Community Oriented Program For The Control Of Rheumatic Diseases Research Articles

Prevalence and pattern of soft‐tissue rheumatism in a rural community in South‐South Nigeria: A cross‐sectional survey

AbstractBackgroundSoft tissue rheumatism arises from the pathology of periarticular structures. They are marked by pain and disability. Epidemiological studies in sub‐Saharan Africa are sparse. This study aimed to determine the epidemiology of soft‐tissue rheumatism in a rural community in South‐South Nigeria.MethodsThis was a community‐based, cross‐sectional study conducted from February to July 2017 in South‐South Nigeria among 319 participants using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. Participants aged 18 years and older were included in the study. Subjects reporting positive musculoskeletal pain were examined for specific soft tissue rheumatism. The diagnosis was based on established criteria.ResultsThe mean age of the study population was 48.87 ± 19.58 years. The prevalence of soft‐tissue rheumatism was 11.0% (35/319). Soft tissue rheumatism was more prevalent in females (24, 68.6%) than in males (11, 31.4%). The most common form of soft‐tissue rheumatism diagnosed was adhesive capsulitis (20.0%), closely followed by rotator cuff tendinitis (14.3%), carpal tunnel syndrome (14.3%), and plantar fasciitis (14.3%). Age (p = 0.06), body mass index (p = 0.034), and dyslipidemia (p = 0.028) were significantly associated with the prevalence of soft‐tissue rheumatism. A significant disability index (HAQ‐DI ≥ 1) was recorded in 40.0% of participants with soft tissue rheumatism. Twelve (34.3%) participants with soft‐tissue rheumatism attributed the disorder to their work, and 74.3% used hospital‐prescribed medications for treatment.ConclusionSoft‐tissue rheumatism is associated with a significant disability affecting activities of daily living. Factors associated with its prevalence include increasing age and obesity.

The burden of the most common rheumatic disease in Colombia

BackgroundEstimating the burden of rheumatic diseases (RDs) requires proper evaluation of its lethal and nonlethal consequences. In Colombia, it is possible to find local data and Global Burden of Disease (GBD) reports that collect information from varied contexts and apply complex statistical models, but no on-site estimations are available.MethodsThis was a descriptive study on the burden of RD based on occurrence and mortality data in the general population during 2015, including information and prevalence estimations from the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) study. Disability-adjusted life years (DALYs) were estimated by combining measures of years of life lost (YLL) and years lived with disability (YLDs). For disability weight estimations among cases, different COPCORD responses were mapped using flowcharts to show the severity distribution according to GBD. All model parameters and results were validated through an expert consensus panel.ResultsLow back pain (LBP) was the RD with the greatest burden of disease, costing 606.05 (95% CI 502.76–716.58) DALYs per 100,000 inhabitants, followed by osteoarthritis (292.11; 95% CI 205.76–386.85) and rheumatoid arthritis (192.46, 95% CI 109.7–239.69).ConclusionsThe burden of RD is as high in Colombia as in other countries of the region. The results offer an interesting tool for optimizing healthcare system design as well as for planning the distribution of human and economic resources to achieve early diagnosis and adequate care of these diseases.

Epidemiology of musculoskeletal symptoms, rheumatologic disorders, and disability in the Zoroastrian population in Yazd, Iran: a WHO-ILAR COPCORD study (stage 1)

BackgroundThe purpose of this study was to determine the prevalence of musculoskeletal complaints, rheumatologic diseases, and disability among the Zoroastrian population in Iran.MethodsThe city of Yazd, in central Iran was selected for this study, with the highest population of Zoroastrians in Iran. Subjects were selected by cluster sampling of 9 neighborhoods populated with Zoroastrians. Subjects ≥15 years old were interviewed by trained interviewers in their houses. The validated Farsi translation of Community Oriented Program for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) was used for this study. Subjects with musculoskeletal complaints (pain, stiffness and/or swelling) were examined by a rheumatologist. Laboratory tests and radiographic exams were performed when deemed necessary.ResultsTwo-thousand subjects were interviewed during a 12-month period, of which 956 were male, and 1044 were female. The mean age was 41.1 ± 18.3 years (95%CI: 40.3–41.9). 36.9% of the subjects had university-level education. In the 7 days prior to the interview, 27.6% of the subjects had musculoskeletal complaints, with the knee, dorsolumbar spine, and shoulder being the most common sites of complaints. The most common rheumatologic diagnoses were osteoarthritis (21.5%) and low back pain (10.3%). Rheumatoid arthritis was diagnosed in 1.2% of the subjects.ConclusionsThe epidemiology of musculoskeletal complaints and rheumatologic disorders was inconsistent with previous COPCORD studies in Iran, with a lower prevalence of musculoskeletal complaints in general, lower rates of Behçet and lupus, and a higher prevalence of rheumatoid arthritis. The findings of this study can be for development of better prevention, screening, and treatment programs for the vulnerable population of Zoroastrians in Iran.

