Abstract
BackgroundIn higher income countries, social disadvantage is associated with higher arthritis prevalence; however, less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE).MethodsSAGE Wave 1 (2007–10) includes nationally-representative samples of older adults (≥50 yrs), plus smaller samples of adults aged 18-49 yrs., from China, Ghana, India, Mexico, Russia and South Africa (n = 44,747). Arthritis was defined by self-reported healthcare professional diagnosis, and a symptom-based algorithm. Marital status and education were self-reported. Arthritis prevalence data were extracted for each country by 10-year age strata, sex and SEP. Country-specific survey weightings were applied and weighted prevalences calculated.ResultsSelf-reported (lifetime) diagnosed arthritis was reported by 5003 women and 2664 men (19.9% and 14.1%, respectively), whilst 1220 women and 594 men had current symptom-based arthritis (4.8% and 3.1%, respectively). For men, standardised arthritis rates were approximately two- to three-fold greater than for women. The highest rates were observed in Russia: 38% (95% CI 36%–39%) for men, and 17% (95% CI 14%–20%) for women. For both sexes and in all LMICs, arthritis was more prevalent among those with least education, and in separated/divorced/widowed women.ConclusionsHigh arthritis prevalence in LMICs is concerning and may worsen poverty by impacting the ability to work and fulfil community roles. These findings have implications for national efforts to prioritise arthritis prevention and management, and improve healthcare access in LMICs.
Highlights
In higher income countries, social disadvantage is associated with higher arthritis prevalence; less is known about arthritis prevalence or determinants in low to middle income countries (LMICs)
For both sexes in each country, arthritis prevalence increased proportionally with advancing age; with the exception of women from China and men and women from South Africa who had the greatest prevalence in the age group of 60–69 years, all other groups showed a peak in arthritis prevalence in the oldest age group ≥70 years
Higher arthritis prevalence was consistently observed for women that were separated, divorced or widowed compared to those that were never married or currently married
Summary
Social disadvantage is associated with higher arthritis prevalence; less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE). Lower and middle income countries (LMICs) are not immune to the burden of musculoskeletal diseases, the prevalence of this non-communicable disease (NCD) group is dramatically increasing in LMICs [3]. The 2010 Global Burden of Disease (GBD) study reported that musculoskeletal diseases accounted for 19.2% of all YLDs in LMICs [3]. Contributing to the global disability burden associated with the musculoskeletal system are arthritis diseases. Osteoarthritis, is a significant contributor to global disability burden, and the YLDs attributable to osteoarthritis have increased by 75% from 1990 to 2013 [2], indicating this disease as a growing problem internationally. In combination with an increasing trajectory of arthritis prevalence [2, 4], growth in YLDs attributable to arthritis is due primarily to increased life expectancy worldwide, and prolonged exposure to arthritis risk factors [5]
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