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Sofyantoro F, Frediansyah A, Priyono DS, Putri WA, Septriani NI, Wijayanti N, Ramadaningrum WA, Turkistani SA, Garout M, Aljeldah M, Al Shammari BR, Alwashmi ASS, Alfaraj AH, Alawfi A, Alshengeti A, Aljohani MH, Aldossary S, Rabaan AA. Growth in chikungunya virus-related research in ASEAN and South Asian countries from 1967 to 2022 following disease emergence: a bibliometric and graphical analysis. Global Health 2023; 19:9. [PMID: 36747262 PMCID: PMC9901127 DOI: 10.1186/s12992-023-00906-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/09/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND ASEAN (Association of Southeast Asian Nations) is composed of ten Southeast Asian countries bound by socio-cultural ties that promote regional peace and stability. South Asia, located in the southern subregion of Asia, includes nine countries sharing similarities in geographical and ethno-cultural factors. Chikungunya is one of the most significant problems in Southeast and South Asian countries. Much of the current chikungunya epidemic in Southeast Asia is caused by the emergence of a virus strain that originated in Africa and spread to Southeast Asia. Meanwhile, in South Asia, three confirmed lineages are in circulation. Given the positive correlation between research activity and the improvement of the clinical framework of biomedical research, this article aimed to examine the growth of chikungunya virus-related research in ASEAN and South Asian countries. METHODS The Scopus database was used for this bibliometric analysis. The retrieved publications were subjected to a number of analyses, including those for the most prolific countries, journals, authors, institutions, and articles. Co-occurrence mapping of terms and keywords was used to determine the current state, emerging topics, and future prospects of chikungunya virus-related research. Bibliometrix and VOSviewer were used to analyze the data and visualize the collaboration network mapping. RESULTS The Scopus search engine identified 1280 chikungunya-related documents published by ASEAN and South Asian countries between 1967 and 2022. According to our findings, India was the most productive country in South Asia, and Thailand was the most productive country in Southeast Asia. In the early stages of the study, researchers investigated the vectors and outbreaks of the chikungunya virus. In recent years, the development of antivirus agents has emerged as a prominent topic. CONCLUSIONS Our study is the first to present the growth of chikungunya virus-related research in ASEAN and South Asian countries from 1967 to 2022. In this study, the evaluation of the comprehensive profile of research on chikungunya can serve as a guide for future studies. In addition, a bibliometric analysis may serve as a resource for healthcare policymakers.
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Affiliation(s)
- Fajar Sofyantoro
- grid.8570.a0000 0001 2152 4506Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia ,grid.8570.a0000 0001 2152 4506Center for Tropical Biodiversity, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia
| | - Andri Frediansyah
- PRTPP, National Research and Innovation Agency (BRIN), Yogyakarta, 55861, Indonesia.
| | - Dwi Sendi Priyono
- grid.8570.a0000 0001 2152 4506Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia ,grid.8570.a0000 0001 2152 4506Center for Tropical Biodiversity, Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia
| | - Wahyu Aristyaning Putri
- grid.8570.a0000 0001 2152 4506Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia
| | - Nur Indah Septriani
- grid.8570.a0000 0001 2152 4506Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281 Indonesia
| | - Nastiti Wijayanti
- Faculty of Biology, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
| | | | | | - Mohammed Garout
- grid.412832.e0000 0000 9137 6644Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah, 21955 Saudi Arabia
| | - Mohammed Aljeldah
- grid.494617.90000 0004 4907 8298Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin, 39831 Saudi Arabia
| | - Basim R. Al Shammari
- grid.494617.90000 0004 4907 8298Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin, 39831 Saudi Arabia
| | - Ameen S. S. Alwashmi
- grid.412602.30000 0000 9421 8094Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452 Saudi Arabia
| | - Amal H. Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq, 33261 Saudi Arabia
| | - Abdulsalam Alawfi
- grid.412892.40000 0004 1754 9358Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, 41491 Saudi Arabia
| | - Amer Alshengeti
