Background Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that circulates predominantly in tropical and subtropical regions, potentially affecting over 1 billion people.
Objectives Fatigue is a major concern in individuals where CHIKV results severe chronic arthralgia and/or arthritis lasting months to years. However, in order to treat fatigue adequately, its sources need to be identified.
Methods All participants had physician-diagnosed CHIKV arthralgia. Data regarding self-reported sleep quality, depression, physical activity, disease activity, muscle strength, functional limitations, and body composition were collected during a single home visit (number of participants=117). Information on demographics, medications, alcohol intake and smoking was collected. The Fatigue Severity Inventory (FSI; measuring average fatigue over the past 7 days) was used as the primary outcome. Analyses were conducted to evaluate bivariate relationships with fatigue and correlations among risk factors. Multivariate analyses identified independent predictors of fatigue.
Results The mean age was 48±16 years, the mean disease duration was 7±6 years, and 71% (M:33, F:84) of subjects were female. The mean FSI rating was 4.1±2.0 (range 0–10). In multivariate analyses, self-reported disease activity, poor sleep, depression, and obesity were independently associated with fatigue. Physical inactivity was correlated with poor sleep, depression, and obesity. Mediation analyses indicated that physical inactivity had an indirect association with fatigue, mediated by poor sleep, depression, and obesity.
Conclusions This cross-sectional study suggests that fatigue may not be solely a result of CHIKV arthralgia, but may result from a constellation of factors that includes CHIKV arthralgia disease activity or pain, but also includes inactivity, depression, obesity, and poor sleep. The results suggest need of various interventions to improve fatigue in individuals with CHIKV arthritis, including increasing physical activity or addressing depression or obesity.
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Disclosure of Interest M. Bhama Consultant for: Orthopedics Consultant