[Perceived morbidity and community burden of chikungunya in La Reunion].
BACKGROUND
Persistence of clinical manifestations, especially polyarthralgia and fatigue, is a characteristic feature of chikungunya virus (CHIK-v) infection. The purpose of this study was to measure the impact of prolonged or late-onset manifestations of CHIK-v infection on the self-perceived health of people on Reunion Island.


METHODS
This retrospective cohort survey, dubbed TELECHIK survey, was conducted eighteen months after the end of the chikungunya outbreak on a representative random sample from the SEROCHIK population-based survey conducted on Reunion Island. A total of 1094 subjects whose CHIK-v specific IgG antibody status had been documented were interviewed about current symptoms.


RESULTS
Analysis of data showed 45% of CHIK+ vs 14% of CHIK- subjects reporting musculoskeletal pain (P < 0.001), 56% vs. 44% reporting fatigue (P = 0.003), 77% vs. 53% reporting cerebral manifestations (P < 0.001), 51% vs. 34% reporting sensorineural impairments (P < 0.001), 18% vs. 13% reporting digestive complaints (P = 0.06), and 38% vs. 32% reporting skin involvement (P = 0.13). The mean delay between infection and interview was two years (range, 15-34 months). Analysis of data after correction for age, gender, body mass index and comorbidity indicated that rheumatic pain, fatigue, cerebral manifestations and sensorineural impairments were more likely in CHIK+ than CHIK- subjects but the likelihood of digestive and skin manifestations was the same.


CONCLUSIONS
With a mean delay of two years after infection, 45% to 77% of CHIK+ subjects reported prolonged or late-onset symptoms attributable to CHIK-v. These results indicate that persistent manifestations of chikungunya infection have a heavy impact on rheumatologic, neurological and sensorineural health.
Centre d'Investigation Clinique - Epidémiologie Clinique (CIC-EC) de La Réunion (INSERM/CHR/URML-OI), Saint Pierre, La Réunion, France. patrick.gerardin@chr-reunion.fr
P
P
Gérardin
A
A
Fianu
D
D
Malvy
C
C
Mussard
K
K
Boussaïd
O
O
Rollot
A
A
Michault
B A
BA
Gaüzere
G
G
Bréart
F
F
Favier
D000293:Adolescent; D000328:Adult; D000368:Aged; D018354:Alphavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D065632:Chikungunya Fever; D015331:Cohort Studies; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards / Q000600:supply & distribution; D017281:Cost of Illness; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009017:Morbidity; D010465:Perception / Q000502:physiology; D011153:Population; D012189:Retrospective Studies; D017508:Reunion / Q000453:epidemiology; D013689:Telephone; D055815:Young Adult