Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia

William C Reeves,Marjorie Morrissey,Elizabeth Maloney,Rebecca Devlin,Christine Heim,Roumiana S Boneva,David C Hoaglin,James F Jones

doi:10.1186/1478-7954-5-5

Abstract

BackgroundChronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources.MethodsBased on a random-digit dialing survey we ascertained CFS cases and controls to estimate the prevalence of CFS in metropolitan, urban, and rural populations of Georgia. This report focuses on the 5,623 of 19,381 respondents ages 18 to 59 years old. Fatigued (2,438), randomly selected unwell not fatigued (1,429) and randomly selected well (1,756) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Subsets of those identified by interview as having CFS-like illness (292), chronic unwellness which was not CFS-like (268 – randomly selected), and well subjects (223, matched to those with CFS-like illness on sex, race, and age) completed a clinical evaluation.ResultsWe estimated that 2.54% of persons 18 to 59 years of age suffered from CFS. There were no significant differences in prevalence of CFS between metropolitan, urban or rural populations or between white and black residents of the three regions. However, there were significant differences in female-to-male ratios of prevalence across the strata (metropolitan female: male 11.2 : 1, urban 1.7 : 1, rural 0.8 : 1).ConclusionWe estimated that 2.54% of the Georgia population suffers from CFS, which is 6- to 10-fold higher than previous population-based estimates in other geographic areas. These differences may reflect broader screening criteria and differences in the application of the case definition. However, we cannot exclude the possibility that CFS prevalence may be higher in Georgia than other areas where it has been measured. Although the study did not identify differences in overall prevalence between metropolitan, urban, and rural Georgia populations, it did suggest the need for additional stratified analyses by geographic strata.

Highlights

Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy
We cannot exclude the possibility that CFS prevalence may be higher in Georgia than Wichita and Chicago
Potential misclassification of study subjects remains a concern, as CFS is clinically heterogeneous and likely represents more than one entity [25,26]. This investigation suggests that 2.54% of the adult population of Georgia suffers from CFS

Summary

Introduction

Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Chronic fatigue syndrome (CFS) is a complex medical and public health problem that is associated with severe personal suffering and loss. The median duration of illness is 7 years, a quarter of those with the illness are unemployed or receiving disability, and the average affected family forgoes approximately $20,000 in annual earnings and wages [1]. Fewer than 20 percent have received medical care for CFS [2,3]. Despite more than 3,000 articles in the peer-reviewed medical literature, the pathophysiology of CFS is not well understood. There is no public health control or prevention strategy for CFS

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Discussion

Conclusion