Background & Aims

Chikungunya Fever is an arbovirus caused by the Chikungunya Virus, transmitted by the bite of an infected female mosquito of the genus Aedes. This pathology has a febrile characteristic, with conditions associated with intense pain and polyarthralgia that can persist in several joints. According to Bulletin 01/2023 from the Ministry of Health, 174,517 probable cases of Chikungunya were registered in Brazil. The Northeast region had the highest incidence with 257.4 cases/100 thousand inhabitants, it is important to highlight that Brejo Santo, Crato and Juazeiro do Norte in the state of Ceará are among the municipalities with the highest number of probable cases in this period (3,000) and 39 of the 94 deaths recorded in the country occurred in Ceará. Given the risks of seasonal epidemics in this region and the functional limitations resulting from this pathology, this study aimed to map the musculoskeletal sequelae of Chikungunya Fever in the municipality of Juazeiro do Norte-Ceará.

Methods

This is a cross-sectional, descriptive epidemiological research with a quantitative approach following the recommendations of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The population was made up of individuals with sequelae resulting from Chikungunya Fever, from the city of Juazeiro do Norte. Data were collected using a socioeconomic assessment form. To assess arthralgias, the Nordic Questionnaire of Musculoskeletal Symptoms (NQMS) was applied. To collect functional data, the Health Assessment Questionnaire (HAQ) was used. To grade each participant’s pain, the Brief Pain Inventory – Short Form (BPI-SF) was applied. The data obtained in the interviews were tabulated in an electronic spreadsheet. The data obtained in the interviews were tabulated in an electronic spreadsheet (Microsoft Office Excel®), to generate the results.

Results

The data reveal a female prevalence profile (67.6%). Arthralgia (70.6%) was the main complaint, followed by myalgia (26.4%). Regarding self-reported limitations in daily activities, 61.7% had difficulty waking up/getting up, 61.7% had difficulty moving around, 58.1% had difficulty reaching objects and 52.9% had difficulty performing household tasks (HQA score = 1, 34). Furthermore, 23.5% report feeling pain daily, 17.6% report feeling constant pain and 23.5% report feeling pain only every 6 months. The most affected joints were wrist/hand (20.5%), ankle (17.6%) and knee (14.7%). Regarding the intensity of joint pain, 61.8% reported some degree of pain in the last 24 hours, the average value of the worst pain in the last 24 hours was equal to 3.5. The least pain in the last 24 hours was equivalent to 1.3, reaching 58.8% of participants, with 67.6% reporting medium intensity pain, corresponding to 2.6. Additionally, 44.1% reported feeling pain at the time of the assessment.

Conclusions

The results demonstrated the predominance of women in the sample, aged between 20 and 64 years, highlighting the demographic influence of these factors on the prevalence of Chikungunya Fever. In the occupational context, most participants performed non-manual work, while the minority was involved in manual work. These data suggest potential implications for the daily and occupational activities of these individuals affected by Chikungunya Fever. In relation to musculoskeletal sequelae and functionality, the prevalence of myalgias and arthralgias in distal joints can be seen. Furthermore, most participants still felt significant pain even after a considerable time since diagnosis. Linked to this, the participants had difficulties in carrying out activities of daily living, such as locomotion and reaching objects.

References

ALMEIDA, Y. A. Relação da dor e limitações funcionais em pessoas na fase crônica da chikungunya. Disponível em: . Acesso em: 1 dez. 2023.

BADAWI, A.; RYOO, S. G.; VASILEVA, D.; YAGHOUBI, S. Prevalence of chronic comorbidities in chikungunya: A systematic review and meta-analysis. International Journal of Infectious Diseases, v. 67, p. 107-113, 2018.

BARRETO, M. L. Esboços para um cenário das condições de saúde da população brasileira 2022/2030. In FUNDAÇÃO OSWALDO CRUZ. A saúde no Brasil em 2030 – prospecção estratégica do sistema de saúde brasileiro: população e perfil sanitário [online]. Rio de Janeiro: Fiocruz/Ipea/Ministério da Saúde/Secretaria de Assuntos Estratégicos da Presidência da República, v. 2, p. 97-120, 2013.

BRASIL. Boletim Epidemiológico – nº 01. Ministério da Saúde. Brasil, 12 jan. 2023. Volume 54. Disponível em: https://www.gov.br/saude/pt-br/centrais-de conteudo/publicacoes/boletins/epidemiologicos/edicoes/2023/boletim-epidemiologico-volume-54-no-01/. Acesso em: 25 fev. 2023.