Translation of revised WHO international league against rheumatism community oriented program for the control of rheumatic diseases core English questionnaire into Bengali and its cross-cultural adaptation and validation

Background: The World Health Organization (WHO) and the International League Against Rheumatism (ILAR) initiated the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) project in 1981. The aim of this study was to translate the revised WHO-ILAR COPCORD questionnaire into Bengali and to test if the Bengali version could be reliably used for the identifying rheumatic diseases in Bangladeshi people.Methods: This was an observational study conducted in rheumatology wing, department of medicine, BSMMU from April to October, 2011. It was implemented in two stages: Translation and cross-cultural adaptation of questionnaire and testing of questionnaire. For translation into Bengali and cross-cultural adaptation, the recommendation by Beaton’s procedure was followed. Respondents were enrolled from rheumatology outpatient departments of medicine, BSMMU, household members and healthy patient’s attendants. Data were collected and analyzed using SPSS windows v16.Results: Thirty subjects completed the preliminary version of the questionnaire. Fifteen males (50%) and fifteen (50%) females were interviewed. Mean age of the respondents were 31.97±10.15 with age range 16-55 years. Test-retest reliability of the Bengali version of the questionnaire was tested by interviewing 70 subjects. To evaluate agreement between two measurement qualitative questions were analyzed using kappa test and quantitative question were tested by spearman’s correlation. Most of the questions (88.2%) showed high or good agreement (kappa agreement >0.6) and one (5.88%) question showed moderate agreement (0.4-0.6). In case of quantitative questions responses in test and re-test were found to have 50% good correlation and remainder poor correlation in Spearman’s correlation.Conclusions: Pretest and reliability has shown the questionnaire clear in wording and culturally appropriate. Process of translation and adaptation using Beaton’s procedure was user friendly, comprehensive and appears an essential method for translation of the questionnaire.

Prevalence of inflammatory back pain and radiographic axial spondyloarthritis in a semi-urban community of Lahore, Pakistan.

To determine the prevalence of inflammatory back pain (IBP) and radiographic axial spondyloarthritis (SpA) in a semi-urban community of Lahore, Pakistan. This cross-sectional household survey was designed as per the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) model. In Phase 1, the subjects were interviewed for musculoskeletal (MSK) pain in the last 7days by clinical assistants. In Phase 2, physiotherapists identified subjects with spinal/back pain and interviewed for Assessment in Spondyloarthritis International Working Group (ASAS) criteria for IBP. In Phase 3 subjects having IBP or chronic back pain (CBP) with an age at onset ≤45years, were assessed and further investigated. A total of 4922 subjects with a mean age of 35.3±14.5years, including 2770 (56%) women were surveyed in Phase 1. MSK pain in last 7days was reported by 1407 (28.6%) of whom 1034 (21%) had spinal pain. The ASAS criteria for IBP were met in 329 (6.7%, 95% CI 6.0-7.0). In Phase 3, 222 with IBP and 83 having CBP with age at onset ≤45years were evaluated. Out of this total of 305, 144 (2.9%) were confirmed to have IBP by rheumatologists as per at least 1 of the 3 criteria. ASAS criteria were met in 107 (2.2%, 95% CI 1.8-2.6). ASAS criteria for radiographic axial SpA were met in 47 (1%, 95% CI 0.7-1.3) of the surveyed population. Inflammatory back pain was reported in 6.7% by physiotherapists, confirmed in 3% by rheumatologists. The prevalence of radiographic axial SpA was 1%.

