Individual and contextual risk factors for chikungunya virus infection: the SEROCHIK cross-sectional population-based study

The purpose of the study was to weigh the community burden of chikungunya determinants on Reunion island. Risk factors were investigated within a subset of 2101 adult persons from a population-based cross-sectional serosurvey, using Poisson regression models for dichotomous outcomes. Design-based ri...

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Bibliographic Details
Published in:Epidemiology and infection 2018-06, Vol.146 (8), p.1056-1064
Main Authors: Fred, A., Fianu, A., Béral, M., Guernier, V., Sissoko, D., Méchain, M., Michault, A., Boisson, V., Gaüzère, B.-A., Favier, F., Malvy, D., Gérardin, P.
Format: Article
Language:English
Subjects:
Arboviruses
Body weight
Chikungunya virus
Cross-sectional studies
Dengue fever
Determinants
Disease prevention
Disease transmission
Health risks
Households
Infections
Infectious diseases
Investigations
Life Sciences
Original Paper
Outbreaks
Overweight
Poisson density functions
Population
Population studies
Population-based studies
Public health
Regression analysis
Regression models
Risk analysis
Risk factors
Santé publique et épidémiologie
Statistical analysis
Tropical diseases
Vector-borne diseases
Vectors (Biology)
Viruses
Zoonoses
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Summary:The purpose of the study was to weigh the community burden of chikungunya determinants on Reunion island. Risk factors were investigated within a subset of 2101 adult persons from a population-based cross-sectional serosurvey, using Poisson regression models for dichotomous outcomes. Design-based risk ratios and population attributable fractions (PAF) were generated distinguishing individual and contextual (i.e. that affect individuals collectively) determinants. The disease burden attributable to contextual determinants was twice that of individual determinants (overall PAF value 89.5% vs. 44.1%). In a model regrouping both categories of determinants, the independent risk factors were by decreasing PAF values: an interaction term between the reporting of a chikungunya history in the neighbourhood and individual house (PAF 45.9%), a maximal temperature of the month preceding the infection higher than 28.5 °C (PAF 25.7%), a socio-economically disadvantaged neighbourhood (PAF 19.0%), altitude of dwelling (PAF 13.1%), cumulated rainfalls of the month preceding the infection higher than 65 mm (PAF 12.6%), occupational inactivity (PAF 11.6%), poor knowledge on chikungunya transmission (PAF 7.3%) and obesity/overweight (PAF 5.2%). Taken together, these covariates and their underlying causative factors uncovered 80.8% of chikungunya at population level. Our findings lend support to a major role of contextual risk factors in chikungunya virus outbreaks.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268818000341