孟加拉国农村和城市社区风湿性疾病的患病率及相关结局：一项社区导向的基层医疗研究（COPCORD研究）

Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study.

作者信息

Haq Syed Atiqul, Darmawan John, Islam Mohammad Nazrul, Uddin Mohammed Zahir, Das Bidhu Bhushan, Rahman Fazlur, Chowdhury Mohammad Abdul Jalil, Alam Mohammad Noor, Mahmud Taimur Abul Khair, Chowdhury Minhaj Rahim, Tahir Mohammad

机构信息

Rheumatology Wing, Department of Medicine, Bangabandhu Sheikh Mujib Medical University Shahbagh, Dhaka, Indonesia.

出版信息

J Rheumatol. 2005 Feb;32(2):348-53.

PMID:15693098

Abstract

OBJECTIVE

To estimate the burden of rheumatic disorders in adults (age >/= 15 yrs) in Bangladeshi rural and urban communities.

METHODS

The survey was carried out in a rural community, an urban slum, and an affluent urban community with samples of 2635, 1317, and 1259 adults, respectively. Through door-to-door surveys, trained interviewers identified subjects with musculoskeletal pain. A socio-culturally adapted and validated Bengali version of the COPCORD (Community Oriented Program for Control of Rheumatic Disorders) questionnaire was used. Trained internists and rheumatologists examined the positive respondents using an English COPCORD examination sheet to identify respondents with definite rheumatic disorders and to reach a diagnosis.

RESULTS

The overall point prevalence of musculoskeleletal pain was 26.3%. The point prevalence estimates of musculoskeletal pain in rural, urban slum, and affluent urban communities were 26.2% (women 31.3%, men 21.1%), 24.9% (women 27.5%, men 22.6%), and 27.9% (women 35.5%, men 18.6%), respectively. Most commonly affected sites were low back, knees, hips, and shoulders in all 3 communities. The point prevalence of definite rheumatic disorders was 24.0%. The commonest rheumatic disorders were osteoarthritis of the knees, nonspecific low back pain, lumbar spondylosis, fibromyalgia, and soft tissue rheumatism. Their prevalence estimates were 7.5%, 6.6%, 5.0%, 4.4%, and 2.7%, respectively, in the rural, 9.2%, 9.9%, 2.0%, 3.2%, and 2.5%, respectively, in the urban slum, and 10.6%, 9.2%, 2.3%, 3.3%, and 3.3% in the urban affluent community. The point prevalence of functional disability was 25.5%, 23.3%, and 24.8%, respectively, in the rural, urban slum, and urban affluent communities. Among the positive respondents, 22%, 52%, and 22% reported loss of work for durations of 49.3 +/- 47.5, 50.90 +/- 103.3, and 29.25 +/- 56.5 days, respectively, within the previous year.

CONCLUSION

Rheumatic disorders are common causes of morbidity, disability, and work loss in rural and urban communities of Bangladesh. Women are affected more frequently than men. Mechanical disorders are more common than inflammatory arthropathies.

摘要

目的

评估孟加拉国农村和城市社区中成年人（年龄≥15岁）风湿性疾病的负担。

方法

该调查在一个农村社区、一个城市贫民窟和一个富裕的城市社区进行，分别抽取了2635名、1317名和1259名成年人作为样本。通过挨家挨户的调查，经过培训的访谈人员识别出有肌肉骨骼疼痛的受试者。使用了经过社会文化改编和验证的孟加拉语版COPCORD（社区风湿性疾病控制项目）问卷。经过培训的内科医生和风湿病学家使用英文COPCORD检查表对阳性应答者进行检查，以识别患有明确风湿性疾病的应答者并做出诊断。

结果

肌肉骨骼疼痛的总体时点患病率为26.3%。农村、城市贫民窟和富裕城市社区肌肉骨骼疼痛的时点患病率估计分别为26.2%（女性31.3%，男性21.1%）、24.9%（女性27.5%，男性22.6%）和27.9%（女性35.5%，男性18.6%）。在所有3个社区中，最常受影响的部位是下背部、膝盖、臀部和肩膀。明确风湿性疾病的时点患病率为24.0%。最常见的风湿性疾病是膝关节骨关节炎、非特异性下背痛、腰椎间盘突出症、纤维肌痛和软组织风湿病。它们在农村的患病率估计分别为7.5%、6.6%、5.0%、4.4%和2.7%，在城市贫民窟分别为9.2%、9.9%、2.0%、3.2%和2.5%，在富裕城市社区分别为10.6%、9.2%、2.3%、3.3%和3.3%。农村、城市贫民窟和富裕城市社区功能残疾的时点患病率分别为25.5%、23.3%和24.8%。在阳性应答者中，分别有22%、52%和22%报告在过去一年中误工时间为49.3±47.5天、50.90±103.3天和29.25±56.5天。