Australia
|
1. Muirden KD, Valkenburg HA, Hopper J, Guest C. The epidemiology
of Rheumatic diseases in Australia. APLAR Rheumatology. Eds. Nasution
AR, Darmawan J. Churchil Livingstone Tokyo. 1992:409-210.
2. Nicola Minaur, Steven Sawyers, Jonathan Parker, John Darmawan.
Rheumatic Disease in an Australian Aboriginal Community in North Queensland,
Australia. A WHO-ILAR COPCORD Survey. J Rheumatol. 2004 May;31(5):965-72. |
| Minaur
N, Sawyers S, Parker J, Darmawan J. Rheumatic disease in an Australian
Aboriginal community in North Queensland, Australia. A WHO-ILAR COPCORD
survey. J Rheumatol. 2004 May; 31(5):965-72. |
| OBJECTIVE:
To estimate prevalences of rheumatic diseases in Aboriginal Australians.
METHODS: The methodology of the Community Oriented Program for the Control
of Rheumatic Diseases (COPCORD) was followed. Everyone aged 15 years or
older in Yarrabah, North Queensland, was invited to complete a COPCORD
Core Questionnaire. Aboriginal health workers carried out a house-to-house
survey during January 2002. People reporting current musculoskeletal symptoms
and 56 others (controls) were examined at the community health center.
RESULTS: Eighty percent of the target population was covered during the
survey. Eight hundred and forty-seven questionnaires were completed (47%
men) and 135 people refused, a response of 86%. Rheumatic symptoms within
the previous 7 days were reported by 33% and past symptoms by 22%. The
most common sites of current pain were low back (12.5%), knee (11.2%),
and shoulder (8.9%). Sixty-seven people (7.7%) said activities were limited
by their symptoms. Two hundred and sixty-three people were examined, and
the most common diagnoses were soft tissue pain (point prevalence 7.4%),
osteoarthritis (5.5%), and low back pain (4.3%). The cumulative prevalence
of gout was 7.0% in men and 0.9% in women over the age of 15 years. The
relative risk of gout associated with drinking regularly was 2.5, and
with body mass index > 25 was 3.3. No rheumatoid arthritis or systemic
lupus erythematosus cases were identified, but there were 4 cases of psoriatic
arthritis (point prevalence 0.5%). CONCLUSION: This is the first unselected
population study of rheumatic diseases in Australian Aboriginals. There
was a high prevalence of gout among men, with modifiable factors of weight
and alcohol identified. |
Bangladesh
|
1.
Haq SA, Das BB, Rahman F, Chowdhury MAJ, Alam MN, Islam N, Chowdhury MR,
Mahmud TAK. Prevalence of rheumatic disorders in a Bangladeshi urban community:
COPCORD study. Abstracts. 10th Asia Pacific League of Associations for
Rheumatology Congress. Bangkok, Thailand, December 1 – 6, 2002, p
182.
2. Haq SA. COPCORD Bangladesh. APLAR 2004 Proceeding Book. The
11th Asia Pacific League of Associations for Rheumatology Congress. Korea,
Jeju, September 11—15, 2004, pp 85-6.
3. Haq SA. A Bangladeshi RA patient treated with Darmawan protocol.
The 11th Asia Pacific League of Associations for Rheumatology Congress.
Korea, Jeju, September 11—15, 2004, pp 308-9.
4. Zahiruddin M, Das BB, Banik S, Haq SA, Saha A, Chowdhury MAJ,
Rahman MF, I MN, Alm MN. Prevalence of knee osteoarthritis in adult population
in a rural area of Bangladesh: a community based study. Journal of Medicine
2004; 5: 69-73.
5. Haq SA, Darmawan J, Islam MN, Uddin MZ, Das BB, Rahman F, Chowdhury
MA, Alam MN, Mahmud TA, Chowdhury MR, Tahir M. Prevalence of Rheumatic
Diseases and Associated Outcomes in Rural and Urban Communities in Bangladesh:
A COPCORD Study. J Rheumatol. 2005 Feb; 32 (2):348-53. |
| Haq
SA, Darmawan J, Islam MN, Uddin MZ, Das BB, Rahman F, Chowdhury MA, Alam
MN, Mahmud TA, Chowdhury MR, Tahir M. Prevalence of rheumatic diseases
and associated outcomes in rural and urban communities in Bangladesh:
a COPCORD study. J Rheumatol. 2005 Feb;32(2):348-53. |
| 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. |
China
|
1.
Chen SL, Xius DO, Bao CD, Liu QY. COPCORD Study in Shanghai. APLAR Rheumatology.
Eds. Nasution AR, Darmawan J. Churchil Livingstone Tokyo. 1992:393-395.
2. Richard D. Wigley, Zhang Nai Zheng, Zeng Qingyu, et al. Rheumatic
Diseases in China: ILAR-China Study Comparing the Prevalence of Rheumatic
Symptoms in Northern and Southern Rural Populations. The Journal of Rheumatology
1994;21(8):1484~1490.
3. Chen S, Du H, Wang Y, Xu L.The epidemiology study of hyperuricemia
and gout in a community population of Huangpu District in Shanghai. Chin
Med J (Engl) 1998;111: 228-230.
