Clinical profile and factors associated with hospitalization during a Chikungunya epidemic in Ceará, Brazil

Pinto, José Reginaldo; Silva Junior, Geraldo Bezerra da; Mota, Rosa Maria Salani; Martins, Pollyana; Santos, Artur Keyler Teixeira; Moura, Dean Carlos Nascimento de; Pires Neto, Roberto da Justa; Daher, Elizabeth De Francesco

doi:10.1590/0037-8682-0167-2019

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Revista da Sociedade Brasileira de Medicina Tropical

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Short Communication • Rev. Soc. Bras. Med. Trop. 52 • 2019 • https://doi.org/10.1590/0037-8682-0167-2019 copy

Clinical profile and factors associated with hospitalization during a Chikungunya epidemic in Ceará, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

The aim of this study was to characterize the clinical-epidemiological profile of Chikungunya virus infection and the factors associated with hospitalization during the peak of the most recent epidemic period in Brazil (2016-2017).

METHODS

Two official databases of the State Health Secretariat of Ceará were used, and a total of 182,731 notifications were analyzed.

RESULTS

Independent factors associated with hospital admission were chronic kidney disease (OR 4.56, 95% CI 3.36-6.17), hypertension (OR 1.90, 95% CI 1.69-2.14), leukopenia (OR 1.89, 95% CI 1.56-2.30) and diabetes mellitus (OR 1.70, 95% CI 1.44-1.99).

CONCLUSIONS

The pre-existing comorbidities have shown the potential to destabilize the patients' clinical status.

Keywords:
Chikungunya; Arboviruses; Comorbidities; Hospitalization; Epidemics

Sociodemographic variable	Hospital admission*	Non-Hospital admission	p
Sociodemographic variable		(n=3,080)	(n=91,586)
Age
≥60 years	726 (25.6%)	14,316 (15.8%)	<0.0001
< 60 years	2,105 (74.4%)	76,056 (84.2%)	<0.0001
Sex
Male	1,240 (40.3%)	34,366 (37.5%)	0.002
Female	1,838 (59.7%)	57,193 (62.5%)	0.002
Level of schooling
1^st to 4^th year of Elementary School	249 (21.4%)	5,260 (17.0%)	<0.0001
5^th to 8^th year of Elementary School	273 (23.5%)	6,743 (21.8%)
Complete Elementary School	257 (22.1%)	8,114 (26.2%)
Complete High School	284 (24.4%)	7,884 (25.5%)
College/University	101 (8.7%)	2,969 (9.6%)

Clinical manifestation	Hospital admission*	Non-Hospital admission	p value
	(n=3,080)	(n=91,586)
Fever	2,802 (91.0%)	84,187 (91.9%)	0.05
Myalgia	2,056 (66.8%)	63,355 (69.2%)	0.004
Headache	1,975 (64.1%)	68,393 (74.7%)	<0.0001
Exanthema	1,133 (36.8%)	28,712 (31.3%)	<0.0001
Vomiting	897 (29.1%)	17,246 (18.8%)	<0.0001
Nausea	1,081 (35.1%)	29,925 (32.7%)	0.005
Back pain	1,124 (36.5%)	34,421 (37.6%)	0.22
Conjunctivitis	192 (6.2%)	5,157 (5,6%)	0.15
Arthritis	849 (27.6%)	21,448 (23.4%)	<0.0001
Severe artralgia	1,885 (61.2%)	65,859 (71.9%)	<0.0001
Petechiae	422 (13.7%)	7,546 (8.2%)	<0.0001
Leukopenia	126 (4.1%)	1,548 (1.7%)	<0.0001
Positive tourniquet test	50 (1.6%)	1,113 (1.2%)	0.04
Retro-orbital pain	542 (17.6%)	14,351 (15.7%)	0.004

Comorbidity	Hospital admission*	Non-Hospital admission	p
	(n=3,080)	(n=91,586)
Diabetes mellitus	238 (7.7%)	2,783 (3.0%)	<0.0001
Hematological diseases	21 (0.7%)	402 (0.4%)	0.05
Liver diseases	25 (0.8%)	428 (0.5%)	0.01
Chronic kidney disease	67 (2.2%)	364 (0.4%)	<0.0001
Systemic arterial hypertension	477 (15.5%)	6,619 (7.2%)	<0.0001
Peptic ulcer disease	29 (0.9%)	515 (0.6%)	0.007
Autoimmune diseases	27 (0.9%)	393 (0.4%)	0.001
Death	269 (10.2%)	68 (0.1%)	<0.0001

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[1] Corresponding author: Dr. Geraldo Bezerra da Silva Junior. e-mail:geraldobezerrajr@unifor.br