Chronic Chikungunya arthralgia reduces functionality, quality of life and occupational performance: descriptive cross-sectional study

Cavalcante, Antonio Felipe Lopes; Okano, Alexandre Hideki; Micussi, Maria Tereza; Souza, Clécio Gabriel de; Passos, João Octávio Sales; Morya, Edgard; Freitas, Rodrigo Pegado de Abreu

doi:10.5935/2595-0118.20220047-en

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ORIGINAL ARTICLE • BrJP 5 (3) • Jul-Sep 2022 • https://doi.org/10.5935/2595-0118.20220047-en copy

Chronic Chikungunya arthralgia reduces functionality, quality of life and occupational performance: descriptive cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Chikungunya virus (CHIKV) chronic polyarthralgia deteriorates general functionality and work productivity. The objective of this study was to evaluate functionality, pain, quality of life, and sleep quality of individuals with chronic CHIKV arthralgia and correlate them with clinical symptoms, work productivity, and activity impairment.

METHODS:

This is a descriptive cross-sectional study with 61 chronic CHIKV arthralgia patients. Functionality was assessed using the Health Assessment Questionnaire (HAQ). Pain intensity and interference were measured by using the Visual Analog Scale (VAS) and the Brief Pain Inventory Short Form (BPI), respectively. Quality of life and sleep were evaluated using the Short Form 36 Health Survey (SF-36) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the effects of health in general symptoms on work.

RESULTS:

Low and moderate level of function was present in 39.4% and 55.7% of the sample, respectively. Moderate pain (5.57 ± 2.25), poor sleep quality (47.54%), and sleep disturbances (42.63%) were also observed. Pearson correlations showed significant correlation between absenteeism and presenteeism with HAQ scores (p = 0.03; r = 0.39 and p = 0.01; r = 0.43, respectively), BPI interference (p = 0.02; r = 0.41 and p = 0.001; r = 0.58, respectively) and SF-36 physical score (p = 0.007; r = -0.49 and p = 0.01; r = 0.58, respectively). Activity impairment showed a significant correlation with HAQ (p = 0.01; r = 0.44), BPI interference (p = 0.006; r = 0.5), SF-36 physical score (p = 0.01; r = -0.6) and SF-36 total score (p = 0.01; r = -0.44). Overall work productivity loss only correlated with BPI interference (p = 0.04; r = 0.37).

CONCLUSION:

These results suggest that CHIKV chronic arthralgia showed bilateral moderate pain in large joints that impacts activities of daily life, work productivity, and functional activity.

HIGHLIGHTS

Chronic chikungunya reduces functionality and causes moderate pain and poor sleep quality
Clinical symptoms impact daily living activity, work productivity, and activity impairment.
Functionality, pain, and sleep correlate with occupational performance.

Variables	CHIKV patients
Age (years)	47.26 ± 10.72
Time of CHIKV (years)	2.84 ± 0.90
Functionality (HAQ total)	1.15 ± 0.48
HAQ Classification (%)
Low	39.4
Moderate	55.7
High	4.9
Pain intensity (VAS)	5.57 ± 2.25
Pain severity (BPI)	20.36 ± 8.11
Pain interference (BPI)	39.05 ± 16.71
Quality of life (SF-36)
Physical status	38.78 ± 10.23
Mental status	43.70 ± 10.69
Total status	39.67 ± 9.60
Quality of sleep (PSQI, %)
Good	9.83
Poor	47.54
Sleep disturbance	42.63
Gender (%)
Female	77.42
Male	22.58
Marital Status (%)
Single	32.78
Married	50.82
Divorced	11.48
Widowed	4.92
Income* (%)
1 Minimum Wage	31.14
2 to 3 Minimum Wage	36.06
4 Minimum Wage or more	18.03
Unreported	14.77
Schooling (%)
Elementary	16.38
Secondary	39.34
University	39.34
Unreported	4.94

WPAI	Employed (n = 29)	Unemployed (n = 32)
	% (p25 – p75)	% (p25 – p75)
Absenteeism	0 (0 - 20.55)	N/A
Presenteeism	60 (35 - 70)	N/A
Overall work productivity loss	40 (23.14 - 60)	N/A
Activity impairment	70 (40 - 85)	55 (32.5 - 80)

Variables	Absenteeism		Presenteeism		Overall work productivity loss		Activity impairment
	r	p	r	p	r	p	r	p
Age (years)	0.1	0.30	-0.19	0.32	-0.49	0.007^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	-0.19	0.31
Time of CHIKV (years)	0.63	0.97	0.007	0.97	0.007	0.97	-0.10	0.62
Functionality (HAQ)	0.39	0.03^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.43	0.01^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.44	0.01^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.12	0.52
Pain intensity (VAS)	0.05	0.76	-0.03	0.85	-0.13	0.48	-0.24	0.19
Pain severity (BPI)	0.09	0.61	0.13	0.47	0.02	0.90	-0.07	0.71
Pain interference (BPI)	0.41	0.02^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.58	0.001^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.5	0.006^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.37	0.04^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.
Quality of life (SF-36 Physical)	-0.49	0.007^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	-0.46	0.01^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	-0.6	0.001^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	-0.27	0.14
Quality of life (SF-36 Mental)	-0.17	0.35	-0.16	0.4	-0.17	0.37	-0.28	0.13
Quality of life (SF-36 Total)	-0.27	0.15	-0.32	0.08	-0.44	0.01^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	-0.36	0.05
PSQI	0.05	0.76	0.17	0.19	0.27	0.03^* * Denote significant correlation. HAQ = Health Assessment Questionnaire; VAS = Visual Analog Scale; BPI = Brief Pain Inventory Short Form; SF-36 = Short Form 36 Health Survey, PSQI = Pittsburgh Sleep Quality Index.	0.2	0.28

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[1] Correspondence to: Antonio Felipe Lopes Cavalcante E-mail felip.lopessh@gmail.com