Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015

Emerg Microbes Infect. 2019;8(1):1490-1500. doi: 10.1080/22221751.2019.1678366.

Abstract

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.

Keywords: Arbovirus; Chikungunya virus; Colombia; Epidemic; South America.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Viral / blood
  • Chikungunya Fever / blood
  • Chikungunya Fever / diagnosis
  • Chikungunya Fever / epidemiology
  • Chikungunya Fever / virology*
  • Chikungunya virus / genetics
  • Chikungunya virus / immunology
  • Chikungunya virus / isolation & purification*
  • Cities / statistics & numerical data
  • Cohort Studies
  • Colombia / epidemiology
  • Cross-Sectional Studies
  • Demography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Antibodies, Viral

Grants and funding

The study was supported by the Colombian Rheumatology Association (Asociación Colombiana de Reumatología – ASOREUMA) [grant number Acta 169 10th July 2015]; Universidad de La Sabana [grant number MED-197-2015]; and Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS) doctoral scholarship [grant number 757-2016].