Interns optimistic about Chikungunya study

POSTED: 11/19/14 9:07 PM

St. Maarten —To date 120 persons locally who have contracted the Chikungunya virus have been contacted and expressed their willingness to participate in the long term complication study that is likely to be conducted here next year by Dutch health experts.

Wiecske Bouwman, one of two Dutch interns who are on island conducting research to gauge the feasibility of the study, told Today that she and fellow RIVM student Lisanne de Langen are optimistic that the number of participants for the study will bump up to 200 by the end of the exercise. With the progress they have made she believes the study will be conducted on St. Maarten some time in 2015.

The two students have been tasked with complementing the line list with missing data as regards Chikungunya patients. This includes 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.

There have been an estimated 400 cases of Chikungunya diagnosed locally and Bouwman and de Langen have been working with local Gps to establish contacts with these persons. The task has proved tedious given that many of the persons are working and it is difficult to contact them during normal working hours. However the interns have by-passed this issue by simply calling persons after working hours. This has paid off to a significant degree.

Another hurdle the interns had to overcome was that in some cases they had to manually review the Gps files which meant going to the various offices for this purpose.

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 expected to increase. 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.

Interviews have been conducted by the interns with GPs to get their ideas and input about the different steps which should be taken in the selection of cohort and approaching cohort, etc. The interns used the general response rate of the GPs and their willingness to participate as indicators in determining the feasibility of conducting the study.

Bouwman explained that while they are on track with the “cohort A” (patients with Chikiungunya) questionnaire, they are not yet on track with “cohort B” (patients without Chikiungunya). They are now looking at new ways of getting around this issue and this may include making direct contact with the patients and not going through their GPs.

Both comparable groups are needed to lend more scientific value to conclusions formed during the study.

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