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Clinical and Epidemiological Follow-up of Patients with Arthralgia Post Probable Chikungunya Referred to a Rheumatology Clinic at a Tertiary Hospital in Trinidad and Tobago T


Objective: To describe the arthralgia post Chikungunya (ChikV) infection in patients referred to a rheumatology clinic at a tertiary hospital in Trinidad. 

Methods: Patients referred for arthralgia and prior probable ChikV-infection were surveyed. Probable ChikV-infection was defined as a clinically compatible case as reported by the patient or the healthcare provider, absence of a more likely explanation and a positive ChikV specific enzyme-linked immunosorbent assay (ELISA) for immunoglobulin (Ig) G. 

Results:  Fifty-two patients referred between October 2015 and May 2016 were recruited, 44 had a positive ELISA ChikV IgG and thus, were included in the analysis. The median recruitment date was 15.5 months post probable ChikV, with an interquartile range (IQR) of 4.5 months. Thirty-four (77.3%) were female, while 10 (22.7%) were male. Median age was 64 years with an IQR of 14.5 years. In the acute episode, 75.0% reported fever and 93.2% severe joint pain. The joints most affected were knees, 27.6%, shoulders, 18.4% and wrists, 15.7%. The involvement was bilateral, 70.6% more so than unilateral, 29.4%; 77.3% of patients felt that their symptoms negatively affected their daily activities, this was attributed to pain, 29.4% or pain and stiffness, 50.0%. 

Conclusion: These data show that patients referred to a rheumatology clinic for arthralgia post ChikV-infection, are likely to be females more than 45 years of age. The joints most involved are the knees, shoulders, wrists and ankles, in a symmetrical distribution. Patients with persistent arthralgia post ChikV perceive that these symptoms negatively affect their daily activities. 

June 15, 2018
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