Epidemiology of musculoskeletal complaints and diseases in Qatar: A cross-sectional study.

Background: Musculoskeletal (MSK) conditions are considered a significant public health problem on account of their high prevalence in communities worldwide and their pervasive impact. Knowledge of the epidemiology of MSK symptoms and diseases is lacking in Qatar. Obtaining this information will guide local health policymakers in the future strategic planning of the health budget.Objective: To estimate the prevalence rate of MSK disorders in the Qatari population above 15 years of age using the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) survey.Methods: This cross-sectional study targeted 1000 Qatari participants, including 500 males and 500 females. A door-to-door survey was conducted using the Arabic version of the COPCORD questionnaire with the help of research assistants. Participants with positive surveys were asked to visit Hamad General Hospital Rheumatology outpatient clinics for clinical evaluation by a rheumatologist. When necessary, laboratory testing and X-rays were conducted to confirm any MSK diagnosis.Results: A total of 1239 (males, 50.8%) Qatari individuals randomly selected from the different municipalities of Qatar completed the COPCORD survey. Among the participants, 563 (45.4%) screened positive for MSK pain. Knee pain (24.5%) and back pain (23.3%) were the most common sites of pain, and both conditions showed no gender predominance (p = 0.073 and 0.108, respectively). Shoulder, wrist, hand, hip, and neck pain were significantly predominant in females (p < 0.001 for all). A total of 237 MSK disorders were diagnosed in 196 (15.8%) participants, including 181 degenerative joint diseases, 52 soft-tissue rheumatism conditions, and 4 autoimmune inflammatory disorders. Among degenerative joint diseases, knee osteoarthritis (6.4%) was the most common. Among soft-tissue rheumatic conditions, muscular lower back pain (1.9%), myofascial neck pain (0.64%), generalized body pain (0.32%), and shoulder tendinitis (0.7%) were the most common diseases. The autoimmune inflammatory disorders identified included rheumatoid arthritis (n = 2), connective tissue disease (n = 1), and inflammatory bowel disease-associated arthritis (n = 1).Conclusion: The overall prevalence rate of MSK disorders in this small cross-sectional cohort of Qatari individuals was 15.8%. Knee pain (24.5%) and knee osteoarthritis (6.4%) were the most common MSK complaints and diagnosis in the studied Qatari population. This study guides future efforts directed toward the prevention and management of MSK diseases. Further studies with a larger sample size are needed to verify the findings.

Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community.

To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina. This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment. A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4). RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients' early referral to a specialist. Key Points • The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America. • The patients with RA had high percentage of familiar history of RA. • The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral. • The mean of the delay in the diagnosis was 5.8years. In this community, the lack of the "migration health" phenomenon may be a social determinant that negatively impacts their health.

Cross-cultural adaptation of the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) in a Colombian population

IntroductionThe validation of questionnaires is fundamental in the measurement process of any research study. The Community Oriented Program for Control of Rheumatic Diseases (COPCORD) questionnaire is useful as a screening tool for the detection of rheumatic diseases. ObjectiveTo adapt and validate the methodology and the COPCORD questionnaire in the Colombian population. Materials and methodsA validation study of the COPCORD methodology was carried out that included: (1) transcultural adaptation of the COPCORD questionnaire of Mexican Spanish, and (2) validation of the questionnaires: COPCORD, socioeconomic level questionnaire, use of health services and a quality of life questionnaire (EQ-5D-3L), following international guidelines. ResultsA total of 329 subjects of 6 cities in Colombia participated in the process, with 10 in the first phase and 309 in the second. Approximately two-thirds (67.3%) were women. The mean age was 46.4±18.4 years, with an educational level between basic and medium (77%). Participants resided in Bogota (29.4%), Barranquilla (22%), Cali (20.3%), Medellin (15.2%), Bucaramanga (6.4%), and Cucuta (6.4%). Musculoskeletal pain in the previous 7 days was reported by 43.6%, and historical pain was reported by 68.9%. A rheumatological diagnosis was established in 127 (41.1%) cases: osteoarthrosis (9.3%), regional pain syndromes (5.5%), low back pain (5.1%), and rheumatoid arthritis (0.9%). The internal validity was 0.70. When comparing the COPCORD questionnaire with the diagnosis made by the rheumatologist, it had a sensitivity of 70.8%, specificity 35%, positive likelihood ratio of 1.09m and area under the curve of 0.53. ConclusionsThe COPCORD questionnaire is valid as a screening test to detect musculoskeletal complaints and rheumatic diseases in the Colombian population.

