ArticlePLoS neglected tropical diseases2024
Longitudinal analysis of post-acute chikungunya-associated arthralgia in children and adults: A prospective cohort study in Managua, Nicaragua (2014-2018).
Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Clinical outcomes of chikungunya across age groups: A systematic review.PLoS neglected tropical diseases · 2025Pooled it
- Chikungunya Virus in 2025: Epidemiology, Immunopathogenesis, and Vaccine Development - A Narrative Review.Infection and drug resistance · 2026Review
- Immune features and clinical characteristics of chikungunya fever in children: differences from adults and across pediatric age groups.Frontiers in pediatrics · 2026Review
- Chikungunya virus and other emerging arthritogenic alphaviruses.Nature reviews. Microbiology · 2025Review
- The possibly neglected victims: Re-examining the involvement of children in the chikungunya epidemic.Pediatric investigation · 2025Article
- Comparison of dengue, chikungunya, and Zika among children in Nicaragua across 18 years: a single-centre, prospective cohort study.The Lancet. Child & adolescent health · 2025Article
- Global burden of chikungunya virus infections and the potential benefit of vaccination campaigns.Nature medicine · 2025Article
- Chikungunya in a pediatric cohort: Asymptomatic infection, seroconversion, and chronicity rates.PLoS neglected tropical diseases · 2025Article
- Lack of pathogenic involvement of CCL4 and its receptor CCR5 in arthritogenic alphavirus disease.ImmunoHorizons · 2025Article
- Granulocyte colony-stimulating factor protects against acute systemic alphavirus disease in a type I IFN-dependent manner.Frontiers in immunology · 2025Article
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13 authors at 4 institutions in 2 countries.
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Abstract
Chikungunya can result in debilitating arthralgia, often presenting as acute, self-limited pain, but occasionally manifesting chronically. Little is known about differences in chikungunya-associated arthralgia comparing children to adults over time. To characterize long-term chikungunya-associated arthralgia, we recruited 770 patients (105 0-4 years old [y/o], 200 5-9 y/o, 307 10-15 y/o, and 158 16+ y/o) with symptomatic chikungunya virus infections in Managua, Nicaragua, during two consecutive chikungunya epidemics (2014-2015). Participants were assessed at ~15 days and 1, 3, 6, 12, and 18 months post-fever onset. Following clinical guidelines, we defined participants by their last reported instance of arthralgia as acute (≤10 days post-fever onset), interim (>10 and <90 days), or chronic (≥90 days) cases. We observed a high prevalence of arthralgia (80-95%) across all ages over the study period. Overall, the odds of acute arthralgia increased in an age-dependent manner, with the lowest odds of arthralgia in the 0-4 y/o group (odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.14-0.51) and the highest odds of arthralgia in the 16+ y/o participants (OR: 4.91, 95% CI: 1.42-30.95) relative to 10-15 y/o participants. Females had higher odds of acute arthralgia than males (OR: 1.63, 95% CI: 1.01-2.65) across all ages. We found that 23-36% of pediatric and 53% of adult participants reported an instance of post-acute arthralgia. Children exhibited the highest prevalence of post-acute polyarthralgia in their legs, followed by the hands and torso - a pattern not seen among adult participants. Further, we observed pediatric chikungunya presenting in two distinct phases: the acute phase and the subsequent interim/chronic phases. Thus, differences in the presentation of arthralgia were observed across age, sex, and disease phase in this longitudinal chikungunya cohort. Our results elucidate the long-term burden of chikungunya-associated arthralgia among pediatric and adult populations.
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