title: Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?
abstract: Chikungunya is an endemo-epidemic infection, which is still considered as an emerging public health problem. The aim of this study was to evaluate in a 65+ population, the accuracy of two chikungunya screening scores that were developed in younger people.
  
  
  
  It was performed in the Martinique University Hospitals from retrospective cases. Patients were 65+, admitted to acute care units, for suspected Chikungunya virus infection (CVI) in 2014, with biological testing using Reverse Transcription Polymerase Chain Reaction. Mayotte tool and Reunion Island tool were also computed. Sensitivity, specificity, positive predictive value, negative predictive value, and Youden's statistic were calculated.
  
  
  
  In all, 687 patients were included, 68% with confirmed CVI, and 32% with laboratory-unconfirmed CVI. Fever (73.1%) and arthralgia (51.4%) were the most frequent symptoms. Sensitivity ranged from 6% (fever+headache) to 49% (fever+polyarthralgia); and Youden's index ranged from 1% (fever + headache) to 30% (fever+polyarthralgia). PPV and NPV ranged from 70% to 95%, and from 32% to 43%, respectively.
  
  
  
  Performances were very poor for both tools, although specificity was good to excellent. Our results suggest that screening scores developed in young population are not accurate in identifying CVI in older people.
authors.affiliation: Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
authors.forename: Lidvine
authors.identifier: 0000-0003-4911-2217
authors.initials: L
authors.lastname: Godaert
authors.affiliation: Department of Virology, University Hospitals of Martinique, Martinique, France.
authors.forename: Fatiha
authors.initials: F
authors.lastname: Najioullah
authors.affiliation: Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Bousquet
authors.affiliation: Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Malmontet
authors.affiliation: Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Fournet
authors.affiliation: Department of Virology, University Hospitals of Martinique, Martinique, France.
authors.forename: Raymond
authors.initials: R
authors.lastname: Césaire
authors.affiliation: Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Fanon
authors.affiliation: University of Reims Champagne-Ardenne, Faculty of Medicine, Reims, France.|University Hospital of Reims, Robert Debré Hospital, Department of Research and Public Health, Reims, France.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Dramé
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D065632:Chikungunya Fever / Q000175:diagnosis* / Q000821:virology; D002646:Chikungunya virus / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008395:Martinique; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*