4/17/2023 0 Comments French guideliner![]() Résumé Objectif : cet article a pour objectif d’évaluer l’effet de l’utilisation des outils de contrôle de gestion sur la performance des CTD en Afrique subsaharienne francophone. Thus, it is important to update our understanding of the immunopathogenesis of chikungunya infection, its clinical manifestations, the diagnosis, and the development of chikungunya vaccines. Additionally, there have been no chikungunya vaccines available to prevent the infection. However, the true burden of chikungunya disease is most likely to be underestimated, particularly in developing countries, due to the lack of standard diagnostic assays and clinical manifestations overlapping with those of other endemic viral infections in the regions. Several underlying factors have likely contributed to the recent re-emergence of chikungunya infection, including urbanization, human travel, viral adaptation to mosquito vectors, lack of effective control measures, and the spread of mosquito vectors to new regions. However, recent expansions and epidemics in the temperate regions have raised concerns about the future public health impact of chikungunya diseases. Chikungunya infection is more commonly identified in tropical and subtropical regions. In some patients, acute chikungunya virus infection progresses to severe and chronic arthralgia that persists for years. Future studies are needed to accomplish the identification of accurate and early biomarkers of poor clinical prognosis, which would allow better understanding of the disease’s evolution and improve patients’ management, modifying CHIKF burden on global public health.Ĭhikungunya virus, the causative agent of chikungunya fever, is generally characterized by the sudden onset of symptoms, including fever, rash, myalgia, and headache. Symptomatic sub-acute disease is a relevant predictor of evolution to chronic arthritis with synovitis, drawing attention to joint pain, edema, multiple articular involvement including small hand and feet joints as risk factors for chronification beyond three months, especially in women. This cohort has provided important insights into the prognostic evaluation of CHIKF. The most common indings were synovitis (65.5%) and joint effusion (58.6%). Twenty-nine pCHIKV-CIJD patients had abnormal articular ultrasonography (90.6% of the examined). Furthermore, patients with no findings in physical examination at D21 were at lower risk of chronic evolution (RR = 0.41, 95% CI = 0.24–0.70, FDR = 0.01). None of the symptoms or signs presented at D0 behaved as an early predictor of pCHIKV-CIJD, while being symptomatic at D21 was a risk factor for chronification (RR = 1.31 95% CI = 1.09–1.55 FDR = 0.03). The relative risk of chronification was higher in women compared to men (RR = 1.52 95% CI = 1.15–1.99 FDR = 0.03). Of 169 patients with CHIKF, 86 (50.9%) completed the follow-up, from whom 39 met clinical criteria for pCHIKV-CIJD (45.3%). We studied a prospective cohort of CHIKF-confirmed volunteers with longitudinal clinical data collection from symptoms onset up to 90 days, including a 21-day visit (D21). We aimed to identify early clinical markers of evolution to pCHIKV-CIJD during acute and post-acute phases. ![]() Chronic cases correspond to 25–40% individuals and, though most of them are characterized by long-lasting arthralgia alone, many of them exhibit persistent or recurrent inflammatory signs that define post-Chikungunya chronic inflammatory joint disease (pCHIKV-CIJD). ![]() It is clinically divided into three phases: acute, post-acute and chronic. Chikungunya-fever (CHIKF) remains a public health major issue. ![]()
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