1
|
Costa LB, Barreto FKDA, Barreto MCA, Santos THPD, Andrade MDMOD, Farias LABG, Freitas ARRD, Martinez MJ, Cavalcanti LPDG. Epidemiology and Economic Burden of Chikungunya: A Systematic Literature Review. Trop Med Infect Dis 2023; 8:301. [PMID: 37368719 DOI: 10.3390/tropicalmed8060301] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Chikungunya (CHIK) is a re-emerging viral infection endemic in tropical and subtropical areas. While the typical clinical presentation is an acute febrile syndrome, long-term articular complications and even death can occur. This review characterizes the global epidemiological and economic burden of chikungunya. The search included studies published from 2007 to 2022 in MEDLINE, Embase, LILACS, and SciELO for a thorough evaluation of the literature. Rayyan software was used for data analysis, and data were summarized descriptively and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventy-six publications were included. Chikungunya is widely distributed in the tropics, including Africa, Asia, South America, and Oceania/the Pacific Islands, and co-circulates with other simultaneous arboviruses such as DENV, ZIKV, and YFV. Chikungunya infection can lead to chronic articular manifestations with a significant impact on the quality of life in the long term. In addition, it generates absenteeism and economic and social losses and can cause fatal infections in vulnerable populations, mainly in high-risk patients with co-morbidities and at the extremes of age. Reported costs associated with CHIKV diseases are substantial and vary by region, age group, and public/private delivery of healthcare services. The chikungunya disease burden includes chronicity, severe infections, increased hospitalization risks, and associated mortality. The disease can impact the economy in several spheres, significantly affecting the health system and national economies. Understanding and measuring the full impact of this re-emerging disease is essential.
Collapse
Affiliation(s)
- Lourrany Borges Costa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Ceara (UFC), Ceara 60020-181, Brazil
- Faculdade de Medicina, Universidade de Fortaleza (UNIFOR), Ceara 60811-905, Brazil
| | | | | | | | | | - Luís Arthur Brasil Gadelha Farias
- Hospital São Jose de Doenças Infecciosas, Ceara 60455-610, Brazil
- Faculdade de Medicina, Centro Universitário Christus (UNICHRISTUS), Ceara 60192-345, Brazil
| | | | - Miguel Julian Martinez
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Luciano Pamplona de Góes Cavalcanti
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Ceara (UFC), Ceara 60020-181, Brazil
- Faculdade de Medicina, Centro Universitário Christus (UNICHRISTUS), Ceara 60192-345, Brazil
| |
Collapse
|
2
|
Badoni G, Gupta PK, Gupta P, Kaistha N, Mathuria YP, Pai MO, Kant R. Dengue-chikungunya infection in the tertiary care hospital of northern India: Cross-sectional latent class cluster analysis in viral infection. Heliyon 2023; 9:e14019. [PMID: 36925523 PMCID: PMC10011203 DOI: 10.1016/j.heliyon.2023.e14019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Cases of dengue and chikungunya fever are escalating all over India. Both viruses share a common vector, the "Aedes" mosquito. Due to similar clinical symptoms, both the dengue (DENV) and chikungunya (CHIKV) virus can circulate as co-infection. There is very limited data available on dengue-chikungunya co-infection in Uttarakhand, India. The purpose of this study was to determine the seroprevalence of dengue and chikungunya virus infections, as well as their co-infection, in patients presenting with clinical symptoms. Serum samples of clinically suspected patients from the tertiary care hospital of Uttarakhand were collected, and Latent Class Cluster Analysis was performed for clinical profiling. ELISA was performed for DENV and CHIKV. 279 cases were enrolled, out of which 222 (79.5%) came positive for dengue NS1 Ag, 143 (51.2%) for dengue IgM, 98 (35.1%) for IgG followed by 16 (5.7%) of CHIKV IgM, and 4 (1.4%) were NS1 Ag with CHIKV IgM. Among the clinical features, fever (n = 270, 96.8%) was the most common symptom in all suspected dengue and chikungunya cases. Other symptoms like chills (n = 254, 91.0%), arthralgia (n = 241, 86.4%), and headache (n = 240, 86.0%) were present in a significant number. Results showed fewer odds of getting both DENV and CHIKV infection simultaneously, but the risk is still not negligible. This study explores the clinical presentation of the suspected dengue-chikungunya case. The increasing incidence of dengue and chikungunya and their co-infection necessitate the authorities' active surveillance of endemic regions and effective patient care management.
Collapse
Affiliation(s)
- Gaurav Badoni
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Puneet Kumar Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bilaspur, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
- Corresponding author.
| | - Neelam Kaistha
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Manju O. Pai
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ravi Kant
- Department of General Medicine, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
3
|
The Seroprevalence and Hidden Burden of Chikungunya Endemicity and Malaria Mono- and Coinfection in Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158896. [PMID: 35897268 PMCID: PMC9330559 DOI: 10.3390/ijerph19158896] [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: 04/30/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
Background: Mosquito-borne infections are of global health concern because of their rapid spread and upsurge, which creates a risk for coinfections. Chikungunya, an arbovirus disease transmitted by Aedes aegypti or A. albopictus, and malaria, a parasitic disease transmitted by Anopheles gambiae, are prevalent in Nigeria and neighbouring countries, but their burden and possible coinfections are poorly understood. In this study, we investigated the seroprevalence, hidden burden and endemicity of chikungunya and malaria in three regions in Nigeria. Methods: A cross-sectional sero-survey was conducted on 871 participants in three regions of Nigeria. The samples were collected from outpatients employing simple random sampling. All serum sample analyses were performed using CHIKV virus-like particle recomLine Tropical Fever for the presence of arboviral antibody serological marker IgG immunoblot for chikungunya and malaria RDT (Rapid Diagnostic Test) for malaria parasites. Results: The seroprevalences of chikungunya and malaria mono-infection were 64.9% and 27.7%, respectively, while the coinfection seroprevalence was 71.9%. The central (69.5%) and northern (67.0%) regions showed more significant seroprevalences than the southern region (48.0%). The seroprevalence and the hidden burden of chikungunya and malaria infections varied across the three geographical regions. Conclusions: This study highlighted an unexpectedly high seroprevalence and hidden endemicity of chikungunya and a less surprising high malaria endemicity in three regions of Nigeria.
Collapse
|
4
|
Gupta M, Singla N, Mohi G. An encounter with potentially reemerging chikungunya infection during 2016-2017. APOLLO MEDICINE 2022. [DOI: 10.4103/am.am_98_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
5
|
Joshi P, Yadav P, Mourya D, Sahare L, Ukey M, Khedekar R, Patil D, Barde PV. Laboratory surveillance of chikungunya in Madhya Pradesh, India (2016-2017). Indian J Med Res 2021; 151:87-92. [PMID: 32134019 PMCID: PMC7055169 DOI: 10.4103/ijmr.ijmr_204_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & objectives: Chikungunya (CHIK) is a neglected, re-emerging arboviral disease. Limited information on CHIK-confirmed cases during interepidemic period is available from India. This surveillance study was conducted in Madhya Pradesh (MP), India, during the years 2016-2017, to provide information about CHIK cases. Methods: Blood samples collected from patients suspected having CHIK were tested by immunoglobulin (Ig) IgM ELISA or real time reverse transcription-polymerase chain reaction (rRT-PCR) for the detection of CHIK virus (CHIKV)-specific IgM antibodies or viral RNA, respectively. Partial envelope-1 gene sequencing was done. Clinical and demographic data were collected and analyzed. Results: Of the 4019 samples tested, 494 (12.2%) were found positive for CHIKV infection. The positivity was detected in both rural and urban areas. The mean age of CHIK-positive cases was 33.12±18.25 yr. Headache and joint pain were the most prominent symptoms, 34.6 per cent (171/494) of the CHIK cases required hospitalization and six patients with CHIKV infection died. The East/Central/South African genotype of CHIKV was found to be circulating in the study area. Interpretation & conclusions: Our study recorded a higher CHIK positivity during 2016-2017 in comparison to earlier reports from MP, India. A high proportion of CHIK cases required hospitalization and deaths were also reported, which indicated the severity of the disease in the study area. In-depth molecular analysis of the virus and other risk factors is essential to understand the trends in disease severity.
