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Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?

ABSTRACT: Chikungunya is an endemo-epidemic infection, which is still considered as an emerging public health problem. The aim of this study was to evaluate in a 65+ population, the accuracy of two chikungunya screening scores that were developed in younger people.It was performed in the Martinique University Hospitals from retrospective cases. Patients were 65+, admitted to acute care units, for suspected Chikungunya virus infection (CVI) in 2014, with biological testing using Reverse Transcription Polymerase Chain Reaction. Mayotte tool and Reunion Island tool were also computed. Sensitivity, specificity, positive predictive value, negative predictive value, and Youden's statistic were calculated.In all, 687 patients were included, 68% with confirmed CVI, and 32% with laboratory-unconfirmed CVI. Fever (73.1%) and arthralgia (51.4%) were the most frequent symptoms. Sensitivity ranged from 6% (fever+headache) to 49% (fever+polyarthralgia); and Youden's index ranged from 1% (fever + headache) to 30% (fever+polyarthralgia). PPV and NPV ranged from 70% to 95%, and from 32% to 43%, respectively.Performances were very poor for both tools, although specificity was good to excellent. Our results suggest that screening scores developed in young population are not accurate in identifying CVI in older people.

SUBMITTER: Godaert L

PROVIDER: S-EPMC5215818 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?

Godaert Lidvine L Najioullah Fatiha F Bousquet Lionel L Malmontet Thomas T Fournet Benoît B Césaire Raymond R Fanon Jean-Luc JL Dramé Moustapha M

PLoS neglected tropical diseases 20170105 1

<h4>Background</h4>Chikungunya is an endemo-epidemic infection, which is still considered as an emerging public health problem. The aim of this study was to evaluate in a 65+ population, the accuracy of two chikungunya screening scores that were developed in younger people.<h4>Methods</h4>It was performed in the Martinique University Hospitals from retrospective cases. Patients were 65+, admitted to acute care units, for suspected Chikungunya virus infection (CVI) in 2014, with biological testin ...[more]

PMID: 28056031

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Project description:Background: Noninvasive ventilation (NIV) is accepted as standard of care for chronic hypercapnic respiratory failure (CHRF) and is being increasingly implemented in older subjects. However, little is known regarding the use of NIV on a long-term basis in the very old. The outcomes of this study were: 1/to report the proportion of patients ? 75 years old (elderly) among a large group of long-term NIV users and its trend since 2000; 2/to compare this population to a younger population (<75 years old) under long-term NIV in terms of diagnoses, comorbidities, anthropometric data, technical aspects, adherence to and efficiency of NIV. Methods: In a cross-sectional analysis of a multicenter cohort study on patients with CHRF under NIV, diagnoses, comorbidities, technical aspects, adherence to and efficiency of NIV were compared between patients ? 75 and <75 years old (chi-square or Welch Student tests). Results: Of a total of 489 patients under NIV, 151 patients (31%) were ? 75 years of age. Comorbidities such as systemic hypertension (86 vs. 60%, p < 0.001), chronic heart failure (30 vs. 18%, p = 0.005), and pulmonary hypertension (25 vs. 14%, p = 0.005) were more frequent in older subjects. In the older group, there was a trend for a higher prevalence of chronic obstructive pulmonary disease (COPD) (46 vs. 36%, p = 0.151) and a lower prevalence of neuromuscular diseases (NMD) (19 vs. 11%, p = 0.151), although not significant. Adherence to and efficacy of NIV were similar in both groups (daily use of ventilator: 437 vs. 419 min, p = 0.76; PaCO2: 5.8 vs. 5.9 kPa, p = 0.968). Unintentional leaks were slightly higher in the older group (1.8 vs. 0.6 L/min, p = 0.018). Conclusions: In this cross-sectional study, one third of the population under NIV was ? 75 years old. Markers of efficacy of NIV, and adherence to treatment were similar when compared to younger subjects, confirming the feasibility of long-term NIV in the very old. Health-related quality of life was not assessed in this study and further research is needed to address this issue.

Project description:ObjectivesTo assess the long-term effect on health and well-being of the Lifestyle Matters programme.DesignQualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT).SettingThe intervention took place at community venues within two sites in the UK.ParticipantsA purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2?years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being.InterventionLifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy.ResultsInterviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed.ConclusionThe majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained.Trial registrationISRCTN, ISRCTN67209155, post results.

Dataset Information

Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?

Publications

Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?

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