No abstract

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.

Background The prevalence of musculoskeletal diseases in indigenous communities in Mexico is unknown. As a response to this challenge, the Latin American Study Group of Rheumatic Diseases in Indigenous Peoples (GLADERPO) was created. This project lies within the framework of this regional effort. Objectives Estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in indigenous communities of the State of Oaxaca (Chontal and Mixteca Alta) using the COPCORD (Community Oriented Program for the Control of Rheumatic Diseases) methodology. Methods Subjects ≥18 years of age from two indigenous communities of the Mixteca Alta and Chontal. This is a cross-sectional and analytical community-based census study using a house-by-house method, in which staff members who received standardized training administered previously cross-culturally validated COPCORD questionnaire (1) in the communities. Positive cases of MSK pain were reviewed by primary care physicians and a rheumatologist. Results 1,060 community residents were surveyed. The mean age was 46.9 years (SD 19.9; age range, 18 to 97 years), 642 (60.5%) of subjects were women; the mean education was 6.8 years (SD 4.7); 1,001 (94.4%) were employed; 679 (64.1%) were covered under National Health Insurance Programme (called “Seguro Popular”). 479 individuals (45.1%, 95% CI 42.1-48.2%) had MSK pain in the last 7 days. Of these, 110 (22.0%, 95% CI 19.2-26.9%) associated pain to a traumatic event; pain intensity was reported as “strong pain-severe pain” in 29.5%. Sites with pain in the last 7 days were the spine (44.1%), knees (22.2%), shoulders (5.3%), and elbows (4.1%). Diagnoses: back pain 164 (15.4%; 95% CI 13.3-17.7); osteoarthritis 156 (14.7%; 95% CI 12.6-16.9); rheumatic regional pain syndromes 27 (2.5%; 95% CI 1.6-3.6); 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 0.0-0.5); gout 1 (0.09%; 95% CI 0.0-0.5). Conclusions The prevalence of MSK disorders in the indigenous communities of Mixteca and Chontal was 45.1%. Back pain and osteoarthritis were the most prevalent rheumatic diseases. We emphasize the overall prevalence of MSK pain in this indigenous population, generating a highly negative impact on the performance of daily activities. Acknowledgements To the municipal authorities of San Antonio Huitepec and San Carlos Yautepec. National Council for Science and Technology (CONACYT)- Salud 2001-01-162154. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.2707