Collapse
Affiliation(s)
- Piyush Joshi
- Division of Virology and Zoonoses, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pragya Yadav
- Maximum Containment Laboratory, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Devendra Mourya
- Maximum Containment Laboratory, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Lalit Sahare
- Division of Virology and Zoonoses, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Mahendra Ukey
- Division of Virology and Zoonoses, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rameshwar Khedekar
- Division of Virology and Zoonoses, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Deepak Patil
- Maximum Containment Laboratory, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Pradip V Barde
- Division of Virology and Zoonoses, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| |
Collapse
|
6
|
de la Cruz-Castro IX, Nava-Aguilera E, Morales-Pérez A, Betanzos-Reyes ÁF, Flores-Moreno M, Morales-Nava L, Balanzar-Martínez A, Serrano-de Los Santos FR, Andersson N. Factors Associated with Chikungunya Relapse in Acapulco, Mexico: A Cross-Sectional Study. Vector Borne Zoonotic Dis 2020; 20:782-787. [PMID: 32552425 DOI: 10.1089/vbz.2020.2615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To estimate the occurrence of self-reported chikungunya relapse and identify associated factors. Materials and Methods: A cross-sectional study in December 2015 included 1305 homes in eight urban clusters considered representative of Acapulco in southern Mexico. Administered questionnaires collated information on 5870 individuals, including sociodemographic variables, a history of chronic conditions, and the self-reporting of chikungunya. Bivariate and multivariate analyses relied on a cluster-adjusted Mantel-Haenszel procedure to identify the factors associated with chikungunya and its relapse. Results: Some 66% (3531/5870) of the population reported suffering chikungunya and 31.1% (1098/3531) reported a relapse. Factors associated with relapse included the severity of the chikungunya case (odds ratio [OR]: 3.35; clusters adjusted 95% confidence interval [95% CIca]: 3.16-3.55); history of arthralgia (OR: 2.96; 95% CIca: 2.27-3.86); age 30 years or older (OR: 1.85; 95% CIca: 1.72-1.98); female (OR: 1.64; 95% CIca: 1.42-1.90); and higher education households (OR: 1.18; 95% CIca: 1.11-1.27). Conclusions: The high occurrence of chikungunya and its relapse are a public health problem. The factors associated with relapse do not immediately suggest specific prevention strategies but emphasize the dire need for effective approaches to vector control.
Collapse
Affiliation(s)
| | - Elizabeth Nava-Aguilera
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Arcadio Morales-Pérez
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Ángel Francisco Betanzos-Reyes
- Centro de Investigación Sobre Enfermedades Infecciosas (CISEI), Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Miguel Flores-Moreno
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Liliana Morales-Nava
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Alejandro Balanzar-Martínez
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | | | - Neil Andersson
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, México.,Department of Family Medicine, McGill University, Montreal, Canada
| |
Collapse
|
7
|
Kaur M, Singh K, Sidhu SK, Devi P, Kaur M, Soneja S, Singh N. Coinfection of chikungunya and dengue viruses: A serological study from North Western region of Punjab, India. J Lab Physicians 2020; 10:443-447. [PMID: 30498319 PMCID: PMC6210850 DOI: 10.4103/jlp.jlp_13_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION: Dengue and chikungunya (CHIK) infections appear to be increasing in all parts of India. Aedes aegypti mosquitoes are common vectors for dengue virus (DENV) and CHIK virus (CHIKV). In areas where both viruses cocirculate, they can be transmitted together. There are very few studies discussing the dengue-chik coinfection from Punjab region of India. The present study was undertaken to study the clinical features of dengue–CHIK coinfection and compare with monoinfection. MATERIALS AND METHODS: IgM antibody capture (MAC) ELISA for dengue IgM and CHIK IgM and ELISA for nonstructural protein 1 antigen was performed on serum samples obtained from suspected patients. RESULTS: Out of total 3160 samples from suspected patients for dengue infection, 2178 (68.92%) samples were positive for DENV while CHIK IgM antibodies were positive in 127 patients out of the total suspected 373 cases (34.04%). In addition to this, 283 samples were tested for both viruses, out of which 27 sera were positive (9.54%) for coinfection of dengue and CHIK. The comparison of signs and symptoms showed that the coinfected patients had fever in all cases while rash was seen in only 30% cases. Arthralgia (79%) and thrombocytopenia (77%) was seen in significant number of coinfected cases thus revealing overlapping nature of dengue–CHIK coinfection. CONCLUSION: Increase in the number of Dengue and Chikungunya infections and their cocirculation is an important public health concern which warrants the implementation of strict control measures.
