Epidemiological studies in Latin America suggest indigenous people lack proper healthcare for musculoskeletal (MSK) and rheumatic diseases.ObjectivesThis study aimed to estimate the prevalence of MSK disorders and rheumatic diseases in eight Latin American indigenous communities, and to identify which factors influence such prevalence using network analysis and syndemic approach.MethodsThis is a cross-sectional, community-based census study according to Community-Oriented Program for the Control of Rheumatic Diseases methodology. Individuals with MSK pain, stiffness or swelling in the past and/or during the last 7 days were evaluated by participating physicians. A descriptive, univariable and multivariable analysis was performed, followed by a network analysis.ResultsWe surveyed 6155 indigenous individuals with a mean age of 41.2 years (SD 17.6; range 18–105); 3757 (61.0%) were women. Point prevalence in rank order was: low back pain in 821 (13.3%); osteoarthritis in 598 (9.7%); rheumatic regional pain syndromes in 368 (5.9%); rheumatoid arthritis in 85 (1.3%); undifferentiated arthritis in 13 (0.2%); and spondyloarthritis in 12 (0.1%). There were marked variations in the prevalence of each rheumatic disease among the communities. Multivariate models and network analysis revealed a complex relationship between rheumatic diseases, comorbidities and socioeconomic conditions.ConclusionsThe overall prevalence of MSK disorders in Latin American indigenous communities was 34.5%. Although low back pain and osteoarthritis were the most prevalent rheumatic diseases, wide variations according to population groups occurred. The relationship between rheumatic diseases, comorbidities and socioeconomic conditions allows taking a syndemic approach to the study.

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This study assessed the overall and specific prevalence of the main rheumatic regional pain syndromes (RRPS) in four Latin-American indigenous groups. A Community Oriented Program for Control of Rheumatic Diseases (COPCORD) methodology-based census study was performed in 4240 adults (participation rate: 78.88 %) in four indigenous groups: Chontal (Oaxaca, Mexico, n = 124), Mixteco (Oaxaca, Mexico; n = 937), Maya-Yucateco (Yucatán, Mexico; n = 1523), and Qom (Rosario, Argentina; n = 1656). Subjects with musculoskeletal pain were identified using a cross-cultural, validated COPCORD questionnaire administered by bilingual personnel, and reviewed by general practitioners or rheumatologists using standardized case definitions for the 12 most frequent RRPS. The overall prevalence of RRPS was confirmed in 239 cases (5.64 %, 95 % CI: 4.98–6.37). The prevalence in each group was Chontal n = 19 (15.32 %, 95 % CI: 10.03–22.69); Maya-Yucateco n = 165 (10.83 %, 95 % CI: 9.37–12.49); Qom n = 48 (2.90 %, 95 % CI: 2.19–3.82); and Mixteco n = 7 (0.75 %, 95 % CI: 0.36–1.53). In the whole sample, the syndrome-specific prevalence was rotator cuff tendinopathy: 1.98 % (95 % CI: 1.60–2.45); lateral epicondylalgia: 0.83 % (95 % CI: 0.59–1.15); medial epicondylalgia: 0.73 % (95 % CI: 0.52–1.04); biceps tendinopathy: 0.71 % (95 % CI: 0.50–1.01); anserine syndrome: 0.64 % (95 % CI: 0.44–0.92); inferior heel pain: 0.61 % (95 % CI: 0.42–0.90); trochanteric syndrome: 0.49 % (95 % CI: 0.25–0.64); de Quervain’s tendinopathy: 0.45 % (95 % CI: 0.29–0.70); trigger finger: 0.42 % (95 % CI: 0.27–0.67); carpal tunnel syndrome: 0.28 % (95 % CI: 0.16–0.49); Achilles tendinopathy (insertional): 0.12 % (95 % CI: 0.05–0.28); and Achilles tendinopathy (non-insertional): 0.07 % (95 % CI: 0.02–0.21). Leaving aside the comparison between Maya-Yucateco and Chontal groups (p = 0.18), we found significant differences (p < 0.001) in overall RRPS prevalence between the remaining pairs of indigenous groups. Syndrome-specific prevalences were also different between groups. Our findings support the hypothesis that overall RRPS prevalence and syndrome-specific prevalences are modulated by population-specific factors.

