of the medical literature on CHIK, 4 subsequent topic conferences, and a workshop. Consensus represents the majority agreement (≥80%) achieved for each recommendation.
The experts' panel reached 4 overarching principles: (1) CHIK virus (CHIKV) is a re-emergent virus transmitted by 2 species of mosquitoes: A. aegypti and A. albopictus; (2) CHIKV caused massive outbreaks in LA; (3) chronic CHIKV infection produces an inflammatory joint disease that, in some cases, can last for several months to years, and (4) currently, there are no vaccines or antivirals licensed for CHIKV infections.
Pan-American League of Associations for Rheumatology-ACCAR achieved 13 endorsements and recommendations on CHIK categorized in 3 groups: (1) epidemiology and clinical manifestations, (2) diagnosis, and (3) treatment, representing the consensus agreement from the panel's members.
背景/目的：虽然在拉丁美洲（LA）的登革热流行的农村和新城市地区，与基孔肯雅热（CHIK）暴发相关的死亡率较低，但处理症状和后遗症都会在感染的急性期后数月至数年产生重大疾病负担，并降低生活质量，对公共和个人健康都有重大影响。本项工作的目的是制定泛美联盟风湿病协会-中美洲、加勒比和安第斯风湿病协会（ACCAR）共识会议，以就通过埃及伊蚊和白纹伊蚊传播的 CHIK 相关炎症性关节炎的诊断和治疗达成共识，并发表在 LA。
根据共识发展会议的格式，由 ACCAR 风湿病投票成员（n = 10）组成的专家组参与了这项泛美联盟风湿病协会倡议。专家从之前对 CHIK 医学文献的内容分析、4 次后续主题会议和一次研讨会中进行投票。共识代表了为每个建议达成的多数（≥80%）同意。
专家组达成了 4 项总体原则：（1）基孔肯雅病毒（CHIKV）是由 2 种蚊子传播的一种重新出现的病毒：埃及伊蚊和白纹伊蚊；（2）CHIKV 在 LA 引起了大规模暴发；（3）慢性 CHIKV 感染会引起炎症性关节疾病，在某些情况下，这种疾病可持续数月至数年；（4）目前，尚无针对 CHIKV 感染的疫苗或抗病毒药物获得许可。
泛美联盟风湿病协会-ACCAR 就 CHIK 达成了 13 项认可和建议，分为 3 组：（1）流行病学和临床表现，（2）诊断，和（3）治疗，代表了专家组成员的共识协议。
