The aim of the study was to determine the prevalence of musculoskeletal disorders and rheumatic diseases in an urban community in Venezuela. We conducted a cross-sectional, community-based study using the COPCORD (Community Oriented Program for Control of Rheumatic Diseases) methodology in subjects older than 18 years. Positive cases were evaluated by rheumatologists. We surveyed 3,973 individuals (1,606 males and 2,367 females), with a mean age of 43.7 years (standard deviation (SD) 17.6). Mean duration of education was 8.9 years (SD 3.7), 79.2 % had a monthly income of < US$569, and 46.4 % were working. Excluding trauma, the prevalence of pain in the 7 days prior to interview was 19.9 % (95 % confidence interval (CI) 18.7-21.2 %). Mean pain intensity on a visual analog scale was 6.3 (SD 2.2), and 30.1 % (95 % CI 28.7-31.6 %) had a history of pain. Respondents reported pain in the knees, back, hands, shoulders, and ankles in the last 7 days; 4.7 % described current functional limitation, with 16.5 % reporting limitations in the past. Regarding treatment, 23.9 % received medication, 6.4 % received physical therapy, and 2.6 % received alternative treatment. The main diagnoses were osteoarthritis in 15.0 % (95 % CI 13.9-16.1 %), rheumatic regional pain syndromes in 6.3 % (95 % CI 5.5-7.1 %), back pain in 2.8 % (95 % CI 2.3-3.4 %), rheumatoid arthritis in 0.4 % (95 % CI 0.2-0.6 %), crystal arthropathy in 0.3 % (95 % CI 0.1-0.5 %), fibromyalgia in 0.2 % (95 % CI 0.1-0.4 %), and systemic lupus erythematosus in 0.07 % (95 % CI 0.01-0.2 %). The prevalence of musculoskeletal disorders was 22.4 %, and the most prevalent disease was osteoarthritis. Pain, in which a patient is receiving treatment for musculoskeletal disorders, and physical disability were associated with the presence of a rheumatic disease.

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 aimed to estimate the prevalence of musculoskeletal disorders and rheumatic diseases in the Warao, Kari’ña, and Chaima indigenous populations of Monagas State, Venezuela. A cross-sectional, analytical, community-based study was conducted in 1537 indigenous subjects ≥18 years old (38.6 % male, mean age 41.4 ± 17.5 years). The cross-culturally validated Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) diagnostic questionnaire was applied. Subjects with a positive COPCORD diagnosis (either historic or current pain) were evaluated by primary care physicians and rheumatologists. A descriptive analysis was performed and comparisons made using analysis of variance and the chi-square test. Pain in the last 7 days was reported by 32.9 %, with pain intensity, according to a Likert-type scale [no pain, 195 (38.5 %); minimal pain, 231 (45.6 %); strong pain, 68 (13.4 %); intense pain, 5 (0.9 %)], 38.0 % reported historical pain, and 641 (41.7 %) had either historic or current pain. Of the COPCORD-positive subjects, pain most frequently occurred in the knee, back, and hands. Musculoskeletal and rheumatic diseases included osteoarthritis (14.1 %), back pain (12.4 %), rheumatic regional pain syndromes (RRPS) (9.7 %), undifferentiated arthritis (1.5 %), rheumatoid arthritis (1.1 %), and fibromyalgia (0.5 %). Chaima (18.3 %) and Kari’ña (15.6 %) subjects had a high prevalence of osteoarthritis, and Warao subjects had a high prevalence of low back pain (13.8 %). The prevalence of RRPS was high in all three ethnic groups. The Chaima group had the highest prevalence of rheumatic diseases, with 2.0 % having rheumatoid arthritis. This study provides useful information for health care policy-making in indigenous communities.

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