Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area

dc.creatorBatista, Raquel Pereira
dc.creatorHökerberg, Yara Hahr Marques
dc.creatorOliveira, Raquel de Vasconcellos Carvalhaes de
dc.creatorPassos, Sonia Regina Lambert
dc.date2023-03-18T02:07:10Z
dc.date2023-03-18T02:07:10Z
dc.date2023
dc.date.accessioned2023-09-26T21:55:05Z
dc.date.available2023-09-26T21:55:05Z
dc.identifierBATISTA, Raquel Pereira et al. Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area. Plos One, v. 18, n. 1, p. 1-13, Jan. 6, 2023.
dc.identifier1932-6203
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/57440
dc.identifier10.1371/journal.pone.0279970
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8874043
dc.descriptionThis study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001. URL: https://www.gov.br/capes/pt-br. YHMH was supported by Estácio de Sá University (Pesquisa Produtividade); SRLP was supported by Conselho Nacional de Desenvolvimento Cientifico e Tecnológico – CNPq (310765/2016-1). The funders had no role in study design, data collection and analysis or preparation of the manuscript.
dc.descriptionRio de Janeiro is a dengue-endemic city that experienced Zika and chikungunya epidemics between 2015 and 2019. Differential diagnosis is crucial for indicating adequate treatment and assessing prognosis and risk of death. This study aims to derive and validate a clinical rule for diagnosing chikungunya based on 3,214 suspected cases consecutively treated at primary and secondary health units of the sentinel surveillance system (up to 7 days from onset of symptoms) in Rio de Janeiro, Brazil. Of the total sample, 624 were chikungunya, 88 Zika, 51 dengue, and 2,451 were negative for all these arboviruses according to real-time polymerase chain reaction (RT-qPCR). The derived rule included fever (1 point), exanthema (1 point), myalgia (2 points), arthralgia or arthritis (2 points), and joint edema (2 points), providing an AUC (area under the receiver operator curve) = 0.695 (95% CI: 0.662-0.725). Scores of 4 points or more (validation sample) showed 74.3% sensitivity (69.0% - 79.2%) and 51.5% specificity (48.8% - 54.3%). Adding more symptoms improved the specificity at the expense of a lower sensitivity compared to definitions proposed by government agencies based on fever alone (European Center for Disease Control) or in combination with arthralgia (World Health Organization) or arthritis (Pan American Health Organization, Brazilian Ministry of Health). The proposed clinical rule offers a rapid, low-cost, easy-to-apply strategy to differentiate chikungunya fever from other arbovirus infections during epidemics.
dc.formatapplication/pdf
dc.languageeng
dc.publisherMDPI
dc.rightsopen access
dc.subjectChikungunya fever
dc.subjectChikungunya
dc.subjectChikungunya virus
dc.subjectZika virus
dc.subjectEpidemic
dc.subjectNeglected arbovirus infection
dc.titleDevelopment and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area
dc.typeArticle


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