Post-chikungunya chronic inflammatory rheumatism: results from a retrospective follow-up study of 283 adult and child cases in La Virginia, Risaralda, Colombia.
OBJECTIVE
There are limited studies in Latin America regarding the chronic consequences of the Chikungunya virus (CHIK), such as post-CHIK chronic inflammatory rheumatism (pCHIK-CIR). We assessed the largest cohort so far of pCHIK-CIR in Latin America, at the municipality of La Virginia, Risaralda, a new endemic area of CHIK in Colombia.


METHODS
We conducted a cohort retrospective study in Colombia of 283 patients diagnosed with CHIK that persisted with pCHIK-CIR after a minimum of 6 weeks and up to a maximum of 26.1 weeks. pCHIK cases were identified according to validated criteria via telephone.


RESULTS
Of the total CHIK-infected subjects, 152 (53.7%) reported persistent rheumatological symptoms (pCHIK-CIR). All of these patients reported joint pains (chronic polyarthralgia, pCHIK-CPA), 49.5% morning stiffness, 40.6% joint edema, and 16.6% joint redness. Of all patients, 19.4% required and attended for care prior to the current study assessment (1.4% consulting rheumatologists). Significant differences in the frequency were observed according to age groups and gender. Patients aged >40 years old required more medical attention (39.5%) than those ≤40 years-old (12.1%) (RR=4.748, 95%CI 2.550-8.840).


CONCLUSIONS
According to our results, at least half of the patients with CHIK developed chronic rheumatologic sequelae, and from those with pCHIK-CPA, nearly half presented clinical symptoms consistent with inflammatory forms of the disease. These results support previous estimates obtained from pooled data of studies in La Reunion (France) and India and are consistent with the results published previously from other Colombian cohorts in Venadillo (Tolima) and Since (Sucre).
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia; Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS), Bucaramanga, Colombia; Committee on Zoonoses and Haemorrhagic Fevers, Asociación Colombiana de Infectología (ACIN), Bogota, Colombia; Working Group on Zoonoses, International Society for Chemotherapy, Aberdeen, UK.
Alfonso J
AJ
Rodriguez-Morales
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Andrés F
AF
Gil-Restrepo
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Valeria
V
Ramírez-Jaramillo
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Cindy P
CP
Montoya-Arias
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Wilmer F
WF
Acevedo-Mendoza
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Juan E
JE
Bedoya-Arias
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Laura A
LA
Chica-Quintero
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
David R
DR
Murillo-García
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia; School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia.
Juan E
JE
García-Robledo
ESE Hospital San Pedro y San Pablo, La Virginia, Colombia.
Juan D
JD
Castrillón-Spitia
School of Medicine, Faculty of Health Sciences, Universidad ICESI, Cali, Colombia.
Jose J
JJ
Londoño
ESE Hospital San Pedro y San Pablo, La Virginia, Colombia.
Hector D
HD
Bedoya-Rendón
ESE Hospital San Pedro y San Pablo, La Virginia, Colombia.
Javier de Jesús
Jde J
Cárdenas-Pérez
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Jaime A
JA
Cardona-Ospina
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Colombia.
Guillermo J
GJ
Lagos-Grisales
Chikungunya; Chronic complications; Colombia; Epidemiology