Collapse
Affiliation(s)
- Maninder Kaur
- Department of Microbiology, GMC, Amritsar, Punjab, India
| | | | | | - Pushpa Devi
- Department of Microbiology, GMC, Amritsar, Punjab, India
| | - Manpreet Kaur
- Virology Research and Diagnostic Laboratory, GMC, Amritsar, Punjab, India
| | - Sapna Soneja
- Department of Microbiology, GMC, Amritsar, Punjab, India
| | | |
Collapse
|
8
|
Sengupta S, Mukherjee S, Haldar SK, Bhattacharya N, Tripathi A. Re-emergence of Chikungunya virus infection in Eastern India. Braz J Microbiol 2020; 51:177-182. [PMID: 31898249 DOI: 10.1007/s42770-019-00212-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022] Open
Abstract
Chikungunya fever is a major public health issue in India. Re-emergence of chikungunya virus (CHIKV) in West Bengal was detected after 32 years in 2006. After 2010, this infection was in apparent decline, but in 2016 a massive outbreak affected the country. Present study was carried out to understand CHIKV infection dynamics during recent outbreaks in West Bengal, Eastern India and its implication on disease manifestations. Blood was collected from 641 symptomatic patients. Patients' sera were serologically diagnosed to detect presence of anti-chikungunya-IgM antibodies. Viral RNA was extracted; presence of CHIKV genome and its respective viral load was determined by real time quantitative reverse transcription-PCR (real-time qRT-PCR). Statistical analysis was performed using EPI INFO software. CHIKV infection was detected in 24.64% of symptomatic patients. Middle-aged patients (31-40 years) were predominantly affected; clinically, both arthralgia and joint-swelling were significantly prevalent among CHIKV-infected patients. Myalgia, joint-swelling, and arthralgic manifestation were found in significantly higher frequency among patients with high chikungunya viral load (> 10,000 copies/ml). Thus, this study clearly indicated the re-emergence of CHIKV in Eastern India. Significant presence of myalgia, joint swelling, and arthralgia among chikungunya patients with high viral load implied association of disease severity with viral load; requiring vigilance for proper management of infected patients as this disease is highly morbid in nature. However, in addition to chikungunya virus, other viral, bacterial, and protozoal infections also occur during post-monsoon season in India, having overlapping symptoms. Hence, continuous monitoring of these infections is required for better clinical management of patients.
Collapse
Affiliation(s)
- Siddhartha Sengupta
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, 700073, India
| | - Saikat Mukherjee
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, 700073, India
| | - Surja Kumar Haldar
- Department of Microbiology, Virus Unit, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, 700073, India
| | - Nemai Bhattacharya
- Department of Microbiology, Virus Unit, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, 700073, India
| | - Anusri Tripathi
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, 108, C. R. Avenue, Kolkata, West Bengal, 700073, India.
| |
Collapse
|
9
|
Contopoulos-Ioannidis D, Newman-Lindsay S, Chow C, LaBeaud AD. Mother-to-child transmission of Chikungunya virus: A systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12:e0006510. [PMID: 29897898 PMCID: PMC6075784 DOI: 10.1371/journal.pntd.0006510] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 08/03/2018] [Accepted: 05/08/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chikungunya virus (CHIKV) is an emerging arboviral infection with a global distribution and may cause fetal and neonatal infections after maternal CHIKV-infections during gestation. METHODOLOGY We performed a systematic review to evaluate the risk for: a) mother-to-child transmission (MTCT), b) antepartum fetal deaths (APFD), c) symptomatic neonatal disease, and d) neonatal deaths from maternal CHIKV-infections during gestation. We also recorded the neonatal clinical manifestations after such maternal infections (qualitative data synthesis). We searched PubMed (last search 3/2017) for articles, of any study design, with any of the above outcomes. We calculated the overall risk of MTCT, APFDs and risk of symptomatic neonatal disease by simple pooling. For endpoints with ≥5 events in more than one study, we also synthesized the data by random-effect-model (REM) meta-analysis. PRINCIPAL FINDINGS Among 563 identified articles, 13 articles from 8 cohorts were included in the quantitative data synthesis and 33 articles in the qualitative data synthesis. Most cohorts reported data only on symptomatic rather than on all neonatal infections. By extrapolation also of these data, the overall pooled-MTCT-risk across cohorts was at least 15.5% (206/1331), (12.6% by REMs). The pooled APFD-risk was 1.7% (20/1203); while the risk of CHIKV-confirmed-APFDs was 0.3% (3/1203). Overall, the pooled-risk of symptomatic neonatal disease was 15.3% (203/1331), (11.9% by REMs). The pooled risk of symptomatic disease was 50.0% (23/46) among intrapartum vs 0% (0/712) among antepartum/peripartum maternal infections. Infected newborns, from maternal infections during gestation were either asymptomatic or presented within their first week of life, but not at birth, with fever, irritability, hyperalgesia, diffuse limb edema, rashes and occasionally sepsis-like illness and meningoencephalitis. The pooled-risk of neonatal death was 0.6% (5/832) among maternal infections and 2.8% (5/182) among neonatal infections; long-term neurodevelopmental delays occurred in 50% of symptomatic neonatal infections. CONCLUSIONS/SIGNIFICANCE Published cohorts with data on the risk to the fetus and/or newborn from maternal CHIKV-infections during gestation were sparse compared to the number of recently reported CHIKV-infection outbreaks worldwide; however perinatal infections do occur, at high rates during intrapartum period, and can be related to neonatal death and long-term disabilities.
Collapse
Affiliation(s)
- Despina Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Shoshana Newman-Lindsay
- Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Camille Chow
- Department of Internal Medicine, St. Agnes Medical Center, Fresno, CA, United States of America
| | - A. Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, United States of America
| |
Collapse
|