Chikungunya infection in Malaysia: Comparison with dengue infection in adults and predictors of persistent arthralgia |
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| Authors: | MA Mohd Zim I-C Sam SF Syed Omar YF Chan S AbuBakar A Kamarulzaman |
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| Institution: | 1. Department of Medicine, Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia;2. Tropical Infectious Diseases Research and Education Centre, Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia;3. Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia;1. Directorate of ISM & Homeopathy, Govt of National Capital Territory of Delhi, India;2. Dr B. R. Sur Homeopathic Medical College, Hospital & Research Centre, New Delhi, India;1. Research Group and Incubator Public Health and Infection, Faculty of Health Sciences, Universidad Tecnologica de Pereira, Pereira, Risaralda, Colombia;2. Department of Medicine, Sylhet M. A. G. Osmani Medical College Hospital, Sylhet, Bangladesh;3. Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia;4. Programa del Doctorado de Medicina Tropical, Universidad de Cartagena, Cartagena, Universidad del Atlántico, Barranquilla, Colombia;5. Committee on Zoonoses and Haemorrhagic Fevers, Asociación Colombiana de Infectología (ACIN), Bogotá, DC, Colombia;6. Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Santander, Colombia;7. Department of Biology, University of Florida, Gainesville, FL, USA;8. Department of Pathology and Laboratory Medicine, Hospital Internacional, Barquisimeto, Venezuela;9. Laboratory of Biochemistry, Instituto de Biomedicina/IVSS, Caracas, Venezuela;1. Division of Rheumatology, Department of Medicine, Queen''s University, Kingston, Ontario, Canada;2. Department of Community Health and Epidemiology, Queen''s University, Ontario, Canada;3. Department of Medicine and Department of Community Health and Epidemiology, Queen''s University, Ontario, Canada |
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| Abstract: | BackgroundChikungunya virus (CHIKV) and dengue virus (DENV) co-circulate in areas endemic with the Aedes mosquito vectors. Both viruses cause similar illnesses which may be difficult to distinguish clinically. CHIKV is also associated with persistent arthralgia.ObjectivesTo compare and describe factors which differentiate between DENV and CHIKV infections on presentation; and to describe predictors of persistent arthralgia in CHIKV patients.Study designPatients aged >14 years diagnosed with acute CHIKV and DENV infections in Kuala Lumpur, Malaysia were retrospectively identified. Clinical and laboratory data were obtained from medical records, and compared. CHIKV patients were telephoned 15–24 months later and interviewed about persistent symptoms. Logistic regression analysis was performed.ResultsA total of 53 CHIKV and 113 DENV patients were included. CHIKV patients were older and more likely to be female. CHIKV was independently associated with arthralgia and rash, while DENV was associated with myalgia, raised aspartate transaminase, and leucopaenia. Forty CHIKV patients were followed up, with a median duration of self-reported arthralgia of 3 months (range, 0–24 months). Eighteen (45%) had persistent arthralgia beyond 4 months, for which age >40 years was an independent predictor. At 1 year, 9 (22.5%) patients had arthralgia.ConclusionIn Kuala Lumpur, selected clinical and laboratory predictors help to distinguish between DENV and CHIKV infections. Persistent arthralgia was a frequent sequel of CHIKV infection in this cohort. |
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