Clinical Diagnosis of Chikungunya Infection: An Essential Aid in a Primary Care Setting Where Serological Confirmation Is Not Available

Juan C. Rueda, Ingris Peláez-Ballestas, Jose Ignacio Angarita, Ana M. Santos, Carlos Pinzon, Eugenia Lucia Saldarriaga, Jorge M. Rueda, Elias Forero, Diego L. Saaibi, Paula X. Pavía, Marta Juliana Mantilla, Gustavo Rodríguez-Salas, Juan Camilo Santacruz, Igor Rueda, Mario H. Cardiel, John Londono

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Chikungunya virus (CHIKV) diagnosis has become a challenge for primary care physicians in areas where the Zika virus and/or Dengue virus are present. Case definitions for the three arboviral infections overlap. Methods: A cross-sectional analysis was carried out. A bivariate analysis was made using confirmed CHIKV infection as the outcome. Variables with significant statistical association were included in an agreement consensus. Agreed variables were analyzed in a multiple regression model. The area under the receiver operating characteristic (ROC) curve was calculated to determine a cut-off value and performance. Results: 295 patients with confirmed CHIKV infection were included. A screening tool was created using symmetric arthritis (4 points), fatigue (3 points), rash (2 points), and ankle joint pain (1 point). The ROC curve identified a cut-off value, and a score ≥ 5.5 was considered positive for identifying CHIKV patients with a sensibility of 64.4% and a specificity of 87.4%, positive predictive value of 85.5%, negative predictive value of 67.7%, area under the curve of 0.72, and an accuracy of 75%. Conclusion: We developed a screening tool for CHIKV diagnosis using only clinical symptoms as well as proposed an algorithm to aid the primary care physician.

Original languageEnglish
Article number213
JournalTropical Medicine and Infectious Disease
Volume8
Issue number4
DOIs
StatePublished - 3 Apr 2023

Keywords

  • Chikungunya virus
  • Colombia
  • arbovirus infections
  • clinical decision making
  • diagnosis

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