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1. Clinical and Laboratory Characteristics of an Acute Chikungunya Outbreak in Bangladesh in 2017

Author

Hossain Ma, Hassan Mm, Abu Bakar Siddique, M. Moniruzzaman, Mallik Mu, M. R. Hasan, Uddin N, Mizanur Rahman, Been Sayed Sj, Kabir Akmh, and Fazle Rabbi Chowdhury

Subjects
Adult, Male, medicine.medical_specialty, Myocarditis, 030231 tropical medicine, Comorbidity, Antibodies, Viral, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Virology, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Maculopapular rash, medicine, Humans, Chikungunya, Bangladesh, Leukopenia, business.industry, Headache, Outbreak, Articles, Middle Aged, medicine.disease, Arthralgia, Survival Analysis, Thrombocytopenia, Infectious Diseases, medicine.anatomical_structure, Immunoglobulin M, Immunoglobulin G, Acute Disease, Hypertension, Chikungunya Fever, Female, Parasitology, Drug Eruptions, medicine.symptom, Ankle, business, Chikungunya virus
Abstract

From April to September 2017, Bangladesh experienced a huge outbreak of acute Chikungunya virus infection in Dhaka. This series describes the clinical and laboratory features of a large number of cases (690; 399 confirmed and 291 probable) suffered during that period. This observational study was carried out at Dhaka Medical College Hospital, Bangladesh. The median age of the patients at presentation was 38 years (IQR 30–50) with a male (57.3%) predominance. Hypertension and diabetes were the most common comorbidities. The mean (±SD) duration of fever was 3.7 (±1.4) days. Other common manifestations were arthralgia (99.2%), maculopapular rash (50.2%), morning stiffness (49.7%), joint swelling (48.5%), and headache (37.6%). Cases were confirmed by anti-chikungunya IgG (173; 43.3%), IgM (165; 42.3%), and reverse transcription polymerase chain reaction (44; 11.0%). Important laboratory findings include high erythrocyte sedimentation rate (156; 22.6%), raised serum glutamic pyruvic transaminase (73; 10.5%), random blood sugar (54; 7.8%), leukopenia (72; 10.4%), thrombocytopenia (41; 5.9%), and others. The oligo-articular (453; 66.1%) variety of joint involvement was significantly more common compared with the poly-articular (237; 34.5%) variety. Commonly involved joints were the wrist (371; 54.1%), small joints of the hand (321; 46.8%), ankle (251; 36.6%), knee (240; 35.0%), and elbow (228; 33.2%). Eleven cases were found to be complicated with neurological involvement and two of them died. Another patient died due to myocarditis. Public health experts, clinicians, and policymakers could use the results of this study to construct the future strategy tackling chikungunya in Bangladesh and other epidemic countries.

Published
2019

2. Clinical and Laboratory Characteristics of an Acute Chikungunya Outbreak in Bangladesh in 2017.

Author

Rahman MM, Been Sayed SJ, Moniruzzaman M, Kabir AKMH, Mallik MU, Hasan MR, Siddique AB, Hossain MA, Uddin N, Hassan MM, and Chowdhury FR

Subjects
Acute Disease, Adult, Arthralgia epidemiology, Arthralgia mortality, Arthralgia physiopathology, Arthralgia virology, Bangladesh epidemiology, Chikungunya Fever mortality, Chikungunya Fever virology, Chikungunya virus genetics, Chikungunya virus isolation & purification, Comorbidity, Diabetes Mellitus epidemiology, Diabetes Mellitus mortality, Diabetes Mellitus physiopathology, Diabetes Mellitus virology, Drug Eruptions epidemiology, Drug Eruptions mortality, Drug Eruptions physiopathology, Drug Eruptions virology, Female, Headache epidemiology, Headache mortality, Headache physiopathology, Headache virology, Humans, Hypertension epidemiology, Hypertension mortality, Hypertension physiopathology, Hypertension virology, Immunoglobulin G blood, Immunoglobulin M blood, Leukopenia epidemiology, Leukopenia mortality, Leukopenia physiopathology, Leukopenia virology, Male, Middle Aged, Survival Analysis, Thrombocytopenia epidemiology, Thrombocytopenia mortality, Thrombocytopenia physiopathology, Thrombocytopenia virology, Antibodies, Viral blood, Chikungunya Fever epidemiology, Chikungunya Fever physiopathology, Chikungunya virus immunology, Disease Outbreaks
Abstract

From April to September 2017, Bangladesh experienced a huge outbreak of acute Chikungunya virus infection in Dhaka. This series describes the clinical and laboratory features of a large number of cases (690; 399 confirmed and 291 probable) suffered during that period. This observational study was carried out at Dhaka Medical College Hospital, Bangladesh. The median age of the patients at presentation was 38 years (IQR 30-50) with a male (57.3%) predominance. Hypertension and diabetes were the most common comorbidities. The mean (±SD) duration of fever was 3.7 (±1.4) days. Other common manifestations were arthralgia (99.2%), maculopapular rash (50.2%), morning stiffness (49.7%), joint swelling (48.5%), and headache (37.6%). Cases were confirmed by anti-chikungunya IgG (173; 43.3%), IgM (165; 42.3%), and reverse transcription polymerase chain reaction (44; 11.0%). Important laboratory findings include high erythrocyte sedimentation rate (156; 22.6%), raised serum glutamic pyruvic transaminase (73; 10.5%), random blood sugar (54; 7.8%), leukopenia (72; 10.4%), thrombocytopenia (41; 5.9%), and others. The oligo-articular (453; 66.1%) variety of joint involvement was significantly more common compared with the poly-articular (237; 34.5%) variety. Commonly involved joints were the wrist (371; 54.1%), small joints of the hand (321; 46.8%), ankle (251; 36.6%), knee (240; 35.0%), and elbow (228; 33.2%). Eleven cases were found to be complicated with neurological involvement and two of them died. Another patient died due to myocarditis. Public health experts, clinicians, and policymakers could use the results of this study to construct the future strategy tackling chikungunya in Bangladesh and other epidemic countries.

Published
2019
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