This study aimed to estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Chontal and Mixtec indigenous communities in the state of Oaxaca, Mexico, using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. After cross-culturally validating the COPCORD questionnaire for these communities, we conducted a cross-sectional, analytical, community-based census study using a house-to-house method. Positive cases of MSK disorders were assessed by primary care physicians and rheumatologists. The study population included participants aged ≥18 years from the indigenous communities of San Antonio Huitepec and San Carlos Yautepec. A total of 1061 persons participated in the study. Mean age was 46.9 years (standard deviation 19.9; age range 18–97 years); 642 (60.5 %) were women; 483 participants (45.5; 42.4–48.5 %) had MSK pain in the previous 7 days. Diagnoses were back pain 170 (16.0 %; 95 % confidence interval [CI] 13.8–18.3); osteoarthritis 157 (14.7 %; 95 % CI 12.7–17.0); rheumatic regional pain syndrome 53 (4.9 %; 95 % CI 3.7–6.4); rheumatoid arthritis 4 (0.3 %; 95 % CI 0.1–0.9); dermatomyositis 1 (0.09 %; 95 % CI 0.0–0.5); ankylosing spondylitis 1 (0.09 %; 95 % CI 0.0–0.5); systemic lupus erythematosus 1 (0.09 %; 95 % CI 0.02–0.5); and gout 1 (0.09 %; 95 % CI 0.0–0.5). 53.2 % had not received medical treatment for their disease. The prevalence of MSK disorders in indigenous communities in the Mixtec and Chontal regions is very high. The most common rheumatic diseases found were back pain and osteoarthritis. A high percentage of participants had not received medical care.

BackgroundGLADERPO group (Latin American Study Group on Rheumatic Diseases in Indigenous Peoples) is an organization aimed to conduct studies on indigenous populations with the purpose of closing the gap of information about rheumatic diseases and develop culturally-sensitive interventions.ObjectivesEstimate the prevalence of musculoskeletal disorders and rheumatic diseases in eight Latinoamerican indigenous communities using the COPCORD methodology.MethodsA cross-sectional, house-by-house, community-based census study was performed. Bilingual staff members, who received standardized training, administered a cross-culturally validated version of the COPCORD questionnaire to adult indigenous population with the assistance of bilingual translators. Individuals with musculoskeletal pain, stiffness or swelling in the last 7 days and/or at any point during their lifetime were evaluated by participating physicians (general physicians and rheumatologist) to classify or diagnosed any rheumatic disease according to specific criteria.ResultsWe surveyed 6,155 indigenous people having a mean age of 41.2 years (SD 17.6; range 18 to 105); 3,757 (61.0%) were women. Mean education was 5.0 years (SD 4.1); and 4,668 (75.8%) work for living.MSK pain in the past and during the last 7 days occurred in 2,778 (45.1%; 95% CI 43.8–46.3) and 2,127 individuals (34.5%, 95% CI 33.3–35.7%), respectively. Of these, 1,195 (56.2%, 95% CI 54.1–58.3%) individuals associated pain to trauma. Pain was severe in 15.8% and according to localization, pain originated from the spine (26.7%), the knees (17.6%), shoulders (15.3%), and hands (10.6%) more frequently.Point-prevalence of main rheumatic diseases was: low back pain (LBP) in 821 (13.3%; 95% CI: 12.4–14.2); osteoarthritis (OA) in 598 (9.7%; 95% CI: 8.9–10.4); rheumatic regional pain syndromes in 368 (5.9%; 95% CI: 5.3–6.6); rheumatoid arthritis (RA) in 85 (1.3%; 95% CI: 1.1–1.7); systemic lupus erythematosus in 7 (0.1; 95% CI: 0.004–0.2); nonspecific arthritis in 13 (0.2%; 95% CI: 0.1–0.3); spondyloarthritis in 12 (0.1; 95% CI: 0.1–0.3); and scleroderma in 3 (0.04%; 95% CI: 0.01–0.1).There were marked variations in the prevalence of each rheumatic disease among the different communities, i.e.: RA prevalence was 2.4% in Qom (Argentina) and 0.4% in Mixtecos (Mexico).ConclusionsThe overall prevalence of MSK disorders in indigenous community of Latin-American was 35.4%. Low back pain and OA were the most prevalent rheumatic conditions, but wide variations according to population groups occurred.AcknowledgementNational Council for Science and Technology (CONACYT)- Salud 2001–01–162154 (Mexico). Federico Wilhelm Agricola Foundation (Argentina). PDVSA East, SUELOPETROL and Bristol-Myers Laboratory (Venezuela).Disclosure of InterestNone declared