4. Dai SM, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.. Prevalence
of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and
gout in Shanghai, China: a COPCORD study.
J Rheumatol. 2003; 30: 2245-51.
5. Zeng Qing Yu,Wang Qing Wen, Chen Ren, et al. Primary gout in
Shantou: a clinical and epidemiological study. Chinese Medical Journal
2003; 116(1): 66~69.
6. Zeng Qing-yu, Chen Ren, Xiao Zheng-Yu, Huang Shao-bi, Liu Yuan,
Xu Jing-cai, Chen Shun-le, John Darmawan, RD Wigley, KD Muirden. Low prevalence
of knee and back pain in southeast China; the Shantou COPCORD study. J
Rheumatol. 2004; 31: 2439-43.
7. Wu ZB, Zhu P, Wang HK, Zheng ZH, Jia Y, Ding J, Leng N, Zhang
HQ, Liu L. [Prevalence of seronegative spondyloarthritis in the army force
of China.]
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Sep;25(9):753-5. Chinese.
8. Zeng QY, Darmawan J, Xiao ZY, Chen SB, Chen R, Lin K, Wigley
R, Chen SL, Zhang NZ. Risk factors associated with rheumatic complaints:
a WHO-ILAR COPCORD study in Shantou, Southeast China. J Rheumatol. 2005;
32: 920-7. |
| Zeng
QY, Darmawan J, Xiao ZY, Chen SB, Chen R, Lin K, Wigley R, Chen SL, Zhang
NZ. Risk factors associated with rheumatic complaints: a WHO-ILAR COPCORD
study in Shantou, Southeast China. J Rheumatol 2005 May;32(5):920-7. |
| OBJECTIVE:
To validate the differences of the prevalence of rheumatic symptoms between
the north and south part of China and to investigate the associated risk
factors for rheumatic complaints in Shantou, China. METHODS: Four samples
together comprising 10,638 people > or = 16 years of age were surveyed
in 1987, 1992, 1995, and 1999. The protocol of the ILAR-China Collaborative
Study or the WHO-ILAR COPCORD Core Questionnaire was implemented. Data
on rheumatic symptoms that were part of these surveys were collected and
analyzed. RESULTS: The prevalence rate of rheumatic complaints was increasing
in the Shantou area during the recent decade (in 1987 11.6%, 1992 12.5%,
1995 16.0%, and 1999 19.8%). However, it was still lower than the rate
in Beijing, China, in 1987 (40.0%). Rheumatic symptoms were more prevalent
in women than in men, and were more frequently seen in the elderly than
in young people. The most frequently involved site was the low back followed
by the knee and neck. Lumbar pain was more frequent among rural residents,
while neck pain was more prevalent in the urban school-age population
group. The prevalence of knee pain was significantly higher in people
living in multi-story buildings without elevators compared with those
living in single-story houses. The peak value of bone mineral density
(BMD) in the Shantou population was 0.839 +/- 0.085 g/cm2 in men, and
0.723 +/- 0.064 g/cm2 in women, significantly higher than that reported
in 13 other provinces and cities of China including Beijing. The sense
of seeking a physician's care was higher in the population with a higher
prevalence of rheumatic symptoms than that in the group with a lower prevalence
of complaints. However, no significant difference was found in the rate
of disability among the different population samples. CONCLUSION: The
prevalence rate of rheumatic complaints was lower in Shantou than in Beijing.
Socioeconomic status, environmental differences (e.g., Shantou in the
southern and Beijing in the northern part of China), sex, age, occupation,
ergonomics, BMD, and awareness of seeking medical care might all be risk
factors associated with the prevalence of rheumatic complaints. |
| Zeng
QY, Chen R, Xiao ZY, Huang SB, Liu Y, Xu JC, Chen SL, Darmawan J, Couchman
KG, Wigley RD, Muirden KD. Low prevalence of knee and back pain in southeast
China; the Shantou COPCORD study. J Rheumatol. 2004 Dec;31(12):2439-43. |
| OBJECTIVE:
To determine whether the previously noted low prevalence of knee pain
(KP) and lumbar pain (LP) in rural southern China compared with the high
prevalence observed in North China was also true in a southern urban population.
METHODS: A population based sample of 2040 adults > or = 16 years of
age was studied in Chenghai City, close to the rural area previously studied
on the southeast coast of China. Primary healthcare workers administered
the COPCORD Phase I and II questionnaires. Those with rheumatic symptoms
were recalled for medical examination, with a response rate at examination
(phase III) of 98.4%. Those suspected of having arthritis had radiographs
and laboratory tests. Prevalences were age and sex adjusted to the total
of populations previously reported. RESULTS: (1) The prevalence for all
rheumatic symptoms at phase III was 18.1%. Of the 7.5% with KP, 55% had
osteoarthritic changes on radiograph (KOA) compared with 29% of a sample
with no KP (p < 0.001). Of the 11.5% with LP, 69% had degenerative
changes on lumbar spine radiograph (LOA). (2) Of residents in single-level
houses the prevalence was 5.6% for KP and 7.9% for LP, whereas in 4 to
6-level apartment buildings these rates were significantly higher, 9.1%
and 16.2%, respectively. All these pain rates were significantly lower
than noted in rural North China. The prevalence of pain together with
radiographic OA changes in the knee (KOA) was half the rate in single-floor
residents (2.7%) compared to apartment residents (5.3%), as was lumbar
spine degenerative disease (5.3% vs 11.5%). CONCLUSION: The prevalence
of knee and lumbar spine pain in this southern urban sample was confirmed
to be much lower than in the rural sample in the North, although higher
than in the rural sample in the South. Comparing COPCORD studies of Han
Chinese in Shanghai and Malaysia there was a decrease in prevalence of
knee and back pain with latitude, suggesting an association with climate.