- grid.412892.40000 0004 1754 9358Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, 41491 Saudi Arabia ,grid.416641.00000 0004 0607 2419Department of Infection Prevention and Control, Prince Mohammad Bin Abdulaziz Hospital, National Guard Health Affairs, Al-Madinah, 41491 Saudi Arabia
| | - Maha H. Aljohani
- Department of infectious diseases, King Fahad Hospital, Madinah, 42351 Saudi Arabia
| | - Sahar Aldossary
- grid.415305.60000 0000 9702 165XPediatric Infectious Diseases, Women and Children’s Health Institute, Johns Hopkins Aramco Healthcare, Dhahran, 31311 Saudi Arabia
| | - Ali A. Rabaan
- grid.415305.60000 0000 9702 165XMolecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, 31311 Saudi Arabia ,grid.411335.10000 0004 1758 7207College of Medicine, Alfaisal University, Riyadh, 11533 Saudi Arabia ,grid.467118.d0000 0004 4660 5283Department of Public Health and Nutrition, The University of Haripur, Haripur, 22610 Pakistan
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Assessment of Post-Dengue Rheumatic Symptoms Using the WOMAC and DAS-28 Questionnaires in a Honduran Population after a Four-Month Follow-Up. Trop Med Infect Dis 2022; 7:tropicalmed7120394. [PMID: 36548649 PMCID: PMC9784921 DOI: 10.3390/tropicalmed7120394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: Alphaviruses may cause arthritis, but there is a lack of studies assessing it in flaviviruses such as dengue. Through the 28 Joint Disease Activity Score (DAS-28), incorporating swollen joint counts, and through the Arthritis Index from Western Ontario and McMaster Universities (WOMAC), we assessed pain, stiffness, and dimensions of arthritic function in post-DENV patients. Methods: Prospective study of a cohort of participants who were diagnosed with dengue in centres in Honduras from December 2019 to February 2020, with a follow-up period of 4 months to evaluate post-dengue rheumatological disease through the WOMAC and DAS-28 questionnaires. Results: After a four-month follow-up phase with 281 participants, the final cohort comprised 58.8% women and 41.20% men. After the follow-up, 63.02% persisted with the clinical findings. According to WOMAC, joint involvement was higher in women with (58.76%) (p < 0.0001) these symptoms or functional limitations when performing daily activities were limited to pain when walking (34.81% vs. 5.51%), climbing or descending stairs (36.46% vs. 8.66%), and at night at bedtime (28.73% vs. 7.08%). With the DAS-28, we found at least one alteration with inflammation or pain in 14.91% of the participants, primarily women (p < 0.01). Discussion: Joint involvement was high during the dengue epidemic in 2019. We observed a significant proportion of women with inflammation and joint pain, showing that dengue may lead to the development of chronic rheumatological findings, although lower than in CHIKV, still affecting everyday life and, consequently, their quality of life. Additional long-term evaluation studies after dengue are required.
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Mourad O, Makhani L, Chen LH. Chikungunya: An Emerging Public Health Concern. Curr Infect Dis Rep 2022; 24:217-228. [DOI: 10.1007/s11908-022-00789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Abstract
Abstract
Purpose of Review
The worldwide spread of chikungunya over the past two decades calls for greater knowledge and awareness of the virus, its route of transmission, methods of diagnosis, and the use of available treatment and prevention measures.
Recent Findings
Chikungunya virus infection, an Aedes mosquito-borne febrile disease, has spread from Africa and Asia to Europe and the Americas and from the tropics and subtropics to temperate regions. International travel is a pivotal influence in the emergence of chikungunya as a global public health threat, as evidenced by a growing number of published reports on travel-related chikungunya infections. The striking features of chikungunya are arthralgia and arthritis, and the disease is often mistaken for dengue. Although mortality is low, morbidity can be profound and persistent. Current treatment for chikungunya is supportive; chikungunya vaccines and therapeutics are in development. Travelers planning to visit areas where the mosquito vectors are present should be advised on preventive measures.
Summary
Chikungunya is an emerging disease in the Americas. Frequent travel, the presence of at least two competent mosquito species, and a largely naïve human population in the Western Hemisphere create a setting conducive to future outbreaks. Awareness of the disease and its manifestations is critical to effectively and safely manage and limit its impact. Vaccines in late-stage clinical trials offer a new pathway to prevention.
