ISSN: 2578-5001
Authors: Hassan MM, Jhora ST, Ahmed M, Hayatun Nabi M, Huq N, Rahman S, Sarker K, Arafat SMG, Ahmad H, Islam MM, Ahamed R
Background: Chikungunya virus (CHIKV) transmits to humans by infected mosquitoes of Aedes Aegypti and Aedes Albopictus that has been emerged as a serious public health threat globally. In 2017, Dhaka city of Bangladesh experienced an explosive outbreak of chikungunya, an arthropod-borne virus resulting in more than 13,800 clinically confirmed cases. This paper focuses on the pattern of massive outbreak of chikungunya in Dhaka City as well as the association between different entomological indicators and chikungunya infection. Methods: The relevant patient information was principally collected from the Institute of Epidemiology, Disease Control and Research (IEDCR) and Dhaka Medical College and Hospital (DMCH), and entomological surveillance data from the Communicable Disease Control (CDC) of Directorate General of Health Services (DGHS) in Dhaka. In addition, surveys were conducted in localities where an outbreak of CHIKV had occurred. A total of 2708 households were visited and a total of 4767 habitats were characterized. Face-to- face interview process was also employed from 436 confirmed patients. The regression analysis, Odds Ratio (OR), and Relative Risk (RR) were used to analyse the risk factors of entomological indicators in making connotation with chikungunya infection. Spatial mapping with proportional symbology and geostatistics were also employed. Results: The overall chikungunya outbreak in 2017 for Dhaka city shows that about 137 per 100,000 population were infected with CHIKV with the average prevalence rate of 1.11±0.65% (95% CI of 0.97- 1.25). Some 97.3% patients had high-grade fever with an average maximum temperature of 103.9±0.78°F, 88.3% patients declared for deep and sharp myalgia, and almost all the patients (98.6%) reported severe arthralgia in different joints. In addition, the average odds of confirmed chikungunya patients in households were found to be 2.43 times (OR: 2.24-2.70 with 95% CI and P <0.001) and the relative risk was calculated for 2.07 (RR: 1.91-2.24 with 95% CI and P <0.001) times compared to the infections in negative households in Dhaka City. Moreover, the entomological information shows that out of 4767 habitats, some 12.96% were positive for Aedes Aegypti larvae and pupae, and positive correlations were found between different entomological indices and chikungunya infections. Conclusion: Since there is no curative treatment for chikungunya, a proper policy including patient management and Behaviour Change Communication (BCC) as well as strong surveillance strategies should be formulated for the prevention of chikungunya infection as well as to lessen the incidence of mosquito vectors.
Keywords: Chikungunya; Arbovirus; Arthralgia; Myalgia; Aedes Aegypti; Aedes Albopictus; Bangladesh
