Chikungunya no Rio Grande do Norte: aspectos epidemiológicos e clínicos

• Ano de defesa: 2022
• Autor(a) principal: Monteiro, Joelma Dantas
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE
• Palavras-chave em Português: Febre chikungunya; Epidemia; Brasil; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/53341

Originating in Africa and first isolated in 1952, the Chikungunya virus (CHIKV) belongs to the Togaviridae family, genus Alphavirus. It has a single-stranded RNA genome with positive polarity, two open reading units, surrounded by a capsid with icosahedral symmetry and a lipid envelope containing glycoprotein spikes. It is a group A arbovírus whose and has mosquitoes of the genus Aedes as its main vectors. CHIKV infection is an acute and self-limited febrile syndrome, in most cases, that affects people of all age groups, causing different symptoms that can last a few days or even years. This study aimed to describe the epidemiological, immunological and clinical aspects of chikungunya fever from the epidemic that occurred in 2016 in the state of Rio Grande do Norte. 284 samples of suspected cases of CHIKV infection were analyzed by using qRT-PCR, of which 125 cases were positive (44.4%). The highest number of positive cases occurred in the first quarter of the year, being March the most representative month, reaching 48 positive cases. The city of Natal had the highest number of confirmed cases. Women represented the highest (52%) frequency, of which 9.2% of them were pregnant. Positive neonates represented 5.6%.The mean age of positive cases was 34 years and the age group above 61 years was one of the most affected by CHIKV. Most positive cases were detected from serum samples (41.2%). The highest viral load occurred at the begining of the acute phase of the infection. CHIKV was detected in ten individuals 23 days after the onset of symptoms. CHIKV negative samples were also tested for DENV and ZIKV viruses using RT-PCR and qRT-PCR techniques, respectively. In addition, to investigate the possibility of flavivirus infection, a total of 120 suspected cases of CHIKV qRT-PCR negative were further tested for anti-Flavivirus and anti-Chikugunya IgM using the ELISA method of those, 57 sera (47.5%) were anti-Chikungunya IgM detectable. Among the anti-Chikungunya IgM negative sera, 21 (21.7%) were positive for anti-Flavivirus IgM and 54 presented IgM to both Chikungunya and Flavivirus simultaneously. Fever, arthralgia and conjunctivitis were the most common symptoms of which, the fever represented 91% of the cases. Skin blisters were a sign found in all seven newborns studied and positive for CHIKV. However, although four adults also presented that sign, only one was positive. These results aim to contribute and build up knowledge on the clinical and epidemiological characteristics of CHIKV transmission and assist the clinical diagnosis of the infection.