Amin Mohammad Robed, Hasan Mohammad Jahid, Khan Md Abdullah Saeed, Rafi Md Abdur, Islam Mohammad Rafiqul, Shams Tarek, Islam Mohammed Jahedul, Kabir Abu Saif Mohammad Lutful, Sharif Mohiuddin, Gozal David
Department of Medicine, Dhaka Medical College and Hospital-2, Room No 502, Dhaka, Bangladesh.
Pi Research Consultancy Center, Dhaka, Bangladesh.
Trop Med Health. 2022 Jan 12;50(1):9. doi: 10.1186/s41182-022-00399-3.
Chikungunya is a severely debilitating disease. Bangladesh witnessed one of the largest outbreaks in 2017. Here, we described the clinical profile of the chikungunya outbreak in Bangladesh and its heterogeneity across three hotspots.
This was a descriptive cross-sectional study of 432 individuals interviewed from the outpatient department of three study sites (Dhaka, Chittagong, and Sitakundu Upazilla of Bangladesh) after confirmation by the study physicians. Both laboratory-confirmed cases and probable cases were recruited between July and October 2017.
Of all, 18% (79) were laboratory confirmed, and 353 82% (335) were probable cases. The male:female ratio was almost equal (1.09:1), and the predominant age group was 18-59 years. The mean age of the presentation was 36.07 ± 13.62 (SD) years. Fever and arthralgia were the most common presentations and were present in > 95% of cases. Other frequent symptoms were fatigue, myalgia, headache, nausea, and vomiting. Approximately half of the patients had arthritis and erythematous rash. Arthritis was predominant in Chittagong city, while maculopapular rash was not observed in Sitakunda city. However, fatigue, nausea, and vomiting are more common among patients in Dhaka city. Significant heterogeneity of clinical manifestations was present across the three hotspots (p < 0.05 for all). Both confirmed and probable cases shared similar characteristics except muscle ache (p = 0.22) and rash (p = 0.37).
The clinical profile of chikungunya virus-induced disease displays significant location-related heterogeneity in Bangladesh during a large outbreak. Although the causes of such differences are unclear, improved public and medical personnel education on this condition may lead to earlier diagnosis and treatment.
基孔肯雅热是一种使人严重衰弱的疾病。2017年，孟加拉国经历了规模最大的疫情之一。在此，我们描述了孟加拉国基孔肯雅热疫情的临床特征及其在三个热点地区的异质性。
这是一项描述性横断面研究，研究医生确诊后，从三个研究地点（达卡、吉大港和孟加拉国锡塔孔杜乌帕齐拉）的门诊部对432名个体进行了访谈。2017年7月至10月期间招募了实验室确诊病例和疑似病例。
其中，18%（79例）为实验室确诊病例，82%（353例）为335例疑似病例。男女比例几乎相等（1.09:1），主要年龄组为18 - 59岁。就诊的平均年龄为36.07±13.62（标准差）岁。发热和关节痛是最常见的症状，超过95%的病例出现这些症状。其他常见症状包括疲劳、肌痛、头痛、恶心和呕吐。约一半的患者有关节炎和红斑疹。关节炎在吉大港最为常见，而在锡塔孔杜市未观察到斑丘疹。然而，疲劳、恶心和呕吐在达卡市的患者中更为常见。三个热点地区的临床表现存在显著异质性（所有p值均<0.05）。确诊病例和疑似病例除肌肉疼痛（p = 0.22）和皮疹（p = 0.37）外，具有相似的特征。
在大规模疫情期间，孟加拉国基孔肯雅病毒引起的疾病的临床特征表现出显著的地域相关异质性。尽管这种差异的原因尚不清楚，但加强公众和医务人员对这种疾病的教育可能会导致早期诊断和治疗。
