Field evaluation of clinical features during chikungunya outbreak in Mayotte, 2005-2006
Autor(es): Sissoko Daouda, Ezzedine Khaled, Moend-zé Amrat, Giry Claude, Renault Philippe, Malvy Denis
Resumo: To record - assess the clinical features of chikungunya fever (CHIKF), with a view to enable diagnosis based on clinical criteria rather than costly laboratory procedures in field conditions. As part of a cross-sectional serologic survey conducted in Mayotte after a massive chikungunya outbreak in 2006, we collected data on clinical features of chikungunya infection - assessed the performance - accuracy of clinical case definition criteria combining different symptoms. Of 1154 participants included, 440 (38.1%) had chikungunya-specific IgM or IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Of symptomatic participants, 318 (72.3%) had confirmed chikungunya, the dominant symptoms reported were incapacitating polyarthralgia (98.7%), myalgia (93.1%), backache (86%), fever of abrupt onset (85%) - headache (81.4%). There was a strong linear association between symptomatic infection - age (chi(2) for trend = 9.85, P < 0.001). Only 52% of persons with presumptive chikungunya sought medical advice, principally at public primary health care facilities. The association of fever - polyarthralgia had a sensitivity of 84% (95% CI: 79-87) - a specificity of 89% (95% CI: 86-91). This association allowed to classify correctly 87% (95% CI: 85-89) of individuals with serologically confirmed chikungunya. Our results suggest that the pair fever - incapacitating polyarthralgia is an accurate - reliable tool for identifying presumptive CHIKF cases in the field. These criteria provide a useful evidence base to support operational syndromic surveillance in laboratory-confirmed chikungunya epidemic settings.
Imprenta: Tropical Medicine & International Health, v. 15, n. 5, p. 600-607, 2010
Identificador do objeto digital: 10.1111/j.1365-3156.2010.02485.x
Descritores: Chikungunya virus - Pathogenesis ; Chikungunya virus - Antibodies ; Chikungunya virus - Viral infections ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Epidemic ; Chikungunya virus - Epidemiology ; Chikungunya virus - Public health
Data de publicação: 2010
