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Joint Bone Spine
Volume 85, n° 6
pages 669-678 (décembre 2018)
Doi : 10.1016/j.jbspin.2018.03.019
accepted : 21 Mars 2018
Recommendations and metaanalyses

Incidence of articular pain and arthritis after chikungunya fever in the Americas: A systematic review of the literature and meta-analysis

Fernando Edington , Douglas Varjão, Paulo Melo
 Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Rodovia Jorge Amado, Km 16, Bairro Salobrinho, CEP 45662-900, Ilhéus-Bahia, Brazil 

Corresponding author.

52% of the patients afflicted with chikungunya fever, may persist with chronic articular pain or arthritis after acute infection.
Almost half of the studies assessed in this systematic review were considered of low methodological quality.
The main limitations of the included studies were lack of control groups and small sample sizes.

The full text of this article is available in PDF format.

To estimate the incidence of chronic articular symptoms after chikungunya virus infection of patients from the American continent.


We performed a systematic review of the literature using the MEDLINE, Web of Science and Scopus databases. We included only cohort studies conducted in the American continent reporting the incidence of chronic articular symptoms after chikungunya virus acute infection. The quality of the selected studies was evaluated through the Newcastle-Ottawa Scale for non-randomized studies and relevant data were extracted. The pooled incidence of post-chikungunya chronic symptoms was estimated using a random-effect model meta-analysis. Heterogeneity was assessed by Q of Cochrane and its P -value, Tau2 and I2. Subgroup analysis was performed, and studies were stratified by quality, sample size, region, country, period of follow-up and study design.


Up to February 24, 2018, a total of 1115 potentially relevant studies were identified through our search strategy. After exclusion of 226 duplicates and 845 irrelevant studies, we retrieved 41 articles for full-text appreciation, from which 18 studies met our inclusion criteria and were included in this systematic review. Our meta-analysis suggests that 52% of the patients infected with the chikungunya virus will present chronic articular symptoms, although a high heterogeneity between studies was also found (I2 = 94%).


Fifty-two percent of chikungunya infected patients in the American continent are expected to develop the chronic stage of the disease. Chikungunya fever needs to be dealt as a major world health problem.

The full text of this article is available in PDF format.

Keywords : Chikungunya virus, Chikungunya fever, Virus arthritis, Post-infectious arthritis

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