Incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community: a WHO‐APLAR‐COPCORD study

Abstract

AbstractAim: To estimate the incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community.Methods: This study was conducted in six villages near Dhaka from January 2001 to June 2002. Door‐to‐door case finding by interviewers was followed by interviewing and examination of positive respondents by trained doctors. The respondents with inflammatory arthropathies were reviewed 5 years later, in December 2006.Results: Four hundred and forty‐one (M = 163, F = 278) out of 2685 adults (M = 1324, F = 1361) developed new musculoskeletal pain yielding an incidence rates of 10.9/100 person‐years (PY) (M = 8.2, F = 13.6). The incidence was highest in the 35–44‐year age group in both genders. It was highest in housewives, followed by weavers and cultivators. The spine (7.5/100 PY) was the most common affected part followed by knees (6.5), shoulder (6.2) and neck (6.2). The most common cause of new musculoskeletal pain was non‐specific low back pain, followed by fibromyalgia and knee osteoarthritis. Forty‐one subjects (M = 17, F = 24) developed inflammatory joint or spinal pain (1000/100,000 PY). The incidence of rheumatoid arthritis, combined spondyloarthropothies, ankylosing spondylitis, reactive arthropathy and psoriatic arthritis were 120 (M = 101, F = 147), 150 (M = 252, F = 49), 75 (M = 151, F = 0), 50 (M = 101, F = 0) and 25 (M = 0, F = 49) per 100,000 PY, respectively. Thirty‐one cases had undiagnosed arthropathies (770/100,000 PY). Seven were unavailable in December, 2006 and one died. The remaining 23 were symptom‐free.Conclusions: The incidence of musculoskeletal pain and rheumatic disorders is considerable in this Bangladeshi rural community. Common incident disorders are non‐specific low back pain, fibromyalgia and osteoarthritis of knees. Inflammatory arthropathies are not common. The majority of undiagnosed arthopathies undergo spontaneous lasting remission.