Clinical Spectrum, Quality of life and Disease Outcomes of Chikungunya Virus Infection: A Prospective Cohort Study from Bangladesh
Keywords:
Bangladesh, chikungunya infection, clinical spectrum, disease outcomes, EQ-5D-3L, quality of life (QoL)Abstract
Introduction
Clinical characteristics and quality of life (QoL) has been described but data on chikungunya chronicity in Bangladeshi population is limited. Therefore this study aims to demonstrate the clinical presentation and QoL during the acute stage of Chikungunya and also determine the proportion of patients developing chronic disease with risk factors associated with chronicity.
Methods
A prospective cohort study performed on 214 laboratory confirmed chikungunya patients over a period of 9 months at Popular Medical College Hospital, Dhaka. Clinical characteristics and QoL data were recorded. Patients were followed up after 3 months to assess outcomes.
Results
Joint pain (97.7%), fever (90.2%), joint swelling (57%), muscle pain (50.9%) and rash (42.5%) were predominant presentations. Frequently affected joints were ankle (83.2%), metacarpophalangeal (72.4%), proximal interphalangeal (72.4%), distal interphalangeal (68.2%) and wrist (55.1%). QoL was impaired with difficulty in usual activities (76.6%), mobility problems (74.3%), pain/discomfort (72%), self-care issues (68.7%) and anxiety/depression (42.5%). Fifty six (32.9%) patients developed chronic disease. Nausea/vomiting, joint swelling, metacarpophalangeal, wrist and knee joint involvement, mobility problems, anxiety/depression and low EQ-VAS score at disease onset were independent risk factors for chronic disease on univariate analysis. However, multivariate model demonstrated nausea/ vomiting (OR: 2.39, 95% CI: 1.13–5.04) and wrist affliction (OR: 3.41, 95% CI: 1.46–8.00) at acute stage as predictors for chronicity.
Conclusion
Fever and arthralgia, especially in the ankle and small hand joints, were the most common presentations, impairing QoL. One-third of the patients developed chronic infection with nausea/vomiting and wrist joint involvement at onset predicting chronicity.
Bangladesh J Medicine 2026; Vol. 37, No. 2(1): pp. 209-210.
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