Osteoarthritis (OA), the most prevalent joint disease in adults, ranks among the top 5 causes of disability. The burden of OA is expected to be greater in developing countries, where life expectancy is increasing and access to joint replacement therapy is not readily available. Risk factors associated with knee OA in Africa may differ from those identified in other parts of the world. This study aimed to establish the prevalence, clinical presentation, and associated factors of knee OA in two large referral centers in Cameroon. Between February and July 2012, we performed a cross-sectional analysis of 148 patients with knee OA followed at two rheumatology units in Douala. We included all patients with mechanical knee pain, who fulfilled the 1986 ACR for the classification and reporting of knee OA. One thousand four hundred ninety-six patients with musculoskeletal complaints were seen; 148 (9.9%) with knee OA were analyzed. Mean age was 56.9 ± 10.7 years, 75% were females, and 68% were post-menopausal. The VAS of pain at the time of diagnosis was higher than 50/100 mm in 64.2% of patients. Mean pain duration was 1 year (7 months-3.5 years). Obesity (BMI > 30) was present in 52% of patients, hypertension in 37.2%, and diabetes in 8.8%. Knee x-ray showed 35.5% of patients with grades III and IV on Kellgren and Lawrence classification. Bilateral bi-compartmental knee OA was found in 38.5% of patients and bilateral tricompartmental in 14.2%. The mean Lequesne disability index (LDI) was 8.4 ± 2.8. Pain intensity did not correlate with radiological findings whereas there was an association between pain and LDI. Knee OA is not rare among patients in Cameroon. Multiple factors including limited access to health care may account for why knee OA patients present at later stages of the disease with severe disability.

ObjectiveTo evaluate health-related quality of life (HRQoL) and its determinants in chronic low back pain (CLBP) patients in Cameroon.DesignObservational cross-sectional study.SettingTertiary hospital.ParticipantsThere were 150 eligible adults with low back pain of at least 12 weeks who provided informed consent. Of these, 136 with complete questionnaires were analysed.OutcomesHRQoL was measured using the WHO Quality of Life questionnaire (WHOQOL-BREF). Outcome measures included its four domain (physical health, psychological, social relationships and environmental) scores and two independent scores for overall quality of life (OQOL) and general health satisfaction (GH).ResultsParticipants had a median age of 52 years, and median pain duration of 33 (IQR: 69) months. The median OQOL score was 50 (IQR: 25). After multivariable adjustment, tertiary education (β=11.43, 95% CI 3.12 to 19.75), age (β=0.49, 95% CI 0.12 to 0.87) and being a student (β=23.07, 95% CI 0.28 to 45.86) contributed to better OQOL. Age (β=0.57, 95% CI 0.10 to 1.04) and physical-type employment (β=−14.57, 95% CI −25.83 to −3.31) affected GH. Smoking (β=−20.49, 95% CI −35.49 to −5.48) and radiological anomalies (β=−7.57, 95% CI −14.64 to −0.49) affected the physical health domain, while disability (β=−0.67, 95% CI −1.14 to −0.20) and duration of pain (β=−0.13, 95% CI −0.20 to −0.05) affected the psychological domain. Income (β=14.94, 95% CI 4.06 to 25.81) affected the social domain, while education (β=9.96, 95% CI 1.41 to 18.50) and disability (β=−0.75, 95% CI −1.26 to −0.24) affected the environmental domain.ConclusionsOur findings suggest that CLBP affects HRQoL and multiple socioeconomic and clinical factors influence its impact on different domains of HRQoL. Multipronged management programmes, especially those that reduce disability, could improve HRQoL in patients with CLBP.

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Purpose: The individual burden is of interest in the evaluation of the effect on the patient and/or family. This is a burden that influences the quality of life, social integration, home life, and use of medical resources (consultations, treatments, etc.). Methods: The goal of this study was to validate a questionnaire that can measure the individual burden of osteoarthritis. Results: The pilot version of the BONe'S (Burden Osteoarthritis New' Scale) questionnaire had 25 questions with a score expressed in %. The higher the score, the heavier the burden. An exploratory factorial analysis made it possible to structure the questionnaire by identifying the most correlated items: the 5 group model was the most effective. 5 questions were deleted due to crossed factor loadings. Each group of items was associated to a dimension: "Independence" (7 questions), "Interaction & Recreation" (4), "Psychological" (3), "Budget" (3), "Hygiene & Beauty" (3). All dimensions correlated well to the overall BONe'S score except for "Budget". However, this dimension appeared significant and strong in the sub population of active subjects (r ¼ 0.40), confirming its importance. For its psychometric evaluation, BONe'S was administered to a random sample of subjects with OA. The questionnaire's internal validity and dimensions were studied using Cronbach's alpha. BONe'S was administered alongside 2 validated questionnaires (SF-12 and PGWBI) in order to validate it externally by calculating the Spearman coefficient (r). 200 questionnaires were considered evaluable. The average age was 69.4 years (AE7.0), 86% of subjects were over the age of 60 and 92% were women. 43%, 26%, 18.5%, and 12.5% of subjects had 1, 2, 3, and 4 joints affected by arthritis respectively. 57% had knee OA, 34% had hip OA. Cronbach's alpha was equal to 0.86 for the entire questionnaire, which indicates excellent internal coherence. Intra-dimensional coherences were all acceptable (>0.67). The average BONe'S score was 21.9 (AE16.0) (median ¼ 17.6). The average score of subjects with 1 or 2 affected joints is significantly different from the score of subjects with 3 or more affected joints (18.6 (AE 14.9) and 29.2 (AE 16.0) respectively), which reinforces the discriminate validity of BONe'S. The BONe'S score also differed according to sex. The average PGWBI score (on 100) was 50.5 (AE12.6) (min ¼ 6, max ¼ 70). Analysis of the SF-12 demonstrated an altered quality of life for the physical dimension (38.9 AE9.9), but not for the mental dimension (49.9 AE11.8). The BONe'S score showed good inverse correlation with the physical dimension of the SF-12 (r¼-0.70) and, to a lesser extent, with the mental dimension (-0.40), as was the case with the PGWBI score (r¼-0.45) Conclusions: The internal and external validity of the Q was confirmed during the assessment. BONe'S is higher when more joints are affected by OA, with a significant difference between 1 or 2 affected joints and 3 or more joints. BONe'S is a validated tool that is short and easy to use. It can evaluate the burden...