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SAT0557 Chikungunya outbreak in brazil: demographic and clinical characterization of 732 patients – chikbrasil cohort
  1. AL Duarte1,
  2. CDL Marques1,
  3. PR Santos1,
  4. A Ranzolin2,
  5. NG Cavalcanti1,
  6. RS Gonçalves3,
  7. AT Dantas1,
  8. MS Luna1,
  9. CA Andrade1,
  10. LF Rocha Junior3,
  11. MR Freitas3,
  12. PR Melo1,
  13. LD Valadares4,
  14. CA da Fonte4,
  15. MLD Valadares4,
  16. E Freire5,
  17. AKG Melo5,
  18. MM Medeiros6,
  19. MC Bezerra6,
  20. VB Marques6,
  21. RA Océa7
  1. 1Internal Medicine, Universidade Federal de Pernambuco
  2. 2Rheumatology
  3. 3Internal Medicine, Instituto de Medicina Integral Prof. Fernando Figueira
  4. 4Rheumatology, Hospital Getulio Vargas, Recife
  5. 5Rheumatology, Universidade Federal da Paraíba, João Pessoa
  6. 6Rheumatology, Universidade Federal do Ceará, Fortaleza
  7. 7Rheumatology, Universidade Federal de Sergipe, Aracaju, Brazil

Abstract

Background Chikungunya Fever (CF) is a disease characterized by acute febrile arthritis and caused by a mosquito-transmitted alphavirus. Considering the wide distribution of the vector, the presence of imported cases from 2010 and Brazilian population's susceptibility, there was a dispersal and establishment of Chikungunya virus (CHIKV) throughout the country. Since 2014, the CF has achieved a large proportion of the Brazilian population and has been responsible for the development of chronic joint symptoms in thousands of people.

Objectives To describe the demographic, clinical and serological characteristics of patients from specialized Rheumatology services from northeastern Brazil, in a large, multicenter cohort.

Methods Data from 732 patients in a prospective, multicenter, observational cohort conducted in six research rheumatology centers were analyzed. Patients 18 years or older who fulfilled the clinical and epidemiological Health Ministry criteria for case definition of CF were included in the study, from April to December 2016.

Results From 732 patients included, 83.1% were women. The mean age was 54.1 (± 13.4) years; 92.4% lived in urban area and 58.6% had only primary education. The most common comorbidities were hypertension (43.8%), hyperlipidemia (25.3%) and diabetes mellitus (13.7%). Prior rheumatologic disease was observed in 16.4% patients, being the most frequent rheumatoid arthritis (32.5%), osteoarthritis (32.5%) and spondyloarthritis (11.7%). Arthralgia was the most frequent symptom referred by all patients; fever and fatigue were also common manifestations, being referred by 95.3% and 87.1% of patients, respectively. Arthritis occurred in 84.3%. The most frequent joint pattern involvement was polyarticular (67.8%) and the additive (84.0%). At the first appointment with the rheumatologist, 75.9% had been or were under corticosteroid use, with the average dose of 15.4 mg (±8.7) of prednisone or equivalent; was observed an median of 8 painfull joints (IQR 4–21) and arthritis was found in 73.6% patients, with an median of 2 swollen joints (IQR 0–5). The median score of patient global assessment at the time of the initial evaluation was 6 (IQR 4–8) using a 10 points visual analogue scale. After resting stiffness was referred by 86.0%, with 58.4% of these longer than 30 minutes. The most commonly prescribed medications were corticosteroids (58.3%) and hydroxychloroquine (59.1%). The serological tests for CHIKV were positive for IgM in 97.1% and for IgG in 71.7% of patients.

Conclusions This is the first descriptive study of a cohort Brazilian patients with CF, with an expressive number of patients when compared to those described in the literature. Most of the features of patients in our cohort were similar to the results described in studies/cohorts published.

Disclosure of Interest None declared

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