Introduction Epidemiological studies of rheumatic diseases have been conducted during the past 20 years in China. The aim of this study was to clarify prevalence rates of common rheumatic diseases in China.

To determine the incidence of musculoskeletal pain, disabilities, and help seeking behaviour, a questionnaire was administered to a rural population of 2184 men and 2499 women and an urban population of 481 men and 590 women aged over 15 years by house to house interviews with completion rates of 95-2% (rural) and 97-1% (urban). The incidences of pain in the joints, back, or neck were 23-6% (rural) and 31-3% (urban). The incidence of disability due to an inability to walk, lift, carry, and dress was 2-8% (rural) and 0-9% (urban). Patients and methodsThe total populations of 2499 women and 2184 men from two villages and the total populations of 590 women and 481 men from two city neighbourhoods, which were considered to be similar to the rural and urban population of Java, respectively, in demographic characteristics such as life expectancy, age structure, sex distribution, race, income, culture, religion, occupations, and social class,3 4 were selected for a house to house interview survey designed to determine musculoskeletal pain, disability, and help seeking behaviour with the phase 2 questionnaire. The rural population consisted of 75% farmhands and farmers, 18% labourers, and 7% employed by motels, hotels, and village offices. They lived in well defined hamlets surrounded by rice fields and market gardens, mostly in thatched houses. The average life expectancy was 45 years for men and 50 for women, despite a heavier workload (Bandungan community health centre data, 1982) for the women.The urban target areas were situated near the centre of a city with more than 900 000 inhabitants with an average life span of 50 and 55 years for men and women, respectively. Its social strata was predominantly classes 5 (unskilled occupations) and 4 (partly skilled occupations) with some class 3 (skilled occupations) and very few classes 2 (intermediate occupations) and 1 (professional occupations). All the rural and urban target populations were Javanese (Malayo-Polynesians) except a negligible number (less than 0-5%) of Chinese (Mongoloids) who were included in the urban subjects.3 4The rural and urban populations were not socially stratified but were considered to represent the social strata of Javanese rural and urban populations.The phase 1 questionnaire (omitted in this survey) records the occurrence of musculoskeletal pain in various body sites and disabilities as determined by primary health care workers2

As part of the WHO/International League Against Rheumatism (ILAR) sponsored community organized programme for the control of rheumatic disease (COPCORD), an arthritis community education programme (ACE) was undertaken utilizing the traditional form of entertainment in a rural area in Central Java-the wayang. The point prevalence rate of musculoskeletal complaints was estimated in 4683 men & women aged 15 years and over by house-to-house interviews. From 1105 respondents recording recent musculoskeletal pain, 844 were randomly selected and half the latter attended a puppet shadow play (wayang) incorporating the ACE. The other half, matched for age, sex and educational level who did not see the play, served as controls. A questionnaire containing biphasic choices of correct or incorrect ways of performing activities of daily living (ADL) to minimize musculoskeletal problems was administered to the whole group before, 1 month and 6 months after the wayang. Increased knowledge of correct ways of performing ADL (correct ADL) in the intervention group compared with the control group at 1 and 6 months after wayang was significant (P less than 0.05). Comprehension of correct ADL following the wayang could be demonstrated even in subjects who were illiterate and those who had attended primary school only. Retention of knowledge at the 6 month assessment declined more markedly in the illiterate group. ACE by wayang was shown to be feasible and effective in transferring knowledge on ADL to people with musculoskeletal problems in the sample population in Java. This effect could be shown even in the poorly educated section of the community.(ABSTRACT TRUNCATED AT 250 WORDS)

Many difficulties were encountered in a population survey of rheumatic complaints in a remote village area in the Philippines affecting the reliability of estimates of population prevalence. In phase I, a simple questionnaire identified 269 adults out of 950 who had rheumatic symptoms. In Phase II, 234 or 87% of positive respondents were requestioned using a more detailed pro forma. There were 196 with peripheral joint pain, 67 with neck pain and 137 with back pain. One third attributed their symptoms to work and 127 subjects had to stop work because of their complaints. Disability, including an inability to carry loads, affected nearly 1.8% of the population. Questions designed to detect rheumatoid arthritis and gout were not satisfactorily answered. Of those with complaints, 82% indicated that they still required help for their symptoms. In phase III, 166 subjects were medically examined. Osteoarthritis of the knee was found in 25 and 17 had Heberden's nodes. There were 16 with epicondylitis; 16 had rotator cuff pain and 35 had levator scapulae insertion pain. Three of these and three others had neck or shoulder swellings related to carrying loads on poles. Definite rheumatoid arthritis was diagnosed in two subjects and gout in five. No case of ankylosing spondylitis was identified. Thus, rheumatic complaints were common in this rural community and were frequently severe enough to cause disability and loss of time from work. Health worker education is required on how to handle these problems.

In initiating a community oriented programme for the control of rheumatic disease (COPCORD), 1685 people of all ages from a rural area in the Philippines were questioned by primary health care workers (PHW) for limb and spinal rheumatic pain and disability. The total complaint rate was 15.3% for men and 18.5% for women. For those 15 years and older the age adjusted rheumatic pain rates for pain present at the time of survey were 28.4% for the Philippines and 22.6% for Lawrence's UK population. The most common rheumatic pain sites in this community were knee, lumbar spine, neck and the trapezius muscle. The disability rate was 4.5% for those 15 years and older. One quarter of those with pain had received medical attention and the remainder, herbal treatment, massage, various faith and/or self-treatment methods.