title: Prevalence of and risk factors for chronic arthralgia and rheumatoid-like polyarthritis more than 2 years after infection with chikungunya virus.
abstract: OBJECTIVE
  Chikungunya virus (CHIKV), transmitted to humans from infected mosquitoes, causes acute fever, arthralgia and rash. There is increasing evidence that it also causes longer-term rheumatic symptoms. In a circumscribed part of Mauritius where infectivity was high, a cohort of inhabitants was surveyed with the objectives of assessing the prevalence of and risk factors for chronic musculoskeletal symptoms and for a rheumatoid arthritis-like condition at 27.5 months after initial infection.
  
  
  METHODS
  Participants were recruited May-November 2008 and invited to complete a questionnaire. CHIKV was diagnosed clinically. The primary outcomes for the analyses were (a) self-reported ongoing musculoskeletal symptoms and (b) fulfilment of modified diagnostic criteria for rheumatoid arthritis. Risk factors for these outcomes were explored in univariate analyses using logistic regression. Subsequently, multivariate logistic regression was used to identify factors that were independently associated with the outcomes.
  
  
  RESULTS
  173 individuals were identified with CHIKV, of whom 136 (78.6%) reported persisting musculoskeletal symptoms 27.5 months after infection. Persistent symptoms were associated with older age at time of infection, female gender and baseline symmetrical distribution of joint symptoms. We found that 5% of those infected with CHIKV fulfilled a modified version of the American College of Rheumatology criteria for rheumatoid arthritis 27.5 months after infection.
  
  
  CONCLUSIONS
  CHIKV is associated with a high prevalence of persistent rheumatic symptoms. Physicians need to be aware of CHIKV as a cause of acute and chronic rheumatic symptoms.
authors: Faculty of Science, University of Mauritius, Reduit, Mauritius.
authors: Khadijah
authors: K
authors: Essackjee
authors: Smita
authors: S
authors: Goorah
authors: Satish Kumar
authors: SK
authors: Ramchurn
authors: Jayrani
authors: J
authors: Cheeneebash
authors: Karen
authors: K
authors: Walker-Bone
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018354:Alphavirus Infections / Q000150:complications* / Q000453:epidemiology; D018771:Arthralgia / Q000453:epidemiology* / Q000473:pathology; D002646:Chikungunya virus; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D008875:Middle Aged; D012213:Rheumatic Fever / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
keywords: EPIDEMIOLOGY; PUBLIC HEALTH; RHEUMATOLOGY