Knee and back pain and radiological degenerative changes in the knee and
lumbar spine were twice as prevalent in apartment residents than in those
living in older single-level houses. Further study is needed to explain
these observations. |
Wu
ZB, Zhu P, Wang HK, Zheng ZH, Jia Y, Ding J, Leng N, Zhang HQ, Liu L.
[Prevalence of seronegative spondyloarthritis in the army force of China.]
[Article in Chinese]. Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Sep;25(9):753-5. |
| OBJECTIVE:
To investigate the prevalence and epidemiologic characteristics of seronegative
spondyloarthritis (SpAs) in Chinese army force in different areas. METHODS:
4-phase survey was conducted in 21 750 Chinese army, including: face-to-face
interviews with standardized COPCORD questionnaires (Phase I screening);
further examination on the suspected cases; identification of inflammatory
joint and spinal diseases (Phase II); identification of SpAs (AS and uSpA)
by more than two experienced specialists in rheumatology; further examination
with X-rays and laboratory detection of HLA-B27 (Phase III); and data
analysis (Phase IV). RESULTS: Among 21 750 army men, 21 cases of RA, 106
cases of SpAs were identified, with prevalence rates of 0.966 per thousand,
4.87 per thousand respectively. In 106 cases of SpAs, there were 46 cases
of ankylosing spondylitis (AS), 52 cases of undifferentiated SpAs (uSpAs)
with the prevalence rates of 2.11 per thousand and 2.39 per thousand respectively.
Few cases of reactive arthritis (ReA) and Reiter's syndrome (RS) were
identified (6 and 1 cases respectively). The prevalence of AS, uSpAs were
higher in navy than that in the ground force or the air force. Soldiers
in cold and damp areas had higher prevalence rates than that in the plain
and drought areas. CONCLUSION: The prevalence of SpA (especially AS and
uSpA) in Chinese army force was similar to that in the civilians. SpA
(AS and uSpA) was more prevalent seen in the Navy. The incidence of SpA
(AS and uSpA) was influenced by environmental factors such as coldness
and dampness. |
| Dai
SM, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM. Prevalence of rheumatic symptoms,
rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China:
a COPCORD study. J Rheumatol. 2003 Oct;30(10):2245-51. |
| OBJECTIVE:
To carry out a cross-sectional survey on prevalence of musculoskeletal
symptoms, rheumatoid arthritis (RA), ankylosing spondylitis (AS), and
gout. METHODS: In Shanghai, 4 communities comprising 7603 inhabitants
over 15 years of age in an urban population were randomly selected from
13 communities. Interviews were conducted from September 1997 to March
1998 by trained physicians using the COPCORD Core Questionnaire. Physical
and radiographic examinations and serologic tests were carried out when
required to classify categories of rheumatic diseases. The diagnoses of
RA, systemic lupus erythematosus (SLE), and gout were based on American
Rheumatism Association criteria. The diagnosis of AS strictly followed
the modified New York criteria of 1984. Crude prevalence rates were standardized
according to a standard Chinese population for age and sex structure.
RESULTS: A total of 6584 adults (3394 women, 3190 men) were interviewed,
and response rate was 86.6%. The age and sex standardized prevalence rate
of rheumatic symptoms at any site amounted to 13.3% (95% CI 12.5-14.1%).
Symptoms occurred more frequently in the following sites: knee 7.0% (95%
CI 6.4-7.6%), lower back 5.6% (95% CI 5.0-6.2%), shoulder 4.7% (95% CI
4.2-5.2%), and neck 2.4% (95% CI 2.0-2.8%). Women complained of rheumatic
symptoms more frequently than men. The standardized rates of RA, AS, gout,
symptomatic knee osteoarthritis, and soft tissue rheumatism were 0.28%
(95% CI 0.15-0.41%), 0.11% (95% CI 0.03-0.19%), 0.22% (95% CI 0.11-0.33%),
4.1% (95% CI 3.6-4.6%), and 3.4% (95% CI 3.0-3.8%), respectively. Two
cases of SLE, one case of dermatomyositis, and one case of systemic sclerosis
were found. CONCLUSION: Compared with rates in European and Western countries
the prevalence rates of RA, AS, and gout are low in Shanghai, China, although
the prevalence rates of rheumatic symptoms are high. |
India
|
1.
Rural COPCORD, Bhigwan, Pune, India. Reference: Chopra A. Longitudinal
measurement of structure, function and psychosocial status (RA). Function
feasibility issues in APLAR. APLAR Proceeding 1996; S186.
2. Chopra A, Patil J, Billempelly V, Relwani J, Tandle HS.Prevalence
of rheumatic diseases in a rural population in western India: a WHO-ILAR
COPCORD Study.
