Rheumatic diseases in the APLAR region

Abstract

Are rheumatic diseases the same in the Western and the Eastern world? This is a major question for physicians because the majority of textbooks come from the Western world and all the figures and statistics and the clinical picture of diseases are those seen in the Western world. It is therefore important to know if they are applicable to the Eastern world. The first step is to know how they are distributed in the APLAR region (Asia and Pacific area). COPCORD (Community Oriented Program for Control of Rheumatic Diseases) was created by the collaboration of World Health Organization (WHO) and the International League of Associations for Rheumatology (ILAR) in 1983. The aim of the program was the recognition, prevention, and the control of Rheumatic diseases in developing countries, where two-thirds of the world’s population live. The program was designed to work with small monetary and material resources. It had three stages: 1 – prevalence of rheumatic disorders and identification of risk factors; 2 – education of primary health care physicians, paramedical professionals, and the community; 3 – improved health care, and environmental aetiologic research of rheumatic diseases. Sixteen countries have performed the program, among them 12 countries from the APLAR region (Fig. 1). The latest study was done in Iran and was finished in September 2005. These countries are Australia, Bangladesh, China, Indonesia, India, Iran, Kuwait, Malaysia, Pakistan, Philippines, Thailand and Vietnam. Stage 1 was designed to evaluate at least 1500 adult people (over 15 years of age). Many of the participating countries, depending on their resources, performed the program on higher numbers. The largest number of evaluated people in a single population was the Iran study with 10 000 participants. Data from Iran are not all compiled and the results presented here are preliminary results on 7000 participants. The number of participants in the Australian study was 1437. There was another study in Aboriginals on 847 persons. The Bangladeshi study was on 5211 people, in China (Shanghai study) on 2010, the China (Shanghai 1998 study) on 6584, in China (Beijing study) on 4192, in China (Shantou study) on 5057, and in China (Chenghai study) on 2040. The Indonesian urban study was on 1071 individuals and the Indonesian rural study on 4683, the Indian study on 4092, the Iranian study on 10 000, the Kuwaiti study on 7670, the Malaysian study on 2594, the Pakistani study on 2090, the Philippine rural study on 846 and the urban study on 3006, the Thai study on 2463, and the Vietnamese study on 2119 people (Fig. 2).