TY - JOUR
T1 - Chikungunya infection in Malaysia
T2 - Comparison with dengue infection in adults and predictors of persistent arthralgia
AU - Mohd Zim, M. A.
AU - Sam, I. C.
AU - Omar, S. F.Syed
AU - Chan, Y. F.
AU - AbuBakar, S.
AU - Kamarulzaman, A.
N1 - Funding Information:
This study was funded by University Malaya (High Impact Research Grant J-73565 ) and the European Union's Seventh Framework Programme (grant agreement no. 261202 ).
PY - 2013/2
Y1 - 2013/2
N2 - Background: Chikungunya virus (CHIKV) and dengue virus (DENV) co-circulate in areas endemic with the Aedes mosquito vectors. Both viruses cause similar illnesses which may be difficult to distinguish clinically. CHIKV is also associated with persistent arthralgia. Objectives: To compare and describe factors which differentiate between DENV and CHIKV infections on presentation; and to describe predictors of persistent arthralgia in CHIKV patients. Study design: Patients aged >14 years diagnosed with acute CHIKV and DENV infections in Kuala Lumpur, Malaysia were retrospectively identified. Clinical and laboratory data were obtained from medical records, and compared. CHIKV patients were telephoned 15-24 months later and interviewed about persistent symptoms. Logistic regression analysis was performed. Results: A total of 53 CHIKV and 113 DENV patients were included. CHIKV patients were older and more likely to be female. CHIKV was independently associated with arthralgia and rash, while DENV was associated with myalgia, raised aspartate transaminase, and leucopaenia. Forty CHIKV patients were followed up, with a median duration of self-reported arthralgia of 3 months (range, 0-24 months). Eighteen (45%) had persistent arthralgia beyond 4 months, for which age >40 years was an independent predictor. At 1 year, 9 (22.5%) patients had arthralgia. Conclusion: In Kuala Lumpur, selected clinical and laboratory predictors help to distinguish between DENV and CHIKV infections. Persistent arthralgia was a frequent sequel of CHIKV infection in this cohort.
AB - Background: Chikungunya virus (CHIKV) and dengue virus (DENV) co-circulate in areas endemic with the Aedes mosquito vectors. Both viruses cause similar illnesses which may be difficult to distinguish clinically. CHIKV is also associated with persistent arthralgia. Objectives: To compare and describe factors which differentiate between DENV and CHIKV infections on presentation; and to describe predictors of persistent arthralgia in CHIKV patients. Study design: Patients aged >14 years diagnosed with acute CHIKV and DENV infections in Kuala Lumpur, Malaysia were retrospectively identified. Clinical and laboratory data were obtained from medical records, and compared. CHIKV patients were telephoned 15-24 months later and interviewed about persistent symptoms. Logistic regression analysis was performed. Results: A total of 53 CHIKV and 113 DENV patients were included. CHIKV patients were older and more likely to be female. CHIKV was independently associated with arthralgia and rash, while DENV was associated with myalgia, raised aspartate transaminase, and leucopaenia. Forty CHIKV patients were followed up, with a median duration of self-reported arthralgia of 3 months (range, 0-24 months). Eighteen (45%) had persistent arthralgia beyond 4 months, for which age >40 years was an independent predictor. At 1 year, 9 (22.5%) patients had arthralgia. Conclusion: In Kuala Lumpur, selected clinical and laboratory predictors help to distinguish between DENV and CHIKV infections. Persistent arthralgia was a frequent sequel of CHIKV infection in this cohort.
KW - Arthralgia
KW - Chikungunya virus
KW - Dengue virus
KW - Differential diagnosis
KW - Malaysia
KW - Rash
UR - http://www.scopus.com/inward/record.url?scp=84872415495&partnerID=8YFLogxK
U2 - 10.1016/j.jcv.2012.10.019
DO - 10.1016/j.jcv.2012.10.019
M3 - Article
C2 - 23201456
AN - SCOPUS:84872415495
SN - 1386-6532
VL - 56
SP - 141
EP - 145
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
IS - 2
ER -