Factors associated with health care seeking behavior for musculoskeletal pain in Indonesia: A cross-sectional study.

To assess the factors defining healthcare-seeking behavior of people with musculoskeletal pain in the urban community of Malang City, East Java, Indonesia. A cross-sectional survey was performed in Malang City, East Java, Indonesia. In total, 2067 participants aged 16-93years were interviewed. The sociodemographic and socioeconomic factors of healthcare seeking behavior, musculoskeletal pain, disability, and adverse drug reactions were assessed using the validated Indonesian version of Community Oriented Program for the Control of Rheumatic Disease (COPCORD) protocol by International League of Associations for Rheumatology and the World Health Organization core questionnaire. Chi-square test was applied to assess the determinants of health-seeking behavior for musculoskeletal pain. Slightly more than one-third of the respondents (36%) with musculoskeletal pain, described as osteoarthritis, low back pain, gouty arthritis, soft tissue rheumatism, and autoimmune arthritis, were assessed for their health-seeking behavior. About 73% of all those participants sought treatment for their musculoskeletal symptoms. Treatment modality used was modern healthcare, traditional healthcare, self-treatment using traditional medication, self-treatment using modern medication with the proportions of 20.94%, 25.23%, 33.95%, 25.77%, respectively. Disability significantly affected health-seeking behavior as the major determinant (prevalence ratio [PR] 1.087, 95% CI 1.031-1.146, P=0.002), followed by age (PR 1.043, 95% CI 1.000-1.087, P=0.049). Healthcare-seeking behavior was associated with the presence of adverse drug reactions (P<0.001). Factors associated with musculoskeletal pain health-seeking behavior were disability and age. Self and traditional healthcare treatment were further associated with an adverse drug reaction.

Prevalence of musculoskeletal diseases in a semi-urban Nigerian community: results of a cross-sectional survey using COPCORD methodology

The International League of Associations for Rheumatology (ILAR) in collaboration with the World Health Organization (WHO) initiated the Community Oriented Program for the Control of Rheumatic diseases (COPCORD) to promote the growth of rheumatology in developing countries. This is the first COPCORD-type survey carried out in a West African community. The objective of this study was to determine the prevalence of musculoskeletal diseases in a semi-urban Nigerian community, using the COPCORD methodology. This is a cross-sectional total population survey, carried out in Katon Rikkos, Jos, Nigeria, from June 2015 to November 2016. All inhabitants of the community who are 15years and older were included in the study, except those who were not available or refused to participate. Trained health workers from the community carried out a house-to-house survey, to administer the COPCORD questionnaire. People reporting musculoskeletal symptoms were examined and investigated at the teaching hospital, to determine the specific type of musculoskeletal diseases. Data was analyzed using Epi-info version 7.1.5 and P values of <0.05 were considered statistically significant. The median age of the study population was 33 (IQR 24-46) years, with a male to female ratio of 1:1.1. The prevalence of musculoskeletal disease was 33%. Females (57.0%) were more affected than males (43.0%); the most common form of musculoskeletal diseases diagnosed was osteoarthritis (22.0%). Male sex and a family history of musculoskeletal diseases were independent predictors of musculoskeletal diseases. A Health Assessment Questionnaire Disability Index (HAQ-DI) ≥1 was recorded in 14% of subjects with musculoskeletal diseases. The prevalence of musculoskeletal diseases in this community is high with significant disability; therefore, there is urgent need for increased access to rheumatology care in the community.

