Nyamwaya Doris K, Thumbi Samuel M, Bejon Philip, Warimwe George M, Mokaya Jolynne
KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.
PLOS Glob Public Health. 2022 Dec 21;2(12):e0000914. doi: 10.1371/journal.pgph.0000914. eCollection 2022.
Chikungunya fever (CHIKF) is an arboviral illness that was first described in Tanzania (1952). In adults, the disease is characterised by debilitating arthralgia and arthritis that can persist for months, with severe illness including neurological complications observed in the elderly. However, the burden, distribution and clinical features of CHIKF in children are poorly described. We conducted a systematic literature review and meta-analysis to determine the epidemiology of CHIKF in children globally by describing its prevalence, geographical distribution, and clinical manifestations. We searched electronic databases for studies describing the epidemiology of CHIKF in children. We included peer-reviewed primary studies that reported laboratory confirmed CHIKF. We extracted information on study details, sampling approach, study participants, CHIKF positivity, clinical presentation and outcomes of CHIKF in children. The quality of included studies was assessed using Joanna Briggs Institute Critical Appraisal tool for case reports and National Institute of Health quality assessment tool for quantitative studies and case series. Random-effects meta-analysis was used to estimate the pooled prevalence of CHIKF among children by geographical location. We summarised clinical manifestations, laboratory findings, administered treatment and disease outcomes associated with CHIKF in children. We identified 2104 studies, of which 142 and 53 articles that met the inclusion criteria were included in the systematic literature review and meta-analysis, respectively. Most of the selected studies were from Asia (54/142 studies) and the fewest from Europe (5/142 studies). Included studies were commonly conducted during an epidemic season (41.5%) than non-epidemic season (5.1%). Thrombocytopenia was common among infected children and CHIKF severity was more prevalent in children <1 year. Children with undifferentiated fever before CHIKF was diagnosed were treated with antibiotics and/or drugs that managed specific symptoms or provided supportive care. CHIKF is a significant under-recognised and underreported health problem among children globally and development of drugs/vaccines should target young children.
基孔肯雅热（CHIKF）是一种虫媒病毒病，于1952年在坦桑尼亚首次被描述。在成年人中，该疾病的特征是使人衰弱的关节痛和关节炎，可持续数月，在老年人中还观察到包括神经并发症在内的严重疾病。然而，关于儿童基孔肯雅热的负担、分布和临床特征的描述却很少。我们进行了一项系统的文献综述和荟萃分析，通过描述其患病率、地理分布和临床表现来确定全球儿童基孔肯雅热的流行病学情况。我们在电子数据库中搜索描述儿童基孔肯雅热流行病学的研究。我们纳入了经同行评审的报告实验室确诊基孔肯雅热的原始研究。我们提取了关于研究细节、抽样方法、研究参与者、基孔肯雅热阳性率、临床表现以及儿童基孔肯雅热结局的信息。使用乔安娜·布里格斯研究所病例报告批判性评价工具和美国国立卫生研究院定量研究及病例系列质量评估工具对纳入研究的质量进行评估。采用随机效应荟萃分析按地理位置估计儿童中基孔肯雅热的合并患病率。我们总结了与儿童基孔肯雅热相关的临床表现、实验室检查结果、给予的治疗和疾病结局。我们识别出2104项研究，其中分别有142篇和53篇符合纳入标准的文章被纳入系统文献综述和荟萃分析。大多数入选研究来自亚洲（54/142项研究），来自欧洲的最少（5/142项研究）。纳入研究通常在流行季节（41.5%）进行，而非流行季节（5.1%）的较少。血小板减少在受感染儿童中很常见，基孔肯雅热严重程度在1岁以下儿童中更普遍。在基孔肯雅热被诊断之前有不明原因发热的儿童接受了抗生素和/或治疗特定症状或提供支持性护理的药物治疗。基孔肯雅热在全球儿童中是一个未得到充分认识和报告的重大健康问题，药物/疫苗的研发应针对幼儿。