J Assoc Physicians India. 2001; 49: 240-6.
3. Chopra A, Saluja M, Patil J, Tandale HS. Pain and disability,
perceptions and beliefs of a rural Indian population: A WHO-ILAR COPCORD
study. WHO-International League of Associations for Rheumatology. Community
Oriented Program for Control of Rheumatic Diseases. J Rheumatol. 2002;
29: 614-21. |
| Chopra
A, Saluja M, Patil J, Tandale HS. Pain and disability, perceptions and
beliefs of a rural Indian population: A WHO-ILAR COPCORD study. WHO-International
League of Associations for Rheumatology. Community Oriented Program for
Control of Rheumatic Diseases. J Rheumatol. 2002 Mar;29(3):614-21. |
| OBJECTIVE:
The WHO-ILAR Community Oriented Program for Control of Rheumatic Diseases
(COPCORD) primarily aims to estimate the burden of rheumatic-musculoskeletal
symptoms/disorders (RMS). We investigated data on pain and disability,
perceptions and beliefs in the first rural community based COPCORD study
in India. METHODS: A total of 4092 adults were interviewed (response rate
89%) in a population survey (Stage 1) in Bhigwan village in 1996 using
modified COPCORD core questionnaires. Twenty-one trained volunteers completed
the survey in 5 weeks. Those reporting RMS were identified (Phase 1) to
complete a self-evaluation questionnaire (Phase 2) prior to rheumatological
evaluation (Phase 3). Phase 2 included questions on perceptions and beliefs
regarding pain, effect on life, work and socioeconomic factors, disability,
and therapy; only the moderate and severe grades were considered significant.
Patients marked their pain sites on a manikin during the presurvey week.
A validated modified Health Assessment Questionnaire disability index
(HAQDI) in the local language evaluated functional disability. RESULTS:
RMS were the predominant ailments reported by 746 adult villagers (18.2%;
95% CI 17.1, 19.2). Moderate pain of > 2 years' duration was reported
by almost 60% of RMS patients. Neck (6%), lumbar (11.4%), shoulder (7.4%),
elbow (6.5%), wrist (6.4%), hand (6.1%), knee (13.2%), calf (6.6%), and
ankle (6.5%) were the common painful sites, predominantly in women; 91%,
89%, and 31% with RMS reported a significant grade of pain, RMS illness,
and disturbed sleep, respectively. In the age group 25-54 years, 21% of
those with RMS perceived a significant effect on work ability, while less
than 20% of those with RMS admitted a similar effect on their personal
life (including finances). About 10% with RMS had ceased to work because
of RMS. Among RMS subjects 21% scored a significant HAQDI, but many more
reported significant difficulty (HAQ) in the individual items of walking,
hygiene (squatting), arising (from sitting cross-legged), reaching, and
occupational/household chores; this corresponded to the dominant pain
sites in low back and lower limbs. Oral tobacco use was reported to be
significantly greater (p < 0.001) in the RMS patients. Past trauma
was recalled by 23% of patients, and many connected this to their RMS.
Modern medicines were consumed by 55% of patients with RMS. Among patients,
86% and 65% expected "pain relief" and "cure," respectively,
from their doctor; 23% of patients wanted greater sympathy and attention.
However, 21% of patients had never visited a doctor and were only identified
by the COPCORD study. CONCLUSION: The findings of this study (1) demonstrate
that RMS, although a predominant ailment, has a modest effect on daily
living in most subjects with RMS; (2) indicate there is inconsistency
between the measures of pain and disability (using HAQ) and their effects;
(3) describe the beliefs and expectations of the community. Based on the
data and community support, the COPCORD has been continued for Stages
II and III, especially with a view to health education. |
| Chopra
A, Patil J, Billempelly V, Relwani J, Tandle HS. Prevalence of rheumatic
diseases in a rural population in western India: a WHO-ILAR COPCORD Study.
J Assoc Physicians India. 2001 Feb;49:240-6. |
|
BACKGROUND: COPCORD (Community oriented program from control of rheumatic
diseases) is a global initiative of the WHO/International League of Associations
from Rheumatology (ILAR). The prevalence data from the first Indian COPCORD
survey (Stage 1), carried out in village Bhigwan (Dist. Pune), in 1996,
is presented. AIM: To study the rural prevalence of rheumatic-musculoskeletal
symptoms/diseases (RMSD). METHODS: A cross-sectional survey of the village
(non-randomised selection) was completed in five weeks, using validated
questionnaires, served by 21 trained volunteers. 746 patients (18.2%,
95% CI: 17-1-19-4) were identified (Phase 1) from 4092 adults (response
89%), and systematically evaluated (Phase 2 and 3) by a medical team,
including a rheumatologist; limited investigations were carried out and
diagnosis confirmed during a planned 12 week initial follow-up. Standard
clinical criteria were used for the diagnosis; point prevalence estimates
(prev)/confidence interval (CI) are shown in parenthesis. RESULTS: There
was a dominant distribution of 'pain at all sites' (articular/soft tissues)
in the females; painful neck (9.5%), back (17.3%), and calf (8.5%) appeared
significant when compared to the Bhigwan males and the Indonesian and
the Chinese rural COPCORD results. 55% RMSD were due to soft tissue rheumatism
(5.5%) and an ill-defined/unclassifiable symptom-related-diagnosis (7.1%).
