Factors Associated With Chronic Arthropathy And Rheumatological Diseases After Chikungunya Infection in Colombia: A Case-Control Study

Abstract

Abstract Objective To identify the factors associated with the development of chronic arthropathy and rheumatological conditions in individuals who presented with clinical chikungunya infection. Methods A case-control study was carried out among individuals with a clinical diagnosis of chikungunya treated at a Colombian Health Provider Institution between 2014 and 2015. Two logistic regression models were constructed: one excluding the variables with more than 50% of the missing data, and another with all the variables but with the imputed data. Results In total 133 cases and 216 controls were obtained (349 individuals). In both models, female gender was a risk factor (OR: 2.27, CI95: 1.03 - 4.97, p = 0.04, and OR: 2.37, CI95: 1.09 - 5.17, p = 0.029, respectively), while acute involvement of the wrists was a protective factor (OR: 0.44, CI95: 0.20 - 0.95, p < 0.037; and OR: 0.29, CI95: 0.13 - 0.65, p = 0.003 respectively). Arthralgia duration was a risk factor in the imputed data model (OR: 1.03, CI95: 1.00 - 1.06, p = 0.02). Conclusion Female gender and the duration of joint symptoms in the acute phase were the main risk factors for the development of chronic chikungunya arthropathy or rheumatological pathology. Wrist involvement was a protective factor. Only rheumatoid arthritis was found to be a rheumatological disease associated with chikungunya infections. Finally, this study suggests that the interaction between usual cardiovascular factors could enhance the probability of developing chronic symptoms.