Epidemiology and Economic Burden of Chikungunya: A Systematic Literature Review

Abstract

Chikungunya (CHIK) is a re-emerging viral infection endemic in tropical and subtropical areas. While the typical clinical presentation is an acute febrile syndrome, long-term articular complications and even death can occur. This review characterizes the global epidemiological and economic burden of chikungunya. The search included studies published from 2007 to 2022 in MEDLINE, Embase, LILACS, and SciELO for a thorough evaluation of the literature. Rayyan software was used for data analysis, and data were summarized descriptively and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventy-six publications were included. Chikungunya is widely distributed in the tropics, including Africa, Asia, South America, and Oceania/the Pacific Islands, and co-circulates with other simultaneous arboviruses such as DENV, ZIKV, and YFV. Chikungunya infection can lead to chronic articular manifestations with a significant impact on the quality of life in the long term. In addition, it generates absenteeism and economic and social losses and can cause fatal infections in vulnerable populations, mainly in high-risk patients with co-morbidities and at the extremes of age. Reported costs associated with CHIKV diseases are substantial and vary by region, age group, and public/private delivery of healthcare services. The chikungunya disease burden includes chronicity, severe infections, increased hospitalization risks, and associated mortality. The disease can impact the economy in several spheres, significantly affecting the health system and national economies. Understanding and measuring the full impact of this re-emerging disease is essential.

Detection of musculoskeletal inflammatory lesions in patients with chronic chikungunya infection using 3T whole-body magnetic resonance imaging

“…Pain has an important role in the course of CHIKV infection as it can cause disabilities, which is more significant in economically active patients, resulting in long-term absence from work and loss of quality of life 14 , 16 , 17 . Several case reports have described pain as moderate or severe in patients with CHIKV infection.…”

Factors associated with hospitalization in the acute phase of Chikungunya

“…In the present study, 19.5% of hospitalized patients in Vito ´ria had less than two years old, being three newborns, which partially explained the milder manifestations in hospitalized patients and contributed to the significantly younger age in hospitalized group compared with non-hospitalized. Young children present a higher risk of developing severe Chikungunya [5,8,13]. Newborns with the infection may have neurological complications, hemorrhage, cardiac involvement, and sequels affecting cognitive development [5].…”

In Silico Drug Repurposing Uncovered the Antiviral Potential of the Antiparasitic Drug Oxibendazole Against the Chikungunya Virus

“…12,14 The economic burden of this disease due to its debilitating nature and costs associated with hospitalization and diagnostics is also raising concerns in many countries. 15 Recently, the FDA has approved a CHIKV vaccine, 16 but there is still a lack of specific antivirals for the treatment of this disease, which highlights the need for new drugs. 17 Drug repurposing is a promising strategy for identifying new medical applications for approved and investigational drugs.…”

“…However, nearly 40% of patients evolve into the chronic phase and experience debilitating arthralgia or polyarthritis that persists for months to years after acute infection . Other severe complications can also occur, such as Guillain–Barré syndrome, encephalitis, retinitis, stroke, pneumonia, and liver and kidney failure. , The economic burden of this disease due to its debilitating nature and costs associated with hospitalization and diagnostics is also raising concerns in many countries . Recently, the FDA has approved a CHIKV vaccine, but there is still a lack of specific antivirals for the treatment of this disease, which highlights the need for new drugs …”