Osteoarthritis (5.8%) and inflammatory arthritis (IA) were seen in 29%
and 10% patients respectively. 240 patients (5.9%) with chronic knee pains
did not show any clinical evidence of OA. The prev of rheumatoid arthritis
(0.5%, 95% CI: 0.3-0.7), as classified by the American College of Rheumatology,
was the highest ever reported from an Asian rural COPCORD study. Though
unclassifiable IA (0.9%, 95% CI: 0.6-1.1) was seen, well defined reactive
arthritis, TB, leprosy and connective tissue disorders were not observed.
Gout was diagnosed in five patients (0.12%). CONCLUSIONS AND DISCUSSION:
The Bhigwan COPCORD survey demonstrates a significant rural spectrum of
RMSD. It provides a reasonable speculation about the Indian rheumatological
burden. Further, an eight year prospective study is in progress to identify
new cases and risk factors, and educate people (Stages 2 and 3). |
Indonesia
|
1.
Darmawan J, Valkenburg H A, Muirden K D, Wigley R D. Epidemiology
of Rheumatic Diseases in rural and urban populations in Indonesia: a World
Health Organization International League Against Rheumatism
COPCORD study, stage I, phase 2. Ann Rheum Dis 1992; 51: 525-528.
2. Darmawan J, Valkenburg HA, Muirden KD, Wigley RD. Arthritis
community education by leather puppet (wayang kulit) shadow play in rural
Indonesia (Java) Rheumatology Internat 1992;12: 97-101.
3. Darmawan J. Valkenburg HA Muirden KD Wigley RD :The epidemiology
of gout and hyperuricemia in a rural population of Java. J Rheumatol 1992;
19: 1595-1599.
4. Darmawan J, Valkenburg HA, Muirden KD, Wigley RD. The epidemiology
of rheumatoid arthritis in Indonesia. Brit J Rheum 1993; 32: 537-540.
5. Darmawan J, Valkenburg HA, Muirden KD, Wigley RD, Eudering
F. Nodules of the shoulder girdle in two Indonesian villages. Rheumatol
Int 1993; 12: 247-50.
6. Darmawan J Lutalo SK. Gout and hyperuricaemia. Baillieres Clin
Rheumatol 1995; 9: 83-94.
7. Darmawan J, Muirden KD, Valkenburg HA, Wigley RD. The prevalence
of Soft Tissue Rheumatism in Indonesia – a WHO-ILAR COPCORD Study.
Rheumatology Internat 1995;15: 121-124.
8. Darmawan J, Ferraz MB, Muirden KD, Tugwell P.Case study: World
Health Organization-International League of Associations for Rheumatology
Community-Oriented Programme for the Control of Rheumatic Diseases (WHO-ILAR
COPCORD) in Indonesia and Brazil. Int J Technol Assess Health Care. 1995;
11: 700-8.
9. Darmawan J, Rasker JJ, Nuralim H. Reduced burden of disease
and improved outcome of patients with rheumatoid factor positive rheumatoid
arthritis compared with dropouts. A 10 year observational study. J Rheumatol
Suppl. 2003 Aug; 67: 50-3.
10. Darmawan J, Rasker JJ, Nuralim H. The effect of control and
self-medication of chronic gout in a developing country. Outcome after
10 years. J Rheumatol. 2003 Nov; 30(11): 2437-43.
11. Darmawan J, Rasker JJ, Nuralim H. Ten years radiographic outcome
of rheumatoid factor positive rheumatoid arthritis patients, treated with
immunosuppressive combination therapy. J Rheumatol. In press 2004 March
31: |
| Darmawan
J, Valkenburg HA, Muirden KD, Wigley RD.The prevalence of soft tissue
rheumatism. A WHO-ILAR COPCORD study. Rheumatol Int. 1995;15(3):121-4. |
| TheThe
prevalence of various forms of soft tissue rheumatism, including painful
low back syndrome (PLBS), painful restricted shoulder syndrome (PRSS),
and epicondylitis without an underlying specific rheumatic disease, and
the resultant loss of time from work were determined in a total population
of 4,683 rural and 1,103 urban subjects aged 15 years and over in Central
Java, Indonesia. In the rural study, 763 respondents with, and 355 respondents
without complaints were examined. The urban survey evaluated 925 subjects.
Prevalence rates in the rural and urban subjects were 20.0% and 25.8%,
respectively, for PLBS, 14.5% and 16.2%, respectively, for PRSS, and 5.8%
and 7.5%, respectively, for epicondylitis. Lost time from work in the
rural and urban subjects was 9% and 2.2%, respectively, for PLBS, 5% and
1.1%, respectively for PRSS, and 2% and 1.3%, respectively for epicondylitis.
