Evaluating the impact of long-term chikungunya disease in Curaçao
Long-term chikungunya disease is predominantly characterized by persistent rheumatic symptoms, including severe joint pain, after infection with the re-emerging mosquito-borne chikungunya virus (CHIKV). The disease is an increasing public health concern worldwide.
Churnalisa Doran investigated the clinical manifestation of rheumatic symptoms and the currently underreported non-rheumatic symptoms following CHIKV infection, and the impact of long-term chikungunya disease over time among patients, in Curaçao. In her thesis, the objectives were approached using quantitative and qualitative research methods.
The thesis describes that both rheumatic and non-rheumatic symptoms may persist 6 years after CHIKV infection. It was found that the persistency of rheumatic symptoms severely impairs the physical, psychological and social well-being of affected patients. This thesis also describes the behaviour of patients including their coping strategies and health-care seeking, as there is currently no curative treatment or disease management guideline for long-term chikungunya disease available. It was found that several adaptive strategies were employed to cope with rheumatic symptoms and that health-care seeking was discontinued, due to perceived barriers related to the health system, and therefore possible harmful analgesics were used to self-manage symptoms.
In this thesis, several suggestions for the development of multidisciplinary interventions are provided to improve the overall well-being, to promote health-care seeking, and health-care system revision by policy makers in Curaçao and other CHIKV affected countries. This will improve the quality of life of patients affected by long-term chikungunya, while awaiting the development of curative treatments.