title: Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study.
abstract: OBJECTIVE
  To estimate the burden of rheumatic disorders in adults (age >/= 15 yrs) in Bangladeshi rural and urban communities.
  
  
  METHODS
  The survey was carried out in a rural community, an urban slum, and an affluent urban community with samples of 2635, 1317, and 1259 adults, respectively. Through door-to-door surveys, trained interviewers identified subjects with musculoskeletal pain. A socio-culturally adapted and validated Bengali version of the COPCORD (Community Oriented Program for Control of Rheumatic Disorders) questionnaire was used. Trained internists and rheumatologists examined the positive respondents using an English COPCORD examination sheet to identify respondents with definite rheumatic disorders and to reach a diagnosis.
  
  
  RESULTS
  The overall point prevalence of musculoskeleletal pain was 26.3%. The point prevalence estimates of musculoskeletal pain in rural, urban slum, and affluent urban communities were 26.2% (women 31.3%, men 21.1%), 24.9% (women 27.5%, men 22.6%), and 27.9% (women 35.5%, men 18.6%), respectively. Most commonly affected sites were low back, knees, hips, and shoulders in all 3 communities. The point prevalence of definite rheumatic disorders was 24.0%. The commonest rheumatic disorders were osteoarthritis of the knees, nonspecific low back pain, lumbar spondylosis, fibromyalgia, and soft tissue rheumatism. Their prevalence estimates were 7.5%, 6.6%, 5.0%, 4.4%, and 2.7%, respectively, in the rural, 9.2%, 9.9%, 2.0%, 3.2%, and 2.5%, respectively, in the urban slum, and 10.6%, 9.2%, 2.3%, 3.3%, and 3.3% in the urban affluent community. The point prevalence of functional disability was 25.5%, 23.3%, and 24.8%, respectively, in the rural, urban slum, and urban affluent communities. Among the positive respondents, 22%, 52%, and 22% reported loss of work for durations of 49.3 +/- 47.5, 50.90 +/- 103.3, and 29.25 +/- 56.5 days, respectively, within the previous year.
  
  
  CONCLUSIONS
  Rheumatic disorders are common causes of morbidity, disability, and work loss in rural and urban communities of Bangladesh. Women are affected more frequently than men. Mechanical disorders are more common than inflammatory arthropathies.
authors.affiliation: Rheumatology Wing, Department of Medicine, Bangabandhu Sheikh Mujib Medical University Shahbagh, Dhaka, Indonesia. sahaq@citech.net
authors.forename: Syed Atiqul
authors.initials: SA
authors.lastname: Haq
authors.forename: John
authors.initials: J
authors.lastname: Darmawan
authors.forename: Mohammad Nazrul
authors.initials: MN
authors.lastname: Islam
authors.forename: Mohammed Zahir
authors.initials: MZ
authors.lastname: Uddin
authors.forename: Bidhu Bhushan
authors.initials: BB
authors.lastname: Das
authors.forename: Fazlur
authors.initials: F
authors.lastname: Rahman
authors.forename: Mohammad Abdul Jalil
authors.initials: MA
authors.lastname: Chowdhury
authors.forename: Mohammad Noor
authors.initials: MN
authors.lastname: Alam
authors.forename: Taimur Abul Khair
authors.initials: TA
authors.lastname: Mahmud
authors.forename: Minhaj Rahim
authors.initials: MR
authors.lastname: Chowdhury
authors.forename: Mohammad
authors.initials: M
authors.lastname: Tahir
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003154:Community Medicine; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012216:Rheumatic Diseases / Q000150:complications / Q000453:epidemiology*; D012423:Rural Health / Q000706:statistics & numerical data*; D012424:Rural Population; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data