Brennan-Olsen Sharon L, Cook S, Leech M T, Bowe S J, Kowal P, Naidoo N, Ackerman I N, Page R S, Hosking S M, Pasco J A, Mohebbi M
Deakin University, Geelong, Australia.
Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne-Western Precinct, Level 3, Western Centre for Health Research and Education (WCHRE) Building, C/- Sunshine Hospital, Furlong Road, St Albans, Melbourne, VIC, 3021, Australia.
BMC Musculoskelet Disord. 2017 Jun 21;18(1):271. doi: 10.1186/s12891-017-1624-z.
In higher income countries, social disadvantage is associated with higher arthritis prevalence; however, less is known about arthritis prevalence or determinants in low to middle income countries (LMICs). We assessed arthritis prevalence by age and sex, and marital status and occupation, as two key parameters of socioeconomic position (SEP), using data from the World Health Organization Study on global AGEing and adult health (SAGE).
SAGE Wave 1 (2007-10) includes nationally-representative samples of older adults (≥50 yrs), plus smaller samples of adults aged 18-49 yrs., from China, Ghana, India, Mexico, Russia and South Africa (n = 44,747). Arthritis was defined by self-reported healthcare professional diagnosis, and a symptom-based algorithm. Marital status and education were self-reported. Arthritis prevalence data were extracted for each country by 10-year age strata, sex and SEP. Country-specific survey weightings were applied and weighted prevalences calculated.
Self-reported (lifetime) diagnosed arthritis was reported by 5003 women and 2664 men (19.9% and 14.1%, respectively), whilst 1220 women and 594 men had current symptom-based arthritis (4.8% and 3.1%, respectively). For men, standardised arthritis rates were approximately two- to three-fold greater than for women. The highest rates were observed in Russia: 38% (95% CI 36%-39%) for men, and 17% (95% CI 14%-20%) for women. For both sexes and in all LMICs, arthritis was more prevalent among those with least education, and in separated/divorced/widowed women.
High arthritis prevalence in LMICs is concerning and may worsen poverty by impacting the ability to work and fulfil community roles. These findings have implications for national efforts to prioritise arthritis prevention and management, and improve healthcare access in LMICs.
在高收入国家，社会劣势与较高的关节炎患病率相关；然而，关于低收入和中等收入国家（LMICs）的关节炎患病率或决定因素知之甚少。我们利用世界卫生组织全球老龄化与成人健康研究（SAGE）的数据，按年龄、性别、婚姻状况和职业评估关节炎患病率，婚姻状况和职业是社会经济地位（SEP）的两个关键参数。
SAGE第一轮（2007 - 2010年）包括来自中国、加纳、印度、墨西哥、俄罗斯和南非的老年人（≥50岁）的全国代表性样本，以及18 - 49岁成年人的较小样本（n = 44,747）。关节炎由自我报告的医疗专业人员诊断和基于症状的算法定义。婚姻状况和教育程度由自我报告。按10岁年龄组、性别和SEP提取每个国家的关节炎患病率数据。应用特定国家的调查权重并计算加权患病率。
自我报告（终生）诊断为关节炎的女性有5003人，男性有2664人（分别为19.9%和14.1%），而目前基于症状诊断为关节炎的女性有1220人，男性有594人（分别为4.8%和3.1%）。男性的标准化关节炎发病率比女性大约高两到三倍。俄罗斯的发病率最高：男性为38%（95%CI 36% - 39%），女性为17%（95%CI 14% - 20%）。在所有低收入和中等收入国家，无论男女，关节炎在受教育程度最低的人群以及分居/离婚/丧偶女性中更为普遍。
低收入和中等收入国家的高关节炎患病率令人担忧，可能会因影响工作能力和履行社区角色的能力而加剧贫困。这些发现对各国优先开展关节炎预防和管理以及改善低收入和中等收入国家医疗服务可及性的努力具有启示意义。