Prevalence of musculoskeletal disorders in Azar cohort population in Northwest of Iran

Musculoskeletal disorders (MSDs) are considered as major public health problems. The purpose of this study was to determine the prevalence of MSDs in Azar cohort population in northwest of Iran. Azar cohort study is a state level of a national cohort project (PERSIAN) which began in 2014. All adults over 35 years old in Khamene city in East Azarbaijan province were recruited for the pilot phase of the Azar cohort. For the purpose of the current study, a total of 952 subjects age range of 35-70 who completed the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) questionnaire as supplementary were included. 299 subjects had MSDs and were introduced to the rheumatologist, only 237 of them referred for further assessment. 33.4% of subjects had MSDs within the past 7 days. The most frequent complaint was pain and the most common sites of complaints were knee, lumbar spine, and shoulder, respectively. Osteoarthritis was the most common rheumatic disease (53.2%) and the knee was the most common region affected (47.7%) followed by low back pain (28.2%). Osteoarthritis and knee osteoarthritis were present in 56.1 and 51.8% of females and 46.6 and 38.4% of males, respectively. Furthermore, low back pain was present in 32.9% of males and 26.2% of females. Peri-arthritis was more prevalent in males (12.3%), whilst fibromyalgia, psychologic pain, and heel spur were prevalent among females (9.1, 5.1, and 1.2%, respectively). Rheumatoid arthritis was observed in 1.4% of males and 1.8% of females, respectively. Prevalence of MSDs is very high in this area. Therefore, it calls for action by heath officials and professionals to plan for appropriate programs of prevention and management of MSDs in society.

Prevalence of musculoskeletal disorders and rheumatic diseases in Cuenca, Ecuador: a WHO-ILAR COPCORD study.

The aim of this study was to determine the prevalence of musculoskeletal pain and rheumatic diseases in subjects over 18years of age from the canton of Cuenca, Ecuador. Cross-sectional analytical community-based study was conducted in subjects over 18years of age using the validated Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) questionnaire. Random sampling was used. The questionnaire was administered by standardized health workers. Subjects were visited house by house. Subjects positive for musculoskeletal (MSK) pain in the last 7days and at some point in life were assessed by rheumatologists to confirm the diagnosis. A total of 4877 subjects participated, with an average age of 42.8 (SD 18.8) years of age; 59.7% were women; 69.7% lived in urban areas. 32.5% reported MSK pain in the last 7days and 45.7% at some point in life. The prevalence of knee osteoarthritis was 7.4%, hand osteoarthritis 5.3%, low back pain 9.3%, rheumatoid arthritis 0.8%, fibromyalgia 2%, gout 0.4%, and lupus 0.06%. Subjects from rural areas reported experiencing more MSK pain in the last 7days and at some point in life, lower income, poorer health-care coverage, and increased physical activity involving repetitive tasks such as lifting weights or cooking with firewood. MSK pain prevalence was high. Osteoarthritis and low back pain were the most common diseases. Age, sex, physical activity, repetitive tasks, living in a rural area, and lack of health-care coverage were found to be associated with MSK pain.

Prevalence of musculoskeletal disorders and rheumatic disease in the Warao, Kari'ña, and Chaima indigenous populations of Monagas State, Venezuela.

This study aimed to estimate the prevalence of musculoskeletal disorders and rheumatic diseases in the Warao, Kari’ña, and Chaima indigenous populations of Monagas State, Venezuela. A cross-sectional, analytical, community-based study was conducted in 1537 indigenous subjects ≥18 years old (38.6 % male, mean age 41.4 ± 17.5 years). The cross-culturally validated Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) diagnostic questionnaire was applied. Subjects with a positive COPCORD diagnosis (either historic or current pain) were evaluated by primary care physicians and rheumatologists. A descriptive analysis was performed and comparisons made using analysis of variance and the chi-square test. Pain in the last 7 days was reported by 32.9 %, with pain intensity, according to a Likert-type scale [no pain, 195 (38.5 %); minimal pain, 231 (45.6 %); strong pain, 68 (13.4 %); intense pain, 5 (0.9 %)], 38.0 % reported historical pain, and 641 (41.7 %) had either historic or current pain. Of the COPCORD-positive subjects, pain most frequently occurred in the knee, back, and hands. Musculoskeletal and rheumatic diseases included osteoarthritis (14.1 %), back pain (12.4 %), rheumatic regional pain syndromes (RRPS) (9.7 %), undifferentiated arthritis (1.5 %), rheumatoid arthritis (1.1 %), and fibromyalgia (0.5 %). Chaima (18.3 %) and Kari’ña (15.6 %) subjects had a high prevalence of osteoarthritis, and Warao subjects had a high prevalence of low back pain (13.8 %). The prevalence of RRPS was high in all three ethnic groups. The Chaima group had the highest prevalence of rheumatic diseases, with 2.0 % having rheumatoid arthritis. This study provides useful information for health care policy-making in indigenous communities.

