title: Identification of musculoskeletal disorders in medically underserved regions of South America and Vietnam.
abstract: BACKGROUND
  Musculoskeletal disorders have been implicated as the leading cause of disability throughout the world, representing a high percentage of the disease burden in many nations. Anecdotal evidence suggests that musculoskeletal pain has become increasingly pervasive, especially among rural populations of developing countries.
  
  
  OBJECTIVE
  To characterize specific musculoskeletal disorders in medically underserved regions where these issues have not yet been thoroughly examined.
  
  
  METHODS
  The sample comprised adult residents receiving care during brief medical outreach trips to South America (Peru, Ecuador, and Argentina) and Vietnam from December 2010 to March 2013. Patients completed an anonymous questionnaire on musculoskeletal pain, self-reported health status, and health care-seeking behavior. Demographic information was also obtained.
  
  
  RESULTS
  In Vietnam, 295 patients aged 20 to 88 years (mean [SD], 59 [14.7] years) completed the survey, 204 (69%) of whom were women. In South America, 552 patients aged 18 to 86 years (mean [SD], 44 [17.24] years) completed the survey, 398 (72.1%) of whom were women. Among the Vietnamese patients, acute pain was most frequently felt in the knees (132 [44.7%]), which were also the most frequent site of chronic pain (122 [41.4%]). Among the South American patients, acute pain was felt most frequently in the lower back (225 [47%]), and the upper back (253 [46.6%]) was the most frequent site of chronic pain. Associations were found between sex and chronic pain, with women reporting more chronic pain than men in the shoulder (17 [53%] vs 15 [47%], respectively), upper back (85 [79%] vs 22 [21%]), hand/wrist (153 [85%] vs 52 [15%]), and knee (40 [80%] vs 7 [20%]). Men reported more acute knee pain than women (73 [48%] vs 148 [38%], respectively). For patients in both samples, acute pain was associated with chronic pain in the same location for all body parts (P<.01).
  
  
  CONCLUSIONS
  This study characterized specific musculoskeletal disorders in selected poor and underserved regions in Vietnam and South America. Owing to reported regional differences, the authors recommend that global treatment protocols be developed with a population-specific approach after conducting a needs assessment for musculoskeletal disorders.
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education rjacobs@nova.edu.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Jacobs
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education.
authors.forename: Belinda A
authors.initials: BA
authors.lastname: Collias
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education.
authors.forename: Arif M
authors.initials: AM
authors.lastname: Rana
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Wallace
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Kane
authors.affiliation: From the Department of Psychiatry and Behavioral Medicine and Biomedical Informatics Program at Nova Southeastern University College of Osteopathic Medicine (NSU-COM) in Fort Lauderdale, Florida (Dr Jacobs, Rana, Wallace, and Boesler); the University of Tennessee Health Science Center in Memphis (Dr Collias); and Florida Atlantic University in Boca Raton (Dr Kane). Dr Jacobs holds a master's degree in biomedical informatics and Dr Rana holds a master's degree in medical education.
authors.forename: David R
authors.initials: DR
authors.lastname: Boesler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D020380:Needs Assessment / Q000592:standards; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010568:Peru / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D057566:Self Report; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult