Field evaluation of clinical features during chikungunya outbreak in Mayotte, 2005-2006
Field evaluation of clinical features during chikungunya outbreak in Mayotte, 2005-2006
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DOI：
10.1111/j.1365-3156.2010.02485.x
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发表时间：
2010-05-01
影响因子：
3.3
通讯作者：
Malvy, Denis
中科院分区：
文献类型：
--
作者：
Sissoko, Daouda;Ezzedine, Khaled;Malvy, Denis
为了记录和评估基孔肯雅热（CHIKF）的临床特征，以便能够基于临床标准而不是昂贵的实验室程序在现场条件下进行诊断。方法作为2006年大规模基孔肯雅热爆发后在马约特进行的横断面血清学调查的一部分，我们收集了基孔肯雅感染的临床特征数据，并结合不同症状评估了临床病例定义标准的性能和准确性。1154名参与者中，440名（38.1%）通过酶联免疫吸附试验（ELISA）检测出基孔肯雅特异性IgM或IgG抗体。在有症状的参与者中，318例（72.3%）确诊为基孔肯雅病，报告的主要症状是失能性多关节痛（98.7%）、肌痛（93.1%）、背痛（86%）、突然发热（85%）和头痛（81.4%）。有症状的感染与年龄之间有很强的线性相关性（趋势卡方= 9.85，P < 0.001）。只有52%的推定基孔肯雅病患者寻求医疗建议，主要是在公共初级卫生保健设施。发热与多关节痛相关性的敏感性为84%（95%CI：79-87），特异性为89%（95%CI：86-91）。这种关联允许正确分类87%（95%CI：85-89）的个人与血清学证实的chikungunya.ConclusionsOur研究结果表明，对发热和失能性多关节痛是一个准确和可靠的工具，用于确定推定CHIKF的情况下，在该领域。这些标准提供了一个有用的证据基础，以支持在实验室确认的基孔肯雅病流行环境中的业务症状监测。
P>BackgroundTo record and assess the clinical features of chikungunya fever (CHIKF), with a view to enable diagnosis based on clinical criteria rather than costly laboratory procedures in field conditions.MethodsAs part of a cross-sectional serologic survey conducted in Mayotte after a massive chikungunya outbreak in 2006, we collected data on clinical features of chikungunya infection and assessed the performance and accuracy of clinical case definition criteria combining different symptoms.ResultsOf 1154 participants included, 440 (38.1%) had chikungunya-specific IgM or IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Of symptomatic participants, 318 (72.3%) had confirmed chikungunya, the dominant symptoms reported were incapacitating polyarthralgia (98.7%), myalgia (93.1%), backache (86%), fever of abrupt onset (85%) and headache (81.4%). There was a strong linear association between symptomatic infection and age (chi 2 for trend = 9.85, P < 0.001). Only 52% of persons with presumptive chikungunya sought medical advice, principally at public primary health care facilities. The association of fever and polyarthralgia had a sensitivity of 84% (95% CI: 79-87) and a specificity of 89% (95% CI: 86-91). This association allowed to classify correctly 87% (95% CI: 85-89) of individuals with serologically confirmed chikungunya.ConclusionsOur results suggest that the pair fever and incapacitating polyarthralgia is an accurate and reliable tool for identifying presumptive CHIKF cases in the field. These criteria provide a useful evidence base to support operational syndromic surveillance in laboratory-confirmed chikungunya epidemic settings.