Asc Academics B.V., Groningen, Netherlands.
Valneva Austria GmbH, Vienna, Austria.
PLoS Negl Trop Dis. 2024 Jun 7;18(6):e0012254. doi: 10.1371/journal.pntd.0012254. eCollection 2024 Jun.
Chikungunya is a viral disease caused by a mosquito-borne alphavirus. The acute phase of the disease includes symptoms such as fever and arthralgia and lasts 7-10 days. However, debilitating symptoms can persist for months or years. Despite the substantial impact of this disease, a comprehensive assessment of its clinical picture is currently lacking.
We conducted a systematic literature review on the clinical manifestations of chikungunya, their prevalence and duration, and related hospitalization. Embase and MEDLINE were searched with no time restrictions. Subsequently, meta-analyses were conducted to quantify pooled estimates on clinical outcomes, the symptomatic rate, the mortality rate, and the hospitalization rate. The pooling of effects was conducted using the inverse-variance weighting methods and generalized linear mixed effects models, with measures of heterogeneity reported.
The systematic literature review identified 316 articles. Out of the 28 outcomes of interest, we were able to conduct 11 meta-analyses. The most prevalent symptoms during the acute phase included arthralgia in 90% of cases (95% CI: 83-94%), and fever in 88% of cases (95% CI: 85-90%). Upon employing broader inclusion criteria, the overall symptomatic rate was 75% (95% CI: 63-84%), the chronicity rate was 44% (95% CI: 31-57%), and the mortality rate was 0.3% (95% CI: 0.1-0.7%). The heterogeneity between subpopulations was more than 92% for most outcomes. We were not able to estimate all predefined outcomes, highlighting the existing data gap.
Chikungunya is an emerging public health concern. Consequently, a thorough understanding of the clinical burden of this disease is necessary. Our study highlighted the substantial clinical burden of chikungunya in the acute phase and a potentially long-lasting chronic phase. Understanding this enables health authorities and healthcare professionals to effectively recognize and address the associated symptoms and raise awareness in society.
基孔肯雅热是一种由蚊子传播的阿尔法病毒引起的疾病。疾病的急性期包括发热和关节痛等症状，持续 7-10 天。然而，衰弱症状可能会持续数月甚至数年。尽管这种疾病的影响很大，但目前缺乏对其临床特征的全面评估。
我们对基孔肯雅热的临床表现、流行率和持续时间以及相关住院情况进行了系统的文献回顾。检索了 Embase 和 MEDLINE，没有时间限制。随后，进行了荟萃分析，以量化临床结局、症状发生率、死亡率和住院率的汇总估计值。使用倒数方差加权法和广义线性混合效应模型进行效果的汇总，报告异质性测量值。
系统文献回顾确定了 316 篇文章。在 28 个感兴趣的结局中，我们能够进行 11 项荟萃分析。急性期最常见的症状包括 90%（95%置信区间：83-94%）的关节痛和 88%（95%置信区间：85-90%）的发热。采用更广泛的纳入标准后，总体症状发生率为 75%（95%置信区间：63-84%），慢性率为 44%（95%置信区间：31-57%），死亡率为 0.3%（95%置信区间：0.1-0.7%）。大多数结局的亚群间异质性超过 92%。我们无法估计所有预先定义的结局，突出了现有数据的差距。
基孔肯雅热是一个新出现的公共卫生关注点。因此，有必要深入了解这种疾病的临床负担。我们的研究强调了基孔肯雅热在急性期和潜在的长期慢性期的大量临床负担。了解这一点，使卫生当局和医疗保健专业人员能够有效地识别和处理相关症状，并提高社会的认识。
