Lessons learned of emerging Chikungunya virus in two populations of social vulnerability of the Colombian tropics: epidemiological analysis

Abstract

BackgroundNotwithstanding the strong epidemiological impact of the Chikungunya in the Colombian Caribbean, in 2014, not the entire population were affected in the same way. This study describe the demographic, socio-economic, clinical and epidemiological aspects of the de Chikungunya in Ovejas and Corozal, two neighboring municipalities with high vulnerability in health in the Colombian Caribbean.MethodsA cross-sectional study was performed in February 2015. A convenience sampling was carried out in 971 families affected with chikungunya. Also, a socio-demographics, clinical and epidemiological questionnaire was carried out for people who met the definition of suspected Chikungunya clinical case. For the statistical analysis, data and variables, frequencies, proportions and means were compared in the two municipalities studied. A logistic regression model was constructed to explain the effect of factors studied on the risk of family infection (RFI) or likelihood of contagion within each household. Was used the software EpiInfo 7.2.2.2 and a significance level with p-value < 0.05.ResultsIn Ovejas, 516 households were affected by Chikungunya, 48% (1269/2631) of their inhabitants became sick; in Corozal, 455 families were affected and 42% (839/1999) of their members became sick. The evolution of the epidemic curves of Chikungunya outbreak was different in the two studied areas, the disease was more aggressive in Ovejas. Ten variables were pre-selected by univariate analysis to explain the RFI by Chikungunya, and were integrated into a logistic regression model. The final model was constructed with the following variables: municipality, gender, occupation, family income, use of repellent and fumigation. The logistic model was assessed as appropriate; however, the biases in the selection of the surveyed dwellings and in the selection of symptomatic patients could influence the results.ConclusionsIt was demonstrated the epidemiological complexity of Chikungunya and the serious problem caused in populations with high vulnerability in health. The accurate association observed in the logistic regression model suggests the role of the factors studied as determinant in the rate of infection of the Chikungunya; coverage problems and surveillance in health care, demographic aspect, socio-economic problems and lack of preventive measures could explains the risk of family infection by Chikungunya in some areas tropics of Colombia.Trial registrationnumber approval 007–2016 ethics committee-IIBT.

Dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean: a systematic review

“…Low socioeconomic status was associated with the presence of CHIKV ( 22 ) and DENV ( 23 ). However, high socioeconomic status was associated with ZIKV in one study ( 24 ).…”

Reconociendo el virus del chikunguña

“…El subregistro de casos ha sido confirmado en varias regiones del país: en Girardot, departamento de Cundinamarca, por ejemplo, se notificaron 8.788 casos de CHIKV entre noviembre del 2014 y mayo del 2015; sin embargo, mediante la búsqueda activa de información en la comunidad y en cuatro instituciones de salud, se estimó un subregistro del 87 %. En otras poblaciones del Caribe colombiano, como Ovejas y Corozal, departamento de Sucre, el subregistro se calculó en 48,4 y 54,2 %, respectivamente (96).…”

Correlation of the basic reproduction number (R0) and eco-environmental variables in Colombian municipalities with chikungunya outbreaks during 2014-2016

“…CHIKV emerged in Colombia in 2014, where the population was generally naïve. The subsequent Colombian epidemic of CHIKV accounts for approximately 49.15% of cases in Latin America as reported by the Pan American Health Organization (PAHO) [3].…”