Zahid-Al-Quadir Ahmad, Zaman M Mostafa, Ahmed Shamim, Bhuiyan Mahfuzur Rahman, Rahman Md Mujibur, Patwary Ismail, Das Bidhu Bhushan, Hossain Shaikh Amir, Paul Sujat, Shahin Abu, Rahman Moshiur, Haq Syed Atiqul
Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
WHO Bangladesh, 10 Gulshan Avenue, Road Number 5, Gulshan 1, Dhaka, 1212, Bangladesh.
BMC Rheumatol. 2020 Dec 16;4(1):69. doi: 10.1186/s41927-020-00169-w.
Nationally representative data on burden of musculoskeletal conditions (MSK) in Bangladesh are not available. The objective of this study was to determine the prevalence of MSK conditions and related disabilities in the adult population of Bangladesh.
A total of 2000 individuals aged 18 years or older were targeted from 20 primary sampling units (urban and rural) of all former seven divisions of Bangladesh in 2015. Structured interviews were done using the modified Community Oriented Program for Control of Rheumatic Disorders questionnaire to detect positive respondents. Standard criteria were used for diagnosing MSK conditions by rheumatology residents. In case of uncertainty, opinion was taken from senior rheumatologists. A Bangla version of the Health Assessment Questionnaire was used to determine disability.
A total of 1843 (92.1%) participated. Among them, 892 men and 951 women participated from rural (n = 716) and urban (n = 1127) areas. Their mean age was 40.5 (standard deviation 14.7) years. Almost a third did not have any formal schooling. Overall, 30.4% (95% confidence interval, 28.3-32.5) had MSK conditions. Low back pain (18.6%, 16.9-20.5), knee osteoarthritis (7.3%, 6.1-8.5) and soft tissue rheumatism 3.8% (2.9-4.7) were the three top-ranking MSK conditions. Rheumatoid arthritis (1.6%, 1.0-2.1), spondyloarthritis (1.2%, 7-1.8) and adhesive capsulitis (1.4%, 0.9-1.9) were relatively uncommon. Among those who had MSK conditions, 24.8% (21.3-28.6) had some degree of disability. Of them, 24.4% (21.0-28.1) had history of work loss during last 12 months.
The high burden of MSK conditions and related disabilities in Bangladesh warrants greater attention of the health system. Further studies are needed to estimate the impact of this group of conditions particularly addressing related disabilities and loss of work.
孟加拉国缺乏关于肌肉骨骼疾病（MSK）负担的全国代表性数据。本研究的目的是确定孟加拉国成年人群中MSK疾病及相关残疾的患病率。
2015年，从孟加拉国前七个行政区的20个初级抽样单位（城乡）中选取了总共2000名18岁及以上的个体。使用改良的社区风湿性疾病控制项目问卷进行结构化访谈，以检测阳性应答者。由风湿病住院医师使用标准标准诊断MSK疾病。如有疑问，则征求资深风湿病学家的意见。使用孟加拉语版的健康评估问卷来确定残疾情况。
共有1843人（92.1%）参与。其中，892名男性和951名女性分别来自农村（n = 716）和城市（n = 1127）地区。他们的平均年龄为40.5岁（标准差14.7）。近三分之一的人没有接受过任何正规教育。总体而言，30.4%（95%置信区间，28.3 - 32.5）患有MSK疾病。腰痛（18.6%，16.9 - 20.5）、膝关节骨关节炎（7.3%，6.1 - 8.5）和软组织风湿病3.8%（2.9 - 4.7）是排名前三的MSK疾病。类风湿关节炎（1.6%，1.0 - 2.1）、脊柱关节炎（1.2%，0.7 - 1.8）和粘连性囊炎（1.4%，0.9 - 1.9）相对不常见。在患有MSK疾病的人群中，24.8%（21.3 - 28.6）有一定程度的残疾。其中，24.4%（21.0 - 28.1）在过去12个月中有工作损失史。
孟加拉国MSK疾病及相关残疾的高负担值得卫生系统给予更多关注。需要进一步研究来评估这组疾病的影响,特别是针对相关残疾和工作损失的情况。