The mean number of lost work days per year in the rural and urban subjects
were 15.3 and 21.1, respectively, for PLBS, 8.1 and 15.2, respectively,
for PRSS, and 3.9 and 2.3, respectively for epicondylitis. Thus, these
forms of soft tissue rheumatism exerted significant effects on community
life, apart from causing pain and discomfort. Work days lost directly
means diminished income in populations lacking any form of unemployment
benefits. |
| Darmawan
J, Valkenburg HA, Muirden KD, Wigley RD. Epidemiology of rheumatic diseases
in rural and urban populations in Indonesia: a World Health Organisation
International League Against Rheumatism COPCORD study, stage I, phase
2. Ann Rheum Dis. 1992 Apr;51(4):525-8. |
| 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). The percentage of the population with pain
who had to stop work owing to disability was 75% (rural) and 78% (urban).
Official health care facilities were used by 62% (rural) and 71% (urban)
of the population. Traditional health care was used by 87% (rural) and
89% (urban). The high percentage of subjects unable to work was due to
a predominance of manual labour occupations (rural, 90%, urban, 80%).
The age and sex specific incidence of rheumatic diseases in these populations
were similar to other developing and developed countries. The primary
rheumatology service was inadequate due to the low priority given by the
health service to non-communicable diseases and inadequate rheumatology
teaching of the primary health care doctors during undergraduate training.
Musculoskeletal pain is a major public health problem in Indonesia and
is still not fully appreciated. |
| Darmawan
J, Muirden KD, Wigley RD, Valkenburg HA. Arthritis community education
by leather puppet (wayang kulit) shadow play in rural Indonesia (Java).
Rheumatol Int. 1992;12(3):97-101. |
|
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. |
Iran
|
| 1.
F. Davatchi. Iran COPCORD Study. APLAR 2004 Proceedings Book. The 11th
Asia Pacific League of Associations for Rheumatology Congress. Korea,
Jeju, September 1115, 2004, pp 89-91. |
| Fereydoun
Davatchi, Ahmad-Reza Jamshidi, Arash Tehrani Bani-Hashemi, Maziar Moradi,
Jaleh Gholami, Farideh Samadi, Mehrzad Hadj-Aliloo, Koorosh Ghaznavi,
Mohsen Soroosh, Bahareh Ghaderi, Parinaz Abyari. Rheumatology Research
Center, Tehran University for Medical Sciences, Shariati Hospital, Tehran,
Iran. Iran COPCORD Study. APLAR 2004 Proceedings Book. The 11th Asia Pacific
League of Associations for Rheumatology Congress. Korea, Jeju, September
1115, 2004, pp 89-91. |
| OBJECTIVE.
To test the feasibility of a COPCORD survey. MATERIALS AND METHODS: Tehran
with 1/10th of the population of Iran of mixed ethnic origin was selected.
It is representative of the ethnic distribution of the country. Subjects
were randomly selected from the 22 districts. Interviewers were selected
from BS certified nurses and midwives. Physicians were selected from subspecialty
fellows of Rheumatology. Both groups completed different levels of training
courses for the survey. RESULTS: The pilot study was completed in one
day, from 9 AM to 6:30 PM. One hundred sixty eight houses were visited
and 284 subjects with age range of 15-82.5 and mean age of 39.2 years
were interviewed. The male to female ratio was 0.87 to 1.00. The ethnic
distribution was Caucasians 66.2%, Turks 32%, and Semites 1.8%. Musculoskeletal
complaints during the past 7 days were detected in 45.4% of the interviewed
subjects. Distribution was: shoulder 18.3%; wrist 13.4%; hand 15.1%; hip
10.2%; knee 26.1%; ankle 12.7%; big toe 11.6%; cervical spine 13.7%; dorsal
and lumbar spine 22.2%; others 12.3%. Degenerative Joint Disease was detected
in: neck 0.70 %; lumbar spine 0.70%; knee 9.76%; others 2.44%; multiple
joints 2.09%. Others were: low back pain 2.79%; sciatica 0.35%; tennis
elbow 0.70%; shoulder tenosynovitis 0.70%; tendonitis and tenosynovitis
1.06%. No inflammatory disorder was encountered. Disability was reported
by 23.9%. CONCLUSION: The pilot study warrants a COCPORD survey covering
10.000 subjects to acquire prevalence rate of Rheumatoid Arthritis with
adequate statistical power. KEYWORDS: COPCORD, Iran, Rheumatic Diseases,
Community-based Epidemiology. |
Kuwait
|
1.
Al-Awadhi A, Olusi S, Moussa M, Al-Zaid N, Shehab D, Al-Herz A, Al-Jarallah
K, Al-Salem I, Pedro A. Validation of the Arabic Version of the WHO-ILAR
COPCORD Core Questionnaire for Community Screening of the Rheumatic Diseases
in Kuwaitis. The Journal of Rheumatology 2002; 29: 1754-9.
2. Al-Awadhi AM, Olusi SO, Moussa M, Shehab D, Al-Zaid N, Al-Herz
A, Al-Jarallah K. Musculoskeletal pain, disability and health-seeking
behavior in adult Kuwaitis using a validated Arabic version of the WHO-ILAR
COPCORD Core Questionnaire. Clin Exp Rheumatol. 2004 Mar-Apr; 22(2):177-83. |
| Al-Awadhi
AM, Olusi SO, Moussa M, Shehab D, Al-Zaid N, Al-Herz A, Al-Jarallah K.
