Acute-phase clinical profile and quality of life in patients with chikungunya during the 2025 outbreak in Bangladesh: A facility-based cross-sectional study

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BACKGROUND: Bangladesh experienced a notable resurgence of chikungunya cases in 2025, following its last major outbreak in 2017. This study aimed to characterize the epidemiological profile of laboratory-confirmed chikungunya cases in Bangladesh. METHODS: This cross-sectional study included and interviewed 442 laboratory-confirmed adult chikungunya cases. Pain was assessed using the Visual Analog Scale (VAS, 0-10) and quality of life was measured via the validated Bangla EQ-5D-3 L instrument, which evaluates five domains-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Overall health was rated using the EQ-VAS, a vertical scale ranging from 0 ("worst imaginable health state") to 100 ("best imaginable health state"). Index scores were derived using the trade-off (TTO) valuation set. Associations with the overall EQ-5D index were analyzed using Tobit regression, whereas domain-specific associations were examined via ordinal logistic regression models. RESULTS: Of all, 16.5% of patients required hospital admission, with a median length of stay of 5 days (IQR 3-6), and the rest of them consulted on an outdoor basis. The mean (SD) age of the participants was 45·3 (15·5) years, and 60% were female. Fever (98%) and arthralgia (97%) were the predominant symptoms. Mild pain was reported by 6% of patients, while 40% had moderate and 54% had severe pain, with a median VAS score of 8.0 (IQR 7.0-9.0). Over 70% of the participants reported mobility limitations, self-care, functional impairment, pain or psychological symptoms. The median EQ-5D index was 0·78 (IQR 0·60-0·96). Female sex (β = -0·10, 95% CI -0·17, -0·02) and greater pain severity (β = -0·26, 95% CI -0·37, -0·15) were independently associated with a lower EQ-5D index. CONCLUSIONS: During the outbreak, chikungunya patients in Bangladesh predominantly presented with fever and joint pain and experienced marked declines in quality of life, with women being disproportionately affected.

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