title: The impact of arthritis on the physical function of a rural Maya-Yucateco community and factors associated with its prevalence: a cross sectional, community-based study.
abstract: This study aims to evaluate the impact of arthritis on the physical function of people living in a Maya-Yucateco rural community and to assess the association of known modifiable risk factors with the prevalence of overall arthritis and its main types (osteoarthritis and rheumatoid arthritis). Using a cross-sectional, community-based census design, data collected from the adult population (≥18 years) of the Municipality of Chankom, Yucatán, México, were analyzed (n = 1523). Participants' physical function was assessed using a culturized version of the health assessment questionnaire disability index. Social, physical, and behavioral factors linked to overall arthritis, osteoarthritis, and rheumatoid arthritis, were assessed through the "Community-Oriented-Program-for-the-Control-of-Rheumatic-Diseases [COPCORD]" questionnaire. A physiatrist and a rheumatologist confirmed all osteoarthritis and rheumatoid arthritis cases using the American College of Rheumatology criteria. Arthritis was confirmed in 169 cases (22 %, 95 % confidence interval (CI) 19-25) of those assessed for musculoskeletal symptoms (n = 779): osteoarthritis = 144, rheumatoid arthritis = 17, and non-specific arthritis = 8. Arthritis was associated with a higher prevalence of disability after controlling for age, gender, and number of comorbidities (odds ratio = 4.0, 95 % CI 3.0-6.0). Higher level of wealth was associated with lower arthritis prevalence (odds ratio = 0.9, 95% CI 0.8-0.9). Higher body mass index was associated with higher hip and/or knee osteoarthritis prevalence (odds ratio = 1.1, 95 % CI 1.03-1.1). Arthritis is highly associated with disability in the Mayan people living in Chankom. The prevalence of arthritis in Chankom is associated with social factors, such as people's level of wealth, while the prevalence of low-extremity osteoarthritis is associated with people's body mass index.
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada. loyolaa@mcmaster.ca.|Institute for Applied Health Sciences, Room 403, 1400 Main St. W., Hamilton, ON, L8S 1C7, USA. loyolaa@mcmaster.ca.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Loyola-Sanchez
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Richardson
authors.affiliation: Rheumatology Department, Hospital General de México, Ciudad de México, Mexico.
authors.forename: Ingris
authors.initials: I
authors.lastname: Pelaez-Ballestas
authors.affiliation: Research Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico.
authors.forename: José
authors.initials: J
authors.lastname: Alvarez-Nemegyei
authors.affiliation: Centre for Health Policy Analysis, McMaster University, Hamilton, ON, Canada.|McMaster Health Forum, McMaster University, Hamilton, ON, Canada.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Department of Political Science, McMaster University, Hamilton, ON, Canada.|Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
authors.forename: John N
authors.initials: JN
authors.lastname: Lavis
authors.affiliation: Centre for Health Policy Analysis, McMaster University, Hamilton, ON, Canada.|McMaster Health Forum, McMaster University, Hamilton, ON, Canada.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Wilson
authors.affiliation: School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
authors.forename: Seanne
authors.initials: S
authors.lastname: Wilkins
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000208:ethnology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007197:Indians, Central American; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000208:ethnology*; D020370:Osteoarthritis, Knee / Q000208:ethnology*; D010147:Pain Measurement; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Arthritis; Disability evaluation; Indians North American; Mexico; Observational study