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Plant-Derived Recombinant Vaccines against Zoonotic Viruses. Life (Basel) 2022; 12:life12020156. [PMID: 35207444 PMCID: PMC8878793 DOI: 10.3390/life12020156] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022] Open
Abstract
Emerging and re-emerging zoonotic diseases cause serious illness with billions of cases, and millions of deaths. The most effective way to restrict the spread of zoonotic viruses among humans and animals and prevent disease is vaccination. Recombinant proteins produced in plants offer an alternative approach for the development of safe, effective, inexpensive candidate vaccines. Current strategies are focused on the production of highly immunogenic structural proteins, which mimic the organizations of the native virion but lack the viral genetic material. These include chimeric viral peptides, subunit virus proteins, and virus-like particles (VLPs). The latter, with their ability to self-assemble and thus resemble the form of virus particles, are gaining traction among plant-based candidate vaccines against many infectious diseases. In this review, we summarized the main zoonotic diseases and followed the progress in using plant expression systems for the production of recombinant proteins and VLPs used in the development of plant-based vaccines against zoonotic viruses.
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Abstract
El virus de chikunguña (CHIKV) es un Alfavirus perteneciente al grupo denominado del Viejo Mundo; estos son virus artritogénicos que causan una enfermedad febril caracterizada por artralgias y mialgias. Aunque la muerte por CHIKV es poco frecuente, la enfermedad puede llegar a ser incapacitante y generar un amplio espectro de manifestaciones atípicas, como complicaciones cardiovasculares, respiratorias, oculares, renales y dérmicas, entre otras. Cuando el dolor articular persiste por tres o más meses, da lugar a la forma crónica de la enfermedad denominada reumatismo inflamatorio crónico poschikunguña, el cual es la principal secuela de la enfermedad. Se considera que este virus no es neurotrópico, sin embargo, puede afectar el sistema nervioso central y generar secuelas graves y permanentes, principalmente, en niños y ancianos. En África, Asia y Europa se habían reportado anteriormente brotes epidémicos por CHIKV, pero solo hasta finales del 2013 se documentó la introducción del virus a las Américas; desde entonces, el virus se ha propagado a 45 países o territorios del continente y el número de casos acumulados ascendió a cerca de dos millones en dos años. Esta revisión describe de manera general la biología molecular del virus, sus manifestaciones clínicas, su patogénesis y las principales complicaciones posteriores a la infección. Además, reúne la información de la epidemia en Colombia y el continente americano publicada entre el 2014 y el 2020.
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Silva MMO, Kikuti M, Anjos RO, Portilho MM, Santos VC, Gonçalves TSF, Tauro LB, Moreira PSS, Jacob-Nascimento LC, Santana PM, Campos GS, Siqueira AM, Kitron U, Reis MG, Ribeiro GS. Risk of chronic arthralgia and impact of pain on daily activities in a cohort of patients with chikungunya virus infection from Brazil. Int J Infect Dis 2021; 105:608-616. [PMID: 33684559 DOI: 10.1016/j.ijid.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/17/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To investigate risk factors for persistent arthralgia in patients with chikungunya, and describe its impact on daily activities. METHODS From September 2014 to July 2016, a surveillance study enrolled patients with acute febrile illness in Salvador, Brazil, and detected those with chikungunya virus infection using IgM enzyme-linked immunosorbent assay or reverse transcriptase polymerase chain reaction. Telephone follow-ups were performed to ascertain the progression of disease. RESULTS Of 153 followed cases, 65 (42.5%) reported chronic arthralgia that lasted >3 months, and 47 (30.7%) were still symptomatic at the time of the interview (approximately 1.5 years after symptom onset). Limitations in daily activities and mental distress were reported by 93.8% and 61.5% of those with chronic arthralgia, respectively. Female sex [risk ratio (RR) 1.79, 95% confidence interval (CI) 1.95-2.69] and age (RR 1.02 for each 1-year increase, 95% CI 1.01-1.03) were independent risk factors for chronic arthralgia. Chronic arthralgia was not associated with co-infection with dengue virus (RR 0.97, 95% CI 0.48-1.94) or chikungunya viral load at diagnosis (median chikungunya virus RNA of 5.60 and 5.52 log10 copies/μL for those with and without chronic arthralgia, respectively; P = 0.75). CONCLUSIONS These findings reinforce the high frequency of chronic chikungunya arthralgia, and highlight the substantial disability associated with the persistence of pain. Development of novel strategies to mitigate the transmission of chikungunya virus and to provide long-term medical assistance for patients with chikungunya are needed urgently.
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Affiliation(s)
| | - Mariana Kikuti
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Moyra M Portilho
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Viviane C Santos
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Laura B Tauro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Instituto de Biologia Subtropical, CONICET-UNAM, Puerto Iguazú, Argentina
| | | | | | - Perla M Santana
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Gúbio S Campos
- Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - André M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Uriel Kitron
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Emory University, Atlanta, GA, USA
| | - Mitermayer G Reis
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil; Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Guilherme S Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
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Quantifying Media Effects, Its Content, and Role in Promoting Community Awareness of Chikungunya Epidemic in Bangladesh. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:84-94. [PMID: 36417192 PMCID: PMC9620935 DOI: 10.3390/epidemiologia2010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chikungunya is a vector-borne disease, mostly present in tropical and subtropical regions. The virus is spread by Ae. aegypti and Ae. albopictus mosquitos and symptoms include high fever to severe joint pain. Dhaka, Bangladesh, suffered an outbreak of chikungunya in 2017 lasting from April to September. With the goal of reducing cases, social media was at the forefront during this outbreak and educated the public about symptoms, prevention, and control of the virus. Popular web-based sources such as the top dailies in Bangladesh, local news outlets, and Facebook spread awareness of the outbreak. OBJECTIVE This study sought to investigate the role of social and mainstream media during the chikungunya epidemic. The study objective was to determine if social media can improve awareness of and practice associated with reducing cases of chikungunya. METHODS We collected chikungunya-related information circulated from the top nine television channels in Dhaka, Bangladesh, airing from 1st April-20th August 2017. All the news published in the top six dailies in Bangladesh were also compiled. The 50 most viewed chikungunya-related Bengali videos were manually coded and analyzed. Other social media outlets, such as Facebook, were also analyzed to determine the number of chikungunya-related posts and responses to these posts. RESULTS Our study showed that media outlets were associated with reducing cases of chikungunya, indicating that media has the potential to impact future outbreaks of these alpha viruses. Each media outlet (e.g., web, television) had an impact on the human response to an individual's healthcare during this outbreak. CONCLUSIONS To prevent future outbreaks of chikungunya, media outlets and social media can be used to educate the public regarding prevention strategies such as encouraging safe travel, removing stagnant water sources, and assisting with tracking cases globally to determine where future outbreaks may occur.
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Abstract
Throughout the last decade, chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have spread globally, causing a spectrum of disease that ranges from self-limited febrile illness to permanent severe disability, congenital anomalies, and early death. Nevertheless, estimates of their aggregate health impact are absent from the literature and are currently omitted from the Global Burden of Disease (GBD) reports. We systematically reviewed published literature and surveillance records to evaluate the global burden caused by CHIKV and ZIKV between 2010 and 2019, to calculate estimates of their disability-adjusted life year (DALY) impact. Extracted data on acute, chronic, and perinatal outcomes were used to create annualized DALY estimates, following techniques outlined in the GBD framework. This study is registered with PROSPERO (CRD42020192502). Of 7,877 studies identified, 916 were screened in detail, and 21 were selected for inclusion. Available data indicate that CHIKV and ZIKV caused the average yearly loss of over 106,000 and 44,000 DALYs, respectively, between 2010 and 2019. Both viruses caused substantially more burden in the Americas than in any other World Health Organization (WHO) region. This unequal distribution is likely due to a combination of limited active surveillance reporting in other regions and the lack of immunity that left the previously unexposed populations of the Americas susceptible to severe outbreaks during the last decade. Long-term rheumatic sequelae provided the largest DALY component for CHIKV, whereas congenital Zika syndrome (CZS) contributed most significantly for ZIKV. Acute symptoms and early mortality accounted for relatively less of the overall burden. Suboptimal reporting and inconsistent diagnostics limit precision when determining arbovirus incidence and frequency of complications. Despite these limitations, it is clear from our assessment that CHIKV and ZIKV represent a significant cause of morbidity that is not included in current disease burden reports. These results suggest that transmission-blocking strategies, including vector control and vaccine development, remain crucial priorities in reducing global disease burden through prevention of potentially devastating arboviral outbreaks. Chikungunya and Zika are 2 mosquito-borne viral diseases that can cause both acute symptoms and long-term, debilitating complications in infected individuals. Chikungunya is best known as a cause of persistent arthritis in otherwise recovered patients and Zika as a cause of cognitive, motor, and sensory anomalies in newborn children. Both diseases emerged in the Americas within the last decade and have since spread rapidly throughout the region. Despite their widespread transmission there and throughout much of the world, chikungunya and Zika remain neglected diseases. One of the most significant obstacles to address their spread is a lack of data involving their burden. We searched the published literature and surveillance reports to collect information about the incidence, mortality, and morbidity associated with each of these diseases to estimate their regional and global burden during the last decade. Our estimates confirm that chikungunya and Zika caused substantial burden throughout this time frame and place them among the most problematic mosquito-borne viral diseases worldwide. We found that the largest proportion of global burden linked to each disease between 2010 and 2019 occurred in the Americas, although this observation is likely due to limited reporting in other regions.
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Díaz-Menéndez M, Esteban ET, Ujiie M, Calleri G, Rothe C, Malvy D, Nicastri E, Bissinger AL, Grandadam M, Alpern JD, Gobbi F, Schlagenhauf P, Duvignaud A, Javelle E, Nakamoto T, Antinori S, Hamer DH. Travel-associated chikungunya acquired in Myanmar in 2019. ACTA ACUST UNITED AC 2020; 25. [PMID: 31937394 PMCID: PMC6961262 DOI: 10.2807/1560-7917.es.2020.25.1.1900721] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Eighteen cases of chikungunya virus infection in travellers returning from Myanmar were reported to the GeoSentinel Surveillance Network, its subnetwork EuroTravNet and TropNet in 2019, reflecting an ongoing local outbreak. This report reinforces the importance of travellers as sentinels of emerging arboviral outbreaks and highlights the importance of vigilance for imported cases, due to the potential for dissemination of the virus into areas with competent local vectors and conducive environmental conditions.
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Affiliation(s)
- Marta Díaz-Menéndez
- These authors contributed equally to the work.,National Referral Unit for Imported Tropical Diseases. Department of Internal Medicine. Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain
| | - Elena Trigo Esteban
- These authors contributed equally to the work.,National Referral Unit for Imported Tropical Diseases. Department of Internal Medicine. Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain
| | - Mugen Ujiie
- Vaccination Support Center, Disease Control and Prevention Center. National Center for Global Health and Medicine, Tokyo, Japan
| | - Guido Calleri
- Travel Medicine Unit. Amedeo di Savoia Hospital. ASL Città di Torino, Torino, Italy
| | - Camilla Rothe
- LMU Hospital Centre, Division of Infectious Diseases and Tropical Medicine, Munich, Germany
| | - Denis Malvy
- Department of Infectious Diseases and Tropical Medicine, CHU de Bordeaux & INSERM 1219, University of Bordeaux, Bordeaux, France
| | - Emanuele Nicastri
- National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Rome, Italy
| | - Alfred L Bissinger
- Institute for Tropical Medicine, Department of Internal Medicine, University Hospital Tübingen, Germany
| | - Marc Grandadam
- Arbovirus & Emerging viral diseases laboratory. Institut Pasteur du Laos, Vientiane, Laos
| | - Jonathan D Alpern
- Department of Travel and Tropical Medicine, HealthPartners; Department of Medicine, University of Minnesota, Minneapolis, United States
| | - Federico Gobbi
- Department of Infectious /Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Zürich, Switzerland
| | - Alexandre Duvignaud
- Department of Infectious Diseases and Tropical Medicine, CHU de Bordeaux & INSERM 1219, University of Bordeaux, Bordeaux, France
| | - Emilie Javelle
- Laveran Military Teaching Hospital, Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences "L Sacco", University of Milan. Tropical Medicine Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Davidson H Hamer
- Department of Global Health and Boston University School of Public Health and Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
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Cunha MS, Costa PAG, Correa IA, de Souza MRM, Calil PT, da Silva GPD, Costa SM, Fonseca VWP, da Costa LJ. Chikungunya Virus: An Emergent Arbovirus to the South American Continent and a Continuous Threat to the World. Front Microbiol 2020; 11:1297. [PMID: 32670231 PMCID: PMC7332961 DOI: 10.3389/fmicb.2020.01297] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/20/2020] [Indexed: 01/23/2023] Open
Abstract