Prevalence of musculoskeletal disorders and rheumatic diseases in the indigenous Qom population of Rosario, Argentina.

This study aimed to estimate the prevalence of musculoskeletal disorders and rheumatic diseases among the indigenous Qom (Toba) population in the city of Rosario, Santa Fe, Argentina. An analytical cross-sectional study using methodology of the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) was performed. Subjects ≥18 years of age were interviewed by advanced students of medicine and nursing, bilingual translator-facilitators, and coordinators. Individuals with musculoskeletal pain (positive cases) were evaluated sequentially for 7 days by internists and rheumatologists for diagnosis and treatment. The study included 1656 individuals (77 % of the census population). Of these, 1020 (61.5 %) were female, with mean age of 35.3 (SD 13.9) years, and 1028 (62.0 %) were bilingual. The public health care system covers 87.1 % of the population. Musculoskeletal pain in the previous 7 days and/or at some time during their life was present in 890 subjects (53.7 %). Of those with pain in the last 7 days, 302 (64.1 %) subjects had an Health Assessment Questionnaire Disability Index (HAQ-DI) score ≥0.8. The most frequent pain sites were lumbar spine (19.3 %), knees (13.0 %), and hands (12.0 %). The prevalence of rheumatic diseases was as follows: mechanical back pain (20.1 %), rheumatic regional pain syndrome (2.9 %), osteoarthritis (4.0 %) rheumatoid arthritis (2.4 %), inflammatory back pain (0.2 %), systemic sclerosis (0.1 %), Sjögren syndrome (0.1 %), fibromyalgia (0.1 %), mixed connective tissue disease (0.06 %), and systemic lupus erythematosus (0.06 %). The prevalence of musculoskeletal disorders was 53.7 % and rheumatic diseases 29.6 %. Rheumatoid arthritis prevalence was 2.4 % using COPCORD methodology, one of the highest reported at present.

Epidemiology of rheumatic diseases in Mixtec and Chontal indigenous communities in Mexico: a cross-sectional community-based study

This study aimed to estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Chontal and Mixtec indigenous communities in the state of Oaxaca, Mexico, using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. After cross-culturally validating the COPCORD questionnaire for these communities, we conducted a cross-sectional, analytical, community-based census study using a house-to-house method. Positive cases of MSK disorders were assessed by primary care physicians and rheumatologists. The study population included participants aged ≥18 years from the indigenous communities of San Antonio Huitepec and San Carlos Yautepec. A total of 1061 persons participated in the study. Mean age was 46.9 years (standard deviation 19.9; age range 18–97 years); 642 (60.5 %) were women; 483 participants (45.5; 42.4–48.5 %) had MSK pain in the previous 7 days. Diagnoses were back pain 170 (16.0 %; 95 % confidence interval [CI] 13.8–18.3); osteoarthritis 157 (14.7 %; 95 % CI 12.7–17.0); rheumatic regional pain syndrome 53 (4.9 %; 95 % CI 3.7–6.4); rheumatoid arthritis 4 (0.3 %; 95 % CI 0.1–0.9); dermatomyositis 1 (0.09 %; 95 % CI 0.0–0.5); ankylosing spondylitis 1 (0.09 %; 95 % CI 0.0–0.5); systemic lupus erythematosus 1 (0.09 %; 95 % CI 0.02–0.5); and gout 1 (0.09 %; 95 % CI 0.0–0.5). 53.2 % had not received medical treatment for their disease. The prevalence of MSK disorders in indigenous communities in the Mixtec and Chontal regions is very high. The most common rheumatic diseases found were back pain and osteoarthritis. A high percentage of participants had not received medical care.

