title: Association of regional and cultural factors with the prevalence of rheumatoid arthritis in the Mexican population: a multilevel analysis.
abstract: BACKGROUND
  The overall estimated prevalence of rheumatoid arthritis (RA) in Mexico is 1.6%, but there are major variations in different geographic areas of the country.
  
  
  OBJECTIVE
  This study aimed to determine the impact of individual and regional variables on the geographic distribution of RA in Mexico.
  
  
  METHODS
  This multilevel analysis used data from a cross-sectional study that investigated the prevalence of RA among 19,213 individuals older than 18 years throughout 5 geographic regions in Mexico. Logistic regression models were used to determine predictors of RA, including individual and regional variables as well as cultural factors. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were determined.
  
  
  RESULTS
  The prevalence of RA varied from 0.77% to 2.8% across the 5 regions. Individual factors associated with RA were sex (OR, 2.32; 95% CI, 1.74-3.07), previous medical diagnosis of RA ( OR 3.3, 95%CI: 2919–5.1 [corrected]), disability (OR, 2.07; 95% CI, 1.48-2.93), and the 56- to 65-year age group (OR, 1.95; 95% CI, 1.08-3.74). The regional factor of speaking an indigenous language had an OR of 2.27 (95% CI, 1.13-4.55).
  
  
  CONCLUSIONS
  Various individual and regional factors were associated with variations in the prevalence of RA in the Mexican population.
authors.affiliation: From the Rheumatology Department, Hospital General de México, Mexico City, México.
authors.forename: José
authors.initials: J
authors.lastname: Moreno-Montoya
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Nemegyei
authors.forename: Luz Helena
authors.initials: LH
authors.lastname: Sanin
authors.forename: Lorena
authors.initials: L
authors.lastname: Pérez-Barbosa
authors.forename: Belem
authors.initials: B
authors.lastname: Trejo-Valdivia
authors.forename: Natalia
authors.initials: N
authors.lastname: Santana
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Goycochea-Robles
authors.forename: Mario Humberto
authors.initials: MH
authors.lastname: Cardiel
authors.forename: Janeth
authors.initials: J
authors.lastname: Riega-Torres
authors.forename: Marco
authors.initials: M
authors.lastname: Maradiaga
authors.forename: Rubén
authors.initials: R
authors.lastname: Burgos-Vargas
authors.forename: Ingris
authors.initials: I
authors.lastname: Peláez-Ballestas
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D055361:Multilevel Analysis; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors