Pablo Monge, José Manuel Vega, Ana María Sapag1, Ilsa Moreno2, Rubén Montúfar3, Vianna Khoury4, Pablo Camilo5, Ruddy Rivera6, Juan C Rueda7, Daniel Jaramillo-Arroyave8, John Londoño9, María Del Carmen Ruiz10, Félix Fernández11, Maritza Quintero12, Yurilis Fuentes-Silva13, José Luis Aguilar14, Carlos Vallejo-Flores15, Carlo V Caballero-Uribe16, Hugo Sandoval17, Carlos Pineda17. 1. Hospital Universitario Japonés, Santa Cruz, Bolivia. 2. Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja de Seguro Social, Panamá, Panamá. 3. Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador. 4. Clínica Unión Médica, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, República Dominicana. 5. Clínica Corominas, Santiago, República Dominicana. 6. Centro Médico Militar, Guatemala, Guatemala. 7. Universidad de La Sabana, Chía, Cundinamarca. 8. Universidad CES-Universidad de Antioquia, IPS Universitaria, Medellín. 9. Universidad de La Sabana-Hospital Militar Central, Bogotá, Colombia. 10. Universidad de Carabobo, Sede Aragua, Maracay. 11. Clínica Razetti de Barquisimeto, Unidad de Reumatología, Barquisimeto. 12. Universidad de Los Andes, Unidad de Reumatología del Instituto Autónomo, Hospital Universitario de Los Andes, Mérida. 13. Unidad de Reumatología-Complejo Hospitalario Universitario Ruiz y Páez, Universidad de Oriente-Departamento de Medicina, Centro Clínico Universitario de Oriente, Bolívar, Venezuela. 14. Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Perú. 15. Pontificia Universidad Católica del Ecuador, Quito, Ecuador. 16. Unidad de Reumatología, Hospital Universidad del Norte, Barranquilla, Colombia. 17. División de Enfermedades Musculoesqueléticas y Reumáticas, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.
Abstract
BACKGROUND/ OBJECTIVE: Although mortality rates related with chikungunya (CHIK) outbreaks in Latin America's (LA's) dengue-endemic rural and new urban regions are low, dealing with symptoms and sequelae can both produce a significant burden of disease and diminish quality of life-from many months to years-after the acute phase of the infection, with a significant impact on public and individual health.The aim of this work was to establish Pan-American League of Associations for Rheumatology-Central American, Caribbean and Andean Rheumatology Association (ACCAR) consensus-conference endorsements and recommendations on the diagnosis and treatment of CHIK-related inflammatory arthropathies transmitted by Aedes aegypti and Aedes albopictus in LA. METHODS: Based on the Consensus Development Conference format, a panel of ACCAR rheumatologist voting members (n = 10) took part in this Pan-American League of Associations for Rheumatology initiative. Experts voted from a previous content analysis of the medical literature on CHIK, 4 subsequent topic conferences, and a workshop. Consensus represents the majority agreement (≥80%) achieved for each recommendation. RESULTS: The experts' panel reached 4 overarching principles: (1) CHIK virus (CHIKV) is a re-emergent virus transmitted by 2 species of mosquitoes: A. aegypti and A. albopictus; (2) CHIKV caused massive outbreaks in LA; (3) chronic CHIKV infection produces an inflammatory joint disease that, in some cases, can last for several months to years, and (4) currently, there are no vaccines or antivirals licensed for CHIKV infections. RECOMMENDATIONS: Pan-American League of Associations for Rheumatology-ACCAR achieved 13 endorsements and recommendations on CHIK categorized in 3 groups: (1) epidemiology and clinical manifestations, (2) diagnosis, and (3) treatment, representing the consensus agreement from the panel's members.
BACKGROUND/ OBJECTIVE: Although mortality rates related with chikungunya (CHIK) outbreaks in Latin America's (LA's) dengue-endemic rural and new urban regions are low, dealing with symptoms and sequelae can both produce a significant burden of disease and diminish quality of life-from many months to years-after the acute phase of the infection, with a significant impact on public and individual health.The aim of this work was to establish Pan-American League of Associations for Rheumatology-Central American, Caribbean and Andean Rheumatology Association (ACCAR) consensus-conference endorsements and recommendations on the diagnosis and treatment of CHIK-related inflammatory arthropathies transmitted by Aedes aegypti and Aedes albopictus in LA. METHODS: Based on the Consensus Development Conference format, a panel of ACCAR rheumatologist voting members (n = 10) took part in this Pan-American League of Associations for Rheumatology initiative. Experts voted from a previous content analysis of the medical literature on CHIK, 4 subsequent topic conferences, and a workshop. Consensus represents the majority agreement (≥80%) achieved for each recommendation. RESULTS: The experts' panel reached 4 overarching principles: (1) CHIK virus (CHIKV) is a re-emergent virus transmitted by 2 species of mosquitoes: A. aegypti and A. albopictus; (2) CHIKV caused massive outbreaks in LA; (3) chronic CHIKV infection produces an inflammatory joint disease that, in some cases, can last for several months to years, and (4) currently, there are no vaccines or antivirals licensed for CHIKV infections. RECOMMENDATIONS: Pan-American League of Associations for Rheumatology-ACCAR achieved 13 endorsements and recommendations on CHIK categorized in 3 groups: (1) epidemiology and clinical manifestations, (2) diagnosis, and (3) treatment, representing the consensus agreement from the panel's members.
Authors: Eika Webb; Melina Michelen; Ishmeala Rigby; Andrew Dagens; Dania Dahmash; Vincent Cheng; Reena Joseph; Samuel Lipworth; Eli Harriss; Erhui Cai; Robert Nartowski; Pande Putu Januraga; Keerti Gedela; Evi Sukmaningrum; Muge Cevik; Helen Groves; Peter Hart; Tom Fletcher; Lucille Blumberg; Peter W Horby; Shevin T Jacob; Louise Sigfrid Journal: EClinicalMedicine Date: 2022-09-28