Musculoskeletal pain, disability and health-seeking behavior in adult
Kuwaitis using a validated Arabic version of the WHO-ILAR COPCORD Core
Questionnaire. Clin Exp Rheumatol. 2004 Mar-Apr; 22(2): 177-83. |
|
OBJECTIVE: The WHO-ILAR Community Oriented Program for Control of Rheumatic
Diseases (COPCORD) primarily aims to estimate the burden of musculoskeletal
symptoms/disorders. We investigated data on musculoskeletal pain, disability
and health-seeking behavior in the first community-based COPCORD study
in Kuwait. METHODS: The validated Arabic version of the WHO-ILAR COPCORD
Core Questionnaire was used in 2,500 randomly selected Kuwaiti households.
The target population comprised Kuwaiti nationals aged 15 years and older.
Twenty-four trained field workers completed the survey in 8 weeks. Those
subjects reporting musculoskeletal pain were identified (Phase 1), and
were asked to complete a self-evaluation questionnaire (Phase 2) prior
to rheumatological examination (Phase 3). Phase 2 included questions on
the site and severity of pain, traumatic events, functional disability,
and treatment. Patients marked their pain sites on a mannequin during
their interviews. "Sufferers" were defined as those with musculoskeletal
pain and no history of trauma. RESULTS: A total of 7,670 adults were interviewed
(response rate 88%), of whom 2,057 had musculoskeletal pain not related
to trauma. Knees, back, and shoulders were the common sites of pain. Most
of the sufferers reported the severity of pain as being moderate to severe.
Functional disability was reported in 39.1% of the sufferers. The age-sex
population adjusted prevalence rate for musculoskeletal pain was 35.7%
in females and 20.2% in males. The most common sources for advice on treatment
were physicians in hospitals (68.8%) and general practitioners (30.4%).
82% had prescriptions for their medications, while 19.4% had self prescribed
tablets. CONCLUSION: Musculoskeletal pain is a major health problem among
Kuwaitis and deserves intense government attention. |
Malaysia
|
|
1. Veerapen K. Epidemiology of rheumatic disease in Malaysia. APLAR
Rheumatology. Ed Urban COPCORD study completed. Eds. Nasution AR, Darmawan
J. Churchil Livingstone Tokyo 1992:297-399. |
Pakistan
|
1. Farooqi A, Gibson T. The prevalence of major rheumatic disorders
in the adult population of Northern Pakistan. APLAR Proceeding 1996; S181.
2. Farooqi A, Gibson T. Prevalence of major rheumatic diseases
in the adult population of north Pakistan. Br J Rheumatol 1998; 37: 491-5. |
The Philippines
|
1.
Manahan L, Caragay R, Muirden KD, Allander D, Valkenburg HA, Wigley RD.
Rheumatic pain in a Philippine village. Rheumatology Internat 1985; 5:149-53.
2. Wigley RD, Manahan L, Muirden KD, Caragay R, Pinfold B, Couchman
KG, Valkenburg HA. Rheumatic disease in a Philippine village II: a WHO-ILAR-APLAR
COPCORD study, phases II and III. Rheumatology Internat 1991; 11: 157-161.
3. Dans LF, Tankeh-Torres S, Amante CM, Penserga EG. The prevalence
of rheumatic diseases in a Filipino urban population: a WHO-ILAR COPCORD
Study. J Rheumatol 1997; 24: 1814-1819. |
| Dans
LF, Tankeh-Torres S, Amante CM, Penserga EG. The prevalence of rheumatic
diseases in a Filipino urban population: a WHO-ILAR COPCORD Study. World
Health Organization. International League of Associations for Rheumatology.
Community Oriented Programme for the Control of the Rheumatic Diseases.
J Rheumatol. 1997 Sep;24(9):1814-9. |
|
OBJECTIVE: To determine the point prevalence of musculoskeletal complaints
and rheumatic diseases in a Filipino urban community. METHODS: A descriptive
cross-sectional 2 phase survey was conducted in an urban community in
Metropolitan manila. Phase I (screening) used face-to-face interviews,
while phase II (examination) involved case identification of the rheumatic
diseases. We sampled 670 households (3065 adults) using a multistage cluster
sampling method. A pilot study was conducted to pretest the questionnaire
for cross-cultural adaptation and validation, field procedures, sampling
design, and data management plan. Standardized translated COPCORD questionnaires
(blind translation and blind back-translation) were administered by trained
interviewers. Two weeks after Phase I, Phase II was conducted at local
health centers. The COPCORD questionnaire screened the number of cases
with musculoskeletal complaints. Identification of cases with rheumatic
disease was based on American College of Rheumatology (ACR) criteria.
RESULTS: Respondents completed 3006 questionnaires (phase I response rate
98%). Of these 489 respondents had musculoskeletal complaints. Functional
disability was reported in 25% among these respondents. We examined 353
(phase II response rate 72%), revealing 294 with rheumatic conditions.