BRASIL. MINISTÉRIO DA SAÚDE. Chikungunya. In: Saude de A a Z. Brasil, [s.d.]. Disponível em: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/c/Chikungunya/. Acesso em: 20 fev. 2023.
CEARÁ. Boletim Epidemiológico nº 01. Secretaria de Saúde do Ceará, 03 mar. 2023. Disponível em: https://www.saude.ce.gov.br/download/boletins/. Acesso em: 02 abr. 2023.

COUTURIER, E. et al. Impaired quality of life after chikungunya virus infection: a 2-year follow-up study. Rheumatology (Oxford), v. 51, n. 7, p. 1315-1322, 2012.

DE-ARAUJO, B. H. J. M. et al. Clinical manifestations in patients with musculoskeletal pain post-chikungunya. BrJP. v. 2, n. 4, p. 326-330, 2019.

FUNDAÇÃO OSWALDO CRUZ. Chikungunya: sintomas, transmissão e prevenção. 2022. Disponível em: https://www.bio.fiocruz.br/index.php/br/Chikungunya-sintomas-transmissao-e-prevencao/. Acesso em: 18 abr. 2023.

GLAUBITZ, S. et al. Myalgia in myositis and myopathies. Best Pract Res Clin Rheumatol., v. 33, n. 3, p. 101433, jun. 2019.

IM, D. D. et al. Brief Pain Inventory–Short Form: A New Method for Assessing Pain in the Emergency Department. Pain Med., v. 21, n. 12, p. 3263–3269, 2020.

INGRIDE, L. et al. Perfil epidemiológico dos pacientes com evolução subaguda e crônica de infecção por Chikungunya Epidemiologic profile of patients with subacute and chronic Chikungunya infection evolution. Rev Soc Bras Clin Med, v. 16, n. 1, p. 13–20, 2018.

JAVELLE, E. et al. Specific Management of Post-Chikungunya Rheumatic Disorders: A Retrospective Study of 159 Cases in Reunion Island from 2006-2012. PLoS Negl Trop Dis, v. 9, n. 3, p. e0003603, 2015.

JEAN-BAPTISTE, E. et al. Chikungunya virus infection and diabetes mellitus: a double negative impact. Am J Trop Med Hyg, v. 95, n. 6, p. 1345, 2016.

LEMOS, J. F. et al. Prevalence, affected joints and intensity of the arthralgias in individuals in the chronic phase of Chikungunya fever. BrJP, v. 4, n. 2, 2021.

MASKA, L.; ANDERSON, J.; MICHAUD, K. Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment Questionnaire II (HAQ-II), Improved Health Assessment Questionnaire (Improved HAQ), and Rheumatoid Arthritis Quality of Life (RAQoL). Arthritis Care Res (Hoboken), v. 63, n. S11, p. S4–S13, 2011.

OLIVEIRA A. S.; SILVA, J. G. Efeito de um programa de tratamento fisioterapêutico em paciente com poliartralgia persistente pós-febre de Chikungunya: Relato de caso. Rev. dor, v. 18, n. 4, p. 370-373, 2017.

PINHEIRO, F. A.; TRÓCCOLIA, B. T.; CARVALHO, C. V. Validação do Questionário Nórdico de Sintomas Osteomusculares como medida de morbidade. Revista de Saúde Pública, São Paulo, v. 36, n. 3, p. 307-312, 2002.

YAMADA, E. F. et al. Efeito dos exercícios de fortalecimento, de marcha e de equilíbrio no tratamento de osteoartrite de joelho. Rev. bras. ciênc. mov., v. 26, n. 3, p. 5-13, 2018.

Presenting Author

Francisco Fábio Bezerra de Oliveira

Poster Authors

Francisco Fábio de Oliveira

PhD

Araripina Medical School/Faculdade Paraíso-Araripina

Lead Author

Hellen Karine Silva Alves

Paraíso University Center

Lead Author

Kairo Alves de Oliveira

Paraíso University Center

Lead Author

Maria Clara Silva Sousa

Paraíso University Center

Lead Author

Maria Misrelma Moura Bessa

Araripina Medical School/Faculdade Paraíso-Araripina

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Pain in Infectious Diseases