Post-Chikungunya Joint Pain Sequelae: A Sudanese Single-Center Study

Abstract

Background: Chikungunya has recently been reported by the WHO to account for many cases in Sudan. The infection is extremely symptomatic,  with fever, skin rash, and incapacitating arthralgia, which can promote chronic arthritis and rheumatism in older patients. A few studies on chronic pain owing to the Chikungunya virus (CHIKV) infection have been issued. The aim of this study was to outline the laboratory findings and the physical symptom frequency of joint pain of the current Sudanese CHIKV outbreak, and evaluate its impact on the individual.
Methods: This cross–sectional study included 23 CHIKV-confirmed patients attending a Sudanese single private medical center between March and September 2019. The included patients were checked for rheumatoid factor (RF) value, C-reactive protein (CRP) titer, erythrocyte sedimentation rate (ESR) value, and uric acid (UA) level. Physical scrutiny was conducted and persistent symptoms were registered.
Results: The significant rheumatologic conditions were polyarthralgia 39.1%, polyarthritis 21.7%, arthralgia 17.4%, arthritis 13%, and osteoarthritis 8.8%. Swelling signs were noted in 21.9% of the patients. Joints implicated were knees 59.4%, wrists 56.3%, fingers 50%, shoulders 37.5%, feet 34.4%, ankles 31.3%, spine 18.8%, and elbow 9.4%. CRP, RF, and ESR were significantly increased in patients with persistent joints pain versus non-persistent joint pain patients (P = 0.000, 0.002, 0.008, respectively). Whereas the UA was insignificant (P = 0.920).
Conclusion: Knee joint pain remarks a significant dilemma post-CHIKV. It is noted that these remarks were linked with the risk of subsequently creating chronic sequelae. Polyarthralgia was the dominant inflammatory sequel post-Chikungunya infection.

Keywords: CHIKV, Arthritis, Arthralgia, Polyarthralgia, Polyarthritis, Sudan