Chikungunya virus (CHIKV) is an arthropod-borne virus (arbovirus) of epidemic concern, transmitted by Aedes ssp. mosquitoes, and is the etiologic agent of a febrile and incapacitating arthritogenic illness responsible for millions of human cases worldwide. After major outbreaks starting in 2004, CHIKV spread to subtropical areas and western hemisphere coming from sub-Saharan Africa, South East Asia, and the Indian subcontinent. Even though CHIKV disease is self-limiting and non-lethal, more than 30% of the infected individuals will develop chronic disease with persistent severe joint pain, tenosynovitis, and incapacitating polyarthralgia that can last for months to years, negatively impacting an individual’s quality of life and socioeconomic productivity. The lack of specific drugs or licensed vaccines to treat or prevent CHIKV disease associated with the global presence of the mosquito vector in tropical and temperate areas, representing a possibility for CHIKV to continually spread to different territories, make this virus an agent of public health burden. In South America, where Dengue virus is endemic and Zika virus was recently introduced, the impact of the expansion of CHIKV infections, and co-infection with other arboviruses, still needs to be estimated. In Brazil, the recent spread of the East/Central/South Africa (ECSA) and Asian genotypes of CHIKV was accompanied by a high morbidity rate and acute cases of abnormal disease presentation and severe neuropathies, which is an atypical outcome for this infection. In this review, we will discuss what is currently known about CHIKV epidemics, clinical manifestations of the human disease, the basic concepts and recent findings in the mechanisms underlying virus-host interaction, and CHIKV-induced chronic disease for both in vitro and in vivo models of infection. We aim to stimulate scientific debate on how the characterization of replication, host-cell interactions, and the pathogenic potential of the new epidemic viral strains can contribute as potential developments in the virology field and shed light on strategies for disease control.
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Affiliation(s)
- Marcela S Cunha
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro A G Costa
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isadora Alonso Correa
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcos R M de Souza
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Teles Calil
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo P Duarte da Silva
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sara Mesquita Costa
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vinícius Wakoff P Fonseca
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana J da Costa
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Characteristics of Chikungunya virus infection in patients with established rheumatoid arthritis. Clin Rheumatol 2020; 39:3639-3642. [DOI: 10.1007/s10067-020-05198-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
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Noor FM, Hossain MB, Islam QT. Prevalence of and risk factors for long-term disabilities following chikungunya virus disease: A meta-analysis. Travel Med Infect Dis 2020; 35:101618. [PMID: 32160972 DOI: 10.1016/j.tmaid.2020.101618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The main aim of this study was to investigate the percentage of individuals who developed long-term disabilities after chikungunya virus (CHIKV) disease on the basis of follow up time interval and its associated risk factors. METHOD In this meta-analysis, electronic databases PubMed, Science Direct and Google Scholar were searched to identify cohort studies of CHIKV disease from January 2000 to June 2018. Total 28 eligible studies were selected for analysis. The pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures were calculated using a random effects model. RESULT Among 28 studies, 24 studies were used for PR calculation and the PR for the long-term disabilities of CHIKV disease patients were found 39.70%, [95% CI: (31.77-47.64), p < 0.01] for follow up time between 6 and 12 months, 35.85%, [95% CI: (24.09-47.61), p < 0.01] for follow up time between 12 and 18 months and 28.20%, [95% CI: (19.74-36.66), p < 0.01] for greater than 18 months respectively. Eighteen studies were used for RR calculation and significant association were found between long-term disabilities after CHIKV disease and gender [RR: 1.46, p < 0.01], age [RR: 1.61, p < 0.01], diabetes [RR: 1.40, p < 0.01], hypertension [RR: 1.37, p < 0.01], severity of pain at acute stage [RR: 2.02, p < 0.01]. CONCLUSION Approximately 40% patients developed long-term disabilities after 6 months of CHIKV disease and 28% patients still suffer from this disease after 18 months of acute infection.
