title: Seroprevalence and clinical manifestations of chikungunya virus infection in rural areas of Chandrapur, Maharashtra, India.
abstract: OBJECTIVE
  Chikungunya virus (CHIKV) infection has recently witnessed re-emergence, affecting rural areas of India with high morbidity rates. This prospective study was conducted to evaluate seroprevalence and clinical manifestation in targeted villages reporting cases of CHIKV infection.
  
  
  METHODS
  A total of 482 patients were recruited from Kalmana and Kothari villages of Ballarpur; Chandrapur district of Maharashtra state, India during CHIKV outbreaks in 2011-12. The serum samples from infected CHIKV patients were simultaneously screened through ELISA for detection of antigen and antibodies (IgM and IgG). Chi-square analysis was used to evaluate differences in seropositivity between age, gender and clinical manifestations of CHIKV.
  
  
  RESULTS
  Out of 482 enrolled participants, 197 (41%) males and 285 (59%) females were aged between 5 and 92 yr. The clinical manifestations such as small joint pain (80%), neck stiffness (75%), fever (49%) and large joint pain (47%) were observed amongst CHIKV infected subjects. Mucocutaneous rashes (91%) on knees (71%), feet (56%), fingers and palms (54%) were also observed. Overall, seroprevalence of CHIKV infection was found to be 46% in infected participants during the epidemic period. Among risk factors, ageing and female gender was strongly associated with a raised seroprevalence of CHIKV infection along with symptoms such as rashes, small joints pain and neck stiffness.
  
  
  CONCLUSIONS
  This study reported high seroprevalence rates of CHIKV infection in targeted popula- tions, suggesting its re-emergence in rural India. Proper surveillance is, therefore, necessary to minimize re-emergence and in controlling these impending and sporadic outbreaks.
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Anuja P
authors.initials: AP
authors.lastname: Kawle
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Amit R
authors.initials: AR
authors.lastname: Nayak
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Shradha S
authors.initials: SS
authors.lastname: Bhullar
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Smita R
authors.initials: SR
authors.lastname: Borkar
authors.affiliation: Guru Nanak College of Science, Chandrapur, Maharashtra, India.
authors.forename: Sanjeev D
authors.initials: SD
authors.lastname: Patankar
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Hatim F
authors.initials: HF
authors.lastname: Daginawala
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Lokendra R
authors.initials: LR
authors.lastname: Singh
authors.affiliation: Biochemistry Research Centre, Central India Institute of Medical Sciences, Nagpur, India.
authors.forename: Rajpal S
authors.initials: RS
authors.lastname: Kashyap
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D065632:Chikungunya Fever / Q000453:epidemiology* / Q000473:pathology*; D002646:Chikungunya virus / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012424:Rural Population; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M