Burden of Illness (BOI) and Paucity of Treatment of the Mosquito-Borne Chikungunya Virus (CHIKV)

OBJECTIVES: Chikungunya virus (CHIKV) is a re-emerging arbovirus with infection characterized by an acute phase commonly presenting with fever, severe polyarthralgia, and myalgia, which can progress to chronic sequelae resulting in productivity losses and a significant reduction in health-related quality-of-life (HRQoL). To investigate the available evidence on the disease burden associated with CHIKV, we conducted a systematic literature review (SLR) of the clinical evidence and a targeted literature review (TLR) on the burden of CHIKV.

METHODS: The SLR of clinical evidence was conducted in Medline and Embase databases (no date restriction) and congress abstract repositories (2019–2021). The search adhered to Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A TLR of burden evidence was also performed.

RESULTS: Of 13,285 records identified, 246 studies were included in the SLR of which 17 (6.91%) were interventional studies. The TLR included 101 studies. The acute and chronic polyarthralgia and myalgia associated with CHIKV infection was found to cause substantial physical incapacity impacting the daily functioning and HRQoL of patients. In addition, mental health is significantly affected, with patients experiencing pain, mental, mood, and sleep disorders. CHIKV infection may lead to long-term disability due to neurocognitive and psychological sequelae associated with a reduction in HRQoL. Population shifts, increased travel, and climate change are contributing to the increased spread of emerging and re-emerging CHIKV infections, yet effective preventive measures or treatments are lacking.

CONCLUSIONS: CHIKV is a serious threat to global public health and causes significant disease burden worldwide. The tools available to prevent and treat CHIKV infection are limited; vector control measures are suboptimal and challenging, and only symptomatic treatment currently exists for chikungunya. Due to the unpredictable nature of CHIKV spread and lack of treatment options for chikungunya, there is an immediate need for effective preventive measures such as vaccines.