In 26 persons there were no abnormalities, while 32 had nonrheumatic conditions
at examination. The most common rheumatic diseases were osteoarthritis
(OA) (n = 124) and soft tissue rheumatism (n = 115). CONCLUSION: The prevalence
of musculoskeletal complaints was 16.3% (95% CI 8.6-24.0) of the adult
population in a FIlipino urban community. The total prevalence of rheumatic
disease is 9.8% (95% CI 8.2-11.4). The prevalence of OA was 4.1% (95%
CI 3.3-4.9) and soft tissue rheumatism 3.8% (95% CI 2.9-4.8). The prevalence
of rheumatoid arthritis, 0.17% (95% CI 0-9.36), was notably low compared
to the prevalence in other developing countries. |
| Wigley
R, Manahan L, Muirden KD, Caragay R, Pinfold B, Couchman KG, Valkenburg
HA. Rheumatic disease in a Philippine village. II: a WHO-ILAR-APLAR COPCORD
study, phases II and III. Rheumatol Int. 1991;11(4-5):157-61. |
| 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. |
| Manahan
L, Caragay R, Muirden KD, Allander E, Valkenburg HA, Wigley RD. Rheumatic
pain in a Philippine village. A WHO-ILAR COPCORD Study. Rheumatol Int.
1985;5(4):149-53. |
| 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. |
Thailand
|
| 1.
Chaiamnuay P, Darmawan J, Muirden KD, Assawatanabodee P. Epidemiology
of Rheumatic Disease in Rural Thailand: a WHO-ILAR COPCORD Study. J Rheumatol
1998; 25: 1382-1387. |
| Chaiamnuay
P, Darmawan J, Muirden KD, Assawatanabodee P. Epidemiology of rheumatic
disease in rural Thailand: a WHO-ILAR COPCORD study. J Rheumatol. 1998
Jul;25(7):1382-7. |
| OBJECTIVE:
To determine the prevalence rates of musculoskeletal disorders in a rural
population of Thailand. METHODS: Nurses applied the WHO-ILAR COPCORD Core
Questionnaire to 2463 rural subjects 15 years of age and over. Respondents
who had current musculoskeletal pain were examined by 2 rheumatologists
within one week after the interview survey. Radiographic and serologic
examinations were carried out when required to classify categories of
rheumatic disease. RESULTS: Response rates of the interview survey and
examination were 99.7 and 94.2%, respectively. Musculoskeletal pain ever
by interview was found in 36.2% of respondents. Of these, 22.7, 12.5,
6.5, and 5% had back, knee, hip region, and neck pain, respectively. Four
hundred thirty-one cases (17.6%) who had musculoskeletal pain within 7
days of the interview were examined by rheumatologists, who confirmed
12.8, 5.7, 0.08, and 3.4% had back, knee, hip, and neck abnormalities,
respectively. Four hundred fifty-eight (18.6%) had past musculoskeletal
pain. Total disability rate was 3%, comprising 3.3% in women and 2.6%
in men. Treatment rates by self-medication for current and past musculoskeletal
pain were 60.3% in women, 65.7% in men. Therapy was by physician 52.1%,
paramedics 9.7%, and masseur 6.8%. The rates of disease prevalence were
osteoarthritis 11.3%, myofascial pain syndrome 6.3%, low back pain 4.0%,
arthralgia 3.2%, gout 0.16%, rheumatoid arthritis and seronegative spondyloarthropathy
each 0.12%, and mixed connective tissue disease and unclassified autoimmune
disease each 0.04%. CONCLUSION: Back and knee pain caused the greatest
burdens of disease, resulting mostly from joint degeneration. |
Vietnam
|
| 1.
Minh Hoa TT, Darmawan J, Chen SL, Van Hung N, Thi Nhi C, Ngoc An T. An.
Prevalence of the rheumatic diseases in urban Vietnam: a WHO-ILAR COPCORD
study. J Rheumatol 2003; 30: 2252-2256. |
Minh
Hoa TT, Darmawan J, Chen SL, Van Hung N, Thi Nhi C, Ngoc An T.
Prevalence of the rheumatic diseases in urban Vietnam: a WHO-ILAR COPCORD
study. J Rheumatol. 2003 Oct;30(10):2252-6. |
| OBJECTIVE:
To determine the prevalence rates of musculoskeletal disorders in an urban
Vietnamese population. METHODS: The Community Oriented Program for Control
of Rheumatic Disease (COPCORD) Stage I study was carried out in 16 groups
in the Trung Liet Commune, Dong Da District, Hanoi City, Vietnam. Phase
1: the WHO ILAR COPCORD Core Questionnaire was applied by primary health
care workers to 2119 urban subjects aged 16 years and over. Phase 2: 276
positive responders who had musculoskeletal complaints were interviewed
by nurses and examined one week later. Phase 3: 261 positive responders
in phase II were examined by 3 rheumatologists and 38% of these subjects
required radiographic and blood tests to classify rheumatic disease categories.
RESULTS: The response rates were 94.4%, 86.2%, and 94.6% in phases 1,
2, and 3, respectively. The prevalence of musculoskeletal pain was 14.9%.
The most common musculoskeletal complaints were knee pain 18.2%, low back
pain 11.2%, and soft tissue disorder 15.4%. Functional disability was
reported in 6.04% of the survey population. The prevalence of rheumatic
diseases was OA 4.1%, rheumatoid arthritis 0.28%, osteoporosis 0.47%,
connective tissue disease 0.09%, and gout 0.14%. CONCLUSION: The prevalence
of musculoskeletal pain in 2119 adults in an urban population in Vietnam
was 14.5%, and osteoarthritis was the most commonly found arthritis. |
Nature
Clinical