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Affiliation(s)
| | - Md Belal Hossain
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
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Stiffness, pain, and joint counts in chronic chikungunya disease: relevance to disability and quality of life. Clin Rheumatol 2020; 39:1679-1686. [PMID: 31916107 DOI: 10.1007/s10067-019-04919-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 01/05/2023]
Abstract
INTRODUCTION/OBJECTIVES To characterize the importance of musculoskeletal stiffness in a cohort of chikungunya patients with chronic joint symptoms. METHOD Eighty-two patients were followed up 3 years after chikungunya infection. Tender and swollen joint counts, a pain intensity scale, Health Assessment Questionnaire-Disability Index (HAQ-DI), and the EuroQol EQ-5D quality of life instrument were completed. A musculoskeletal stiffness questionnaire provided scores for overall stiffness and its components: stiffness severity, physical impact, and psychosocial impact. RESULTS Patients had a mean age 51 ± 14 years. Sixty-seven patients were still experiencing chronic arthralgia. Musculoskeletal stiffness was reported by 43/67 patients with arthralgia and 3/15 patients without arthralgia. A physical impact of stiffness was reported by 87% patients and psychosocial impact by 71% patients. Mean tender joint count in patients reporting arthralgia was 6 ± 7, mean pain intensity 65 ± 20 out of 100, mean HAQ-DI was 0.54 ± 0.52, and mean EQ-VAS global health perception was 68 ± 62 out of 100. Stiffness severity was correlated with tender joint counts (ρ = 0.46) and pain intensity (ρ = 0.40). All three measures were equally well correlated with the EuroQol-VAS global health perception. Pain and tender joints were better correlated with the HAQ-DI (ρ = 0.68 and ρ = 0.63), but stiffness was more strongly correlated with several quality of life domains, including mobility. Swollen joints were a poor predictor of outcomes. CONCLUSIONS Musculoskeletal stiffness following chikungunya infection is distinct from arthralgia. It does not always occur in the same patients or with a corresponding intensity. Joint pain and stiffness may be independently associated with disability and quality of life assessments.
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Ninla-Aesong P, Mitarnun W, Noipha K. Proinflammatory Cytokines and Chemokines as Biomarkers of Persistent Arthralgia and Severe Disease After Chikungunya Virus Infection: A 5-Year Follow-Up Study in Southern Thailand. Viral Immunol 2019; 32:442-452. [PMID: 31718485 DOI: 10.1089/vim.2019.0064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Chikungunya fever is a re-emerging viral disease caused by chikungunya virus (CHIKV). The disease is generally self-limiting, but chronic arthralgia/arthritis may persist for months or years. We evaluated the expression of 12 cytokines/chemokines and matrix metalloproteinases (MMP)-1 and MMP-3 using enzyme-linked immunosorbent assays (ELISAs) and compared among patients who still had arthralgia (persistent arthralgia), patients who had fully recovered, and healthy controls. There was a significant increase in interleukin (IL)-1β, IL-6, IL-8, monocyte chemotactic protein-1 (MCP-1), MMP-1, and MMP-3 levels in patients with persistent arthralgia in comparison to healthy controls (p < 0.05) and a significant increase in tumor necrosis factor-alpha (TNF-α), MMP-1, and MMP-3 levels in patients with persistent arthralgia in comparison to patients who had fully recovered (p < 0.05). Interferon (IFN)-γ, IL-6, and transforming growth factor beta (TGF-β) levels tended to be increased in patients with chronic CHIKV-induced arthritis compared with fully recovered. TNF-α, IL-12, and MCP-1 levels were elevated (p < 0.05), whereas regulated on activation, normal T cell expressed and secreted (RANTES) levels were decreased in patients with severe pain compared with patients with nonsevere pain (p < 0.05). IFN-γ, IL-1β, IL-6, and IL-8 levels tended to be elevated in patients with severe pain compared with patients with nonsevere pain. We proposed a role played by TNF-α, IL-6, IL-8, and MCP-1 in persistent arthralgia or chronic disease through the activation of MMP-1 and MMP-3. The increase in TNF-α, IL-12, and MCP-1 levels (and the tendency toward an increase in IFN-γ, IL-1β, IL-6, and IL-8 levels) in patients with severe pain compared with patients with nonsevere pain suggests the role of these inflammatory markers in chronic disease and severity of the disease.
