在墨西哥城开展的一项基于社区的研究，旨在估计风湿性疾病的患病率、疾病负担及寻求帮助行为。一项社区导向基层医疗研究（COPCORD研究）

Community based study to estimate prevalence, burden of illness and help seeking behavior in rheumatic diseases in Mexico City. A COPCORD study.

作者信息

Cardiel M H, Rojas-Serrano J

机构信息

Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

出版信息

Clin Exp Rheumatol. 2002 Sep-Oct;20(5):617-24.

PMID:12412191

Abstract

OBJECTIVE

To estimate the prevalence, burden of illness and help seeking behavior of musculoskeletal complaints and provide point prevalence estimates of osteoarthritis, low back pain, fibromyalgia, rheumatoid arthritis and gout among adult population in a suburban community in Mexico city.

METHODS

Home survey of adults in a balanced and stratified sample validated against physical exam. Three trained interviewers applied a validated COPCORD core questionnaire. Subjects with pain (in the last seven days or ever) > or = 4 (0-10) and no trauma; or with current or past disability were evaluated preferably the same day by a trained clinician in a structured interview. A diagnosis using ACR criteria when available, recommendation or referral was provided as required. Analysis was based on descriptive statistics of participant characteristics, pain site and distribution, patterns of help seeking behavior. Point prevalence with 95% confidence intervals of most common diseases and associated disability rate.

RESULTS

1169 men and 1331 women were included. Pain in the last 7 days not associated with trauma was reported in 419 (17%) participants. The most common sites of involvement were knee (12.3%); low back (6.3%); ankles (6%) and shoulders (5.3%). The mean/SD pain score was 4.8/2.5. Thirteen percent of the total sample had some treatment. The general practitioner treated 72% of those; 75% perceived good efficacy with medications. Point prevalence estimates and 95% CI were: disability: 1.4% (0.0-1.9); osteoarthritis: 2.3% (1.7-2.9); fibromyalgia: 1.4 (1.0-2.0); low back pain: 6.3% (5.4-7.3); rheumatoid arthritis: 0.3% (0.1-0.6) and gout 0.4% (0.1-0.7).

CONCLUSION

Pain in the last 7 days due to musculoskeletal disorders is 17% in this community. Medications were commonly prescribed. Point prevalence estimates of most common diagnoses was similar to other community surveys using COPCORD methodology but very different help seeking behavior.

摘要

目的

评估肌肉骨骼疾病的患病率、疾病负担及就医行为，并提供墨西哥城一个郊区社区成年人群中骨关节炎、腰痛、纤维肌痛、类风湿关节炎和痛风的时点患病率估计值。

方法

对经过均衡分层抽样的成年人进行家访，并通过体格检查进行验证。三名经过培训的访谈员使用经过验证的COPCORD核心问卷。疼痛（在过去七天内或曾经）评分≥4（0-10）且无创伤的受试者；或目前或过去有残疾的受试者，最好在同一天由一名经过培训的临床医生进行结构化访谈评估。如有可能，使用美国风湿病学会（ACR）标准进行诊断，并根据需要提供建议或转诊。分析基于参与者特征、疼痛部位和分布、就医行为模式的描述性统计。最常见疾病的时点患病率及其95%置信区间和相关残疾率。

结果

纳入1169名男性和1331名女性。419名（17%）参与者报告在过去7天内有与创伤无关的疼痛。最常受累的部位是膝盖（12.3%）；下背部（6.3%）；脚踝（6%）和肩膀（5.3%）。平均/标准差疼痛评分为4.8/2.5。总样本中有13%接受了某种治疗。全科医生治疗了其中的72%；75%的人认为药物疗效良好。时点患病率估计值及其95%置信区间为：残疾：1.4%（0.0-1.9）；骨关节炎：2.3%（1.7-2.9）；纤维肌痛：1.4（1.0-2.0）；腰痛：6.3%（5.4-7.3）；类风湿关节炎：0.3%（0.1-0.6）；痛风：0.4%（0.1-0.7）。