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Prevalence of Post‐Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta‐Analysis

2016; Wiley; Volume: 68; Issue: 12 Linguagem: Inglês

10.1002/acr.22900

2151-4658

Alfonso J. Rodríguez‐Morales, Jaime A. Cardona‐Ospina, Sivia Fernanda Urbano‐Garzón, Juan Sebastian Hurtado‐Zapata,

Kawasaki Disease and Coronary Complications

Objective To determine the percentage of patients who would develop chronic inflammatory rheumatism (CIR) following chikungunya (CHIK) virus disease. Methods We conducted a systematic review of the literature in 3 databases (PubMed, Science Citation Index, and Scopus) to identify studies assessing the proportion of patients who progress to CHIK‐CIR. We performed a random‐effects model meta‐analysis to calculate the pooled prevalence and 95% confidence intervals (95% CIs). A 2‐tailed alpha level of 5% was used for hypothesis testing. Measures of heterogeneity, including Cochran's Q statistic, the I 2 index, and the tau‐squared test, were calculated and reported. Subgroup analyses were conducted by type of study and country, by studies evaluating chronic arthritis, and by studies with ≥200 patients and followup ≥18 months. Publication bias was assessed using a funnel‐plot. Results Up to June 15, 2015, our literature search yielded 578 citations. The pooled prevalence of CHIK‐CIR in 18 selected studies among 5,702 patients was 40.22% (95% CI 31.11–49.34; τ 2 = 0.0838). From studies derived from India, prevalence was 27.27% (95% CI 15.66–38.88; τ 2 = 0.0411), while from France, prevalence was 50.25% (95% CI 25.38–75.12; τ 2 = 0.1797). The prevalence of CHIK chronic arthritis was 13.66% (95% CI 9.31–18.00; τ 2 = 0.0060). Considering just those studies with ≥200 patients assessed, prevalence was 34.14% (95% CI 23.99–44.29; τ 2 = 0.0525). In studies with a followup ≥18 months, prevalence was 32.13% (95% CI 22.21–42.04; τ 2 = 0.0453). Conclusion According to our results in the most conservative scenario, approximately 25% of CHIK cases would develop CHIK‐CIR (34% if we just consider the most representative studies), and 14% would develop chronic arthritis.