Epidemiology of rheumatic diseases in Iran from analysis of four COPCORD studies.

To calculate the epidemiology of Rheumatic Diseases in Iran. The data of Tehran, Zahedan, Sanandaj (urban) and Tuyserkan (rural) stage Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) studies were gathered. The data were adjusted to the population number of the studied areas to represent Iran. The population of Iran is 75 149 669 (71.5% urban areas, males 50.4%) and of the mentioned area were respectively 10 000 000, 580 071, 311 444 and 109 262. The interviewed subjects were 10 291, 1565, 2100 and 5830. Male/female ratio was 0.9/1, 0.8/1, 08/1 and 0.8/1. Musculoskeletal complaints during the past 7 days (people aged ≥ 15 years) were detected in 44.7% of subjects. They were: shoulder 15.6%, wrist 10.4%, hands and fingers 10.2%, hip 8.3%, knee 27.4%, ankle 12.3%, toes 6.2%, cervical spine 14.2% and dorsolumbar spine 23.7%. Osteoarthritis (OA) was detected in 16.9%: knee 15.5%, hands 2.9% and hip 0.32%. Low back pain was found in 15.7%, sciatica in 0.94%, and soft tissue rheumatism in 4.6% (shoulder tenosynovitis 2.5%, frozen shoulder 0.56%, tennis elbow 1.2%, golf elbow 0.48%, de Quervain tenosynovitis 0.24%, trigger finger 0.2%, carpal tunnel syndrome 1.3%). Rheumatoid arthritis was detected in 0.37%, seronegative spondyloarthropathy in 0.24%, ankylosing spondylitis in 0.12%, systemic lupus erythematosus in 0.06%, Behcet's disease in 0.08%, fibromyalgia in 0.79% and gout in 0.13%. Compared to other COPCORD reports (17 countries), Iran gets the following rank: musculoskeletal complaints second, low back pain fourth, osteoarthritis second, knee osteoarthritis third, soft tissue rheumatism sixth, rheumatoid arthritis tenth, seronegative spondyloarthropathies fifth, gout eleventh and fibromyalgia fifth.

FRI0187 Epidemiology Musculoskeletal Disorders and Rheumatic Diseases in Indigenous Communities of Oaxaca, Mexico: A Community-Based Study

BackgroundThe prevalence of musculoskeletal diseases in indigenous communities in Mexico is unknown. As a response to this challenge, the Latin American Study Group of Rheumatic Diseases in Indigenous Peoples (GLADERPO)...

FRI0186 Epidemiology of Rheumatic Diseases in Maya-Yucateco People: A Community-Based Study

BackgroundScientific information concerning the prevalence of musculoskeletal disorders in indigenous communities in Latin America is virtually absent. As a response to this knowledge gap, the Latin American Study Group of...

Culture-sensitive adaptation and validation of the Community-Oriented Program for the Control of Rheumatic Diseases methodology for rheumatic disease in Latin American indigenous populations

The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0-10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.

Assessment of the dimensions, construct validity, and utility for rheumatoid arthritis screening of the COPCORD instrument

This study aims to evaluate the structural validity of the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) core instrument as a screening tool for rheumatoid arthritis (RA) by means of assessing the existence of domains in the questionnaire. The Mexican version of the COPCORD instrument was applied to individuals over18years of age in five regions of the country through a probabilistic/convenience household survey. Clinical confirmation of RA diagnosis was used. The variables analyzed included self-reported comorbidities and manifestations of the disease, as well as sociodemographic characteristics. The statistical approach was based on polychoric exploratory factor analysis and confirmatory factor analysis by means of probit structural equation models. A total of 19,213 subjects were included in the analysis. The average age for the total sample was 42.89years old; 40.64% of the subjects were older than 45years of age and 20.42% older than 55. More than 80% of the variation was related to three underlying factors: recent pain, historical pain, and disability. The findings verified the usefulness of the COPCORD instrument as a screening tool for RA. The results also allowed to characterize how the variation in terms of manifestations of the disease could be accounted for diagnosing the disease in the Mexican context and examined the capabilities of the instrument to measure correctly the main characteristics of patients suffering from RA.