Feasibility of Chikungunya study being done locally

POSTED: 11/5/14 9:40 AM

St. Maarten—Two interns from Holland–Wietske Bouwman and Lisanne de Langen (RIVM’s students)– are currently on island assessing the feasibility of a long term complication study with regard to Chikungunya virus in St. Maarten.

Lisanne de Langen told Today in an invited comment that she and her colleague have been tasked with complementing the line list with missing data with regard to chikungunya patients;  interviewing general practitioners about their role in the procedure of chikungunya diagnosis; input about executing the long term complication study and additional missing data; performing a pilot study to test the method (questionnaire), which will be used in the future long term complication study.

De Langen explained that this is a prelude to a study that will be conducted here next year by experts. As part of their efforts the interns have contacted the local GPs to compile a patient list and they are currently in the process of making contact with these patients to ascertain whether they would be interested in participating in next years’ study.

To date there have been an estimated 400 persons affected locally with the Chikungunya virus. De Langen explained that the initial contact is being done over the phone and there have been a few challenges including a language barrier as some of the patients don’t speak English. Another challenge the team is currently facing is that many times persons are not home during the day. They are not discouraged however; instead, they have opted to call back the persons at a later hour who could not be contacted during the day.

“Chikungunya is an emerging problem with considerable disease burden in the Caribbean. Since the start of the epidemic in December 2013, 402 cases have been diagnosed in St. Maarten and that number is still increasing. Besides the acute symptoms, previous studies in other chikungunya endemic areas have identified frequent, long lasting, rheumatic disorders. Long term complications may result in a significant burden of disease for public health. Due to geographical and genetic differences, the clinical presentation of an infection may differ between regions.  Therefore to be able to estimate the impact of long-term complications in the Caribbean, a new investigation is needed and worth full,” de Langen explained.

Three sources of data with regard to chikungunya cases will be used to complement the line list. SLS (laboratory) together with the general practitioners will be approached to invite them for participation in complementing the line-list with new and/or missing data. SLS will be the first stakeholder by providing the basic data for each patient. General practitioners willing to participate will provide additional missing data to complement the line list. The line list available at the Collective Prevention Services also will be used as a back-up.

“To be able to estimate the feasibility of the long term complication study in the future, interviews will be held with the general practitioners. Their ideas and input about the different steps which need to be taken in the study (selection of cohort, approaching cohort, etc.), are of high importance. Furthermore, the general response rate of the GPs and their willingness to participate will be indicators in determining the feasibility of conducting the study. Finally, for testing the questionnaire which will be used in the long term study, GPs are asked to select a small sample of patients who had confirmed chikungunya (Cohort A) and patients without (Cohort B). The questionnaire will be tested in both cohorts.  By asking GPs assistance in selecting patients for cohort B, a comparable group is made and conclusions about chikungunya-related health problems will have more scientific value.”

The Chikungunya virus is caused by the bite from an infected mosquito.


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