Neuropathic Pain Associated with Chikungunya: A Cross-Sectional Study

Background: Chikungunya is a tropical arboviral disease affecting millions of people around the world. It is characterized by fever and debilitating pain which frequently turns into chronic pain as a long-term complication of the infection. Neuropathic pain after acute infection lasting for months to years has been reported, but very few studies have evaluated this aspect of the disease. Hence, this study was aimed to evaluate neuropathic pain in post chikungunya infection. Methods: A six months long cross-sectional study was conducted in the pain clinic of a tertiary care hospital of Bangladesh. One hundred and thirty-six serologically confirmed patients of chikungunya suffering from chronic pain were enrolled and assessed by visual analogue scale (VAS) and Questionnaire Douleur Neuropathique 4 (DN4) to evaluate the pain intensity and presence of neuropathic component, respectively. Patients with causes of chronic pain other than chikungunya were excluded. All statistical tests were performed using SPSS version 23. Results: A total of 26 patients had post-chikungunya neuropathic pain accounting foran overall estimated prevalence of 19.1% (95% Confidence Interval [CI]: 12.5 – 25.7). The prevalence of male and female were 17.54% (95% CI: 7.67 – 27.42) and 20.25% (95% CI: 11.39 – 29.12), respectively. The mean intensity of chronic pain on the visual analogue scale was 5.54 ± 0.81 and the mean duration was 5.25±1.47 months. There were no significant differencs in intensity and duration of pain between patients with or without neuropathic pain (p > 0.05). The most common affected location was lower (96%) and upper limbs (91%) respectively and the most commonly affected joints were ankle/foot (80%), knee (76%), and hand/wrist (64%). Conclusion: A significant proportion of chronic pain patients develop neuropathic pain after acute chikungunya virus infection which requires particular attention during management.