Mohammad Jahid Hasan, Md Shahabul Huda Chowdhury, Muna Islam, Sadia Islam, Tanzin Naher, H M Hamidullah Mehedi, Abu Saif Mohammad Lutful Kabir, Jannatul Fardous, Refaya Tasnim, Asif Ahmed, Md Atiquel Islam Chowdhury, Madhabi Karmaker, Mahir Faisal Akash, Mohiuddin Sharif, Quazi Tarikul Islam
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.
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.