Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study.
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.
Haq
Syed Atiqul
SA
Rheumatology Wing, Department of Medicine, Bangabandhu Sheikh Mujib Medical University Shahbagh, Dhaka, Indonesia. sahaq@citech.net
Darmawan
John
J
Islam
Mohammad Nazrul
MN
Uddin
Mohammed Zahir
MZ
Das
Bidhu Bhushan
BB
Rahman
Fazlur
F
Chowdhury
Mohammad Abdul Jalil
MA
Alam
Mohammad Noor
MN
Mahmud
Taimur Abul Khair
TA
Chowdhury
Minhaj Rahim
MR
Tahir
Mohammad
M
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