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Affiliation(s)
| | - Winyou Mitarnun
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Kusumarn Noipha
- Faculty of Health and Sports Science, Thaksin University, Paphayom, Phatthalung, Thailand
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Spatial distribution of dengue in Honduras during 2016-2019 using a geographic information systems (GIS)-Dengue epidemic implications for public health and travel medicine. Travel Med Infect Dis 2019; 32:101517. [PMID: 31715270 DOI: 10.1016/j.tmaid.2019.101517] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/30/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND After serious epidemics of chikungunya (CHIKV) and Zika (ZIKV) in the Americas, dengue (DENV) have reemerged in most countries. We analyzed the incidence, incidence rates, and evolution of DENV cases in Honduras from 2015 to 2018 and the ongoing 2019 epidemic. METHODS Using epidemiological weeks (EW) surveillance data on the DENV in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental, and municipal levels. RESULTS From January 1, 2016 to July 21, 2019, a total of 109,557 cases of DENV were reported, 28,603 in 2019, with an incidence rate of 312.32 cases/100,000 population this year; 0.13% laboratory-confirmed. The highest peak was reached on the EW 28°, 2019 (5299 cases; 57.89 cases/100,000 population). The department with the highest number of cases and incidence rate was Cortes (8404 cases, 479.68 cases/100,000 population in 2019). DISCUSSION The pattern and evolution of DENV epidemic in 2019 in Honduras has been similar to that which occurred for in 2015. As previously reported, this epidemic involved the north and central areas of the country predominantly, reaching municipality incidences there >1000 cases/100,000 population (or 1%). Studies using geographical information systems linked with clinical disease characteristics are necessary to obtain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.
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Cabrera M, Córdova-Lepe F, Valero-Cedeño N, Reyes-Baque J, Rodríguez-Morales AJ. Chikungunya in Ecuador, 2014–2017: Maps and more. Travel Med Infect Dis 2019; 29:63-66. [DOI: 10.1016/j.tmaid.2019.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 10/27/2022]
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Murillo-Zamora E, Mendoza-Cano O, Trujillo-Hernández B, Guzmán-Esquivel J, Higareda-Almaraz E, Higareda-Almaraz MA, Sánchez-Piña RA, Lugo-Radillo A. Persistent Arthralgia and Related Risks Factors: A Cohort Study at 12 Months from Laboratory-Confirmed Chikungunya Infection. Arch Med Res 2018; 49:65-73. [PMID: 29703609 DOI: 10.1016/j.arcmed.2018.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 04/11/2018] [Indexed: 01/04/2023]
Abstract
AIM OF THE STUDY To assess the cumulative incidence and clinical markers associated with persistent arthralgia (PA) at 12 months from acute chikungunya virus (CHIKV) infection. METHODS A multicenter retrospective cohort study was conducted in the state of Colima, Mexico, and 217 serologically confirmed cases of CHIKV infection were enrolled. Participants aged 15 years and older were interviewed on 6 months basis from acute illness onset and the main binary outcome was self-reported PA at 12 months. To assess clinical markers associated with PA we used a generalized linear model. The 2-item Patient Health Questionnaire (PHQ-2) was used to screen for depressive symptoms among PA-positive individuals. RESULTS The cumulative incidence of PA was 31.8%. In the generalized linear model, individuals ≥40 years of age (risk ratio (RR) = 1.68; 95% confidence interval (CI), 1.10-2.55) and those with 8 or more arthralgia sites (RR = 2.91, 95% CI 1.87-4.53) at acute disease had a significantly increased risk of PA at 12 months from CHIKV infection. Self-reported arthralgia (any site) at 3 months post-infection, a sub-chronic clinical marker, was also associated with a significantly increased risk of long-term articular manifestations (RR = 7.06, 95% CI 2.97-16.81). Depressive symptoms (PHQ-2 score ≥3) were reported by 33.3% of PA-positive participants. CONCLUSIONS Our findings suggest that chronic CHKV-related articular manifestations were a frequent event in the study sample and the impact on functional status was potential. These results may be useful in health care settings in the risk-stratification of PA after CHIKV infection.
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Affiliation(s)
- Efrén Murillo-Zamora
- Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Colima, Colima, México; Programa de Doctorado en Ciencias Médicas, Universidad de Colima, Facultad de Medicina, Colima, Colima, México
| | - Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, Coquimatlán, Colima, México; T.H. Chan School of Public Health, Center for Health and the Global Environment, Harvard University, Boston, Massachusetts, USA.
| | | | - José Guzmán-Esquivel
- Facultad de Medicina, Universidad de Colima, Colima, Colima, México; Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, Colima, México
| | - Enrique Higareda-Almaraz
- Jefatura de Servicios de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Colima, Colima, México
| | | | - Ramón Alberto Sánchez-Piña
- T.H. Chan School of Public Health, Center for Health and the Global Environment, Harvard University, Boston, Massachusetts, USA
| | - Agustin Lugo-Radillo
- CONACYT-Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca, Oaxaca, México
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