Compromiso Neurológico en Chikungunya: Un Meta-Análisis de su Prevalencia

espanolObjetivo Determinar la proporcion de pacientes que desarrollan manifestaciones y/o complicaciones neurologicas de la infeccion por chikungunya (NeuroCHIK) Metodos Se llevo a cabo una revision sistematica de la literatura en tres bases de datos (PubMed, SCI y Scopus) con el fin de identificar estudios que evaluaran la proporcion de pacientes que presentan NeuroCHIK. Se realizo un modelo de meta-analisis de efectos aleatorios para calcular la prevalencia combinada y su IC95%. Se estimaron y reportaron medidas de heterogeneidad, incluyendo el estadistico Q de Cochrane, el indice I2 y la prueba de tau cuadrado. Se hicieron analisis de subgrupos por tipos de estudios, paises, estudios con ≥200 pacientes, estudios evaluando dificultades de atencion, encefalitis y convulsiones. El sesgo de publicacion se evaluo usando un funnel-plot. Conclusion conclusion de acuerdo a los resultados, en el escenario mas conservador, cerca de 33% de casos cHiK Desarrollarian neurocHiK (36% si consideramos solo los estudios prospectivos), 10% en cefalitis y 3% convulsiones EnglishObjective To determine the percentage of patients that would develop neurological manifestations and/or complications of chikungunya infection (NeuroCHIK). MethodsWe conducted a systemic review of the literature in three databases (PubMed, SCI, Scopus and SciELO) in order to identify studies assessing the proportion of patients that present NeuroCHIK. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% CI. Measures of heterogeneity, including Cochran’s Q statistic, the I2 index, and the tau-squared test, were estimated and reported. Subgroup analyses were conducted by type of study, country, studies with ≥200 patients, studies evaluating attention difficulties, encephalitis and seizures. Publication bias was assessed using a funnel-plot. ResultsUp to June 15, 2015, our literature search yielded 143 citations. The pooled prevalence of NeuroCHIK at nine selected studies among 2,161 patients was 34.53% [95%CI, (20.78–48.27%), τ2 = 0.0734]. Prospective cohorts shown a prevalence of NeuroCHIK of 36.87% [95%CI, (5.17%-68.57%), τ2 = 0.0818]. Occurrence of attention difficulties prevalence was 16.46% [95%CI, (5.65%-27.27%), τ2 = 0.0149]. In the case of encephalitis its prevalence was 9.90% [95%CI, (8.25%-11.54%), τ2 ConclusionsAccording with our results, in the most conservative scenario, about 33% of CHIK cases would develop NeuroCHIK (36% if we just consider prospective studies), 10% encephalitis, and 3% seizures.