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Nearly 40% of Patients May Have Persistent Pain Following Chikungunya Infection
Many patients who contracted chikungunya reported persistent pain 18 months after being infected in the Calicut District in North Kerala, India in 2009, according to a recently published study.
Trained local health volunteers interviewed 3,869 individuals older than the age of 15 years from 840 households. More than 85% of women in the community worked at home, while 67.3% of men worked as laborers. The mean age of the cohort was 48.22 years. Overall, 62.3% were women and 3.6% of participants were vegetarians.
A confirmed epidemiological diagnosis of chikungunya was identified in 1,195 individuals. Of these, 581 reported persistent pain. A history of rheumatic musculoskeletal disorder was reported by 53.5% of participants with persistent pain. In addition to fever and joint pain during the acute phase of chikungunya infection, 68.8% participants reported swelling in the joints; 55.4% reported rashes; 53.5% reported itching; and ulcers were reported by 21.3% of participants.
Persistent pain was most commonly found in knees (61.1%), followed by ankles (43.9%), elbows (22%), wrists (19.9%) and shoulders (19.3%). Soft tissue involvement was most common in the chest wall (25%), followed by the legs (23.8%), heels (17.9%) and calf (17.6%). Investigators found 49.9% of individuals reported involvement of both joints and soft tissue. Only joint involvement was reported by 32.8% of participants, and only soft-tissue involvement was reported by 17.3%.
Less than 12% of participants rested for 1 week to 4 weeks during the acute phase of illness, 44.2% returned to work after 1 week and 44.2% returned to work after 4 weeks.
Mild disability was reported by 60.6%. Investigators found 23.3% of respondents to the Health Assessment Questionnaire (HAQ) had no disability, while 16.2% of respondents had moderate to severe disability based on the HAQ. The severity of HAQ disability was associated with female sex, previous history of rheumatic musculoskeletal disease, the presence of joint swelling during the acute phase of disease and diet. The disability-adjusted life-years were calculated at 169.22 years. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.