Background/Purpose :

The maiden COPCORD (Community Oriented Program for Control of Rheumatic Diseases) population survey in village Bhigwan (Pune) findings proposed a high burden of pain and arthritis in India (J Rheumatol 2002; 29: 614-21). We carried out a national survey using COPCORD Bhigwan fast track  model.

Methods:

COPCORD population survey (Stage I) was completed in 3 parallel phases: 1(cross sectional house to house survey for demographics and screening), 2 [record pain (human mannequin) and disability (validated Indian HAQ), 3 (standard of care rheumatology evaluation). 12 volunteer rheumatologists chose non-random sites (Fig) and survey sample as per COPCORD diktat (http://www.copcord.org). Population was essentially screened for current (last 7 days) and/or past pain in joints or musculoskeletal (MSK) soft tissues. Trained volunteers from the community completed phases 1 & 2. The classification/ diagnosis were essentially clinical with minimal supporting investigations. Indigenously designed Windows based program was used for a central data entry and analysis using std stat software (SPSS & Epi Info v6). Prevalence rates were age-sex standardized to India census population 2001; 95% confidence intervals shown in parenthesis. Response rate at all sites > 80%.

Results:
56,541 populations surveyed.16% (14.2, 18.3) self reported MSK pain(current &/or past, any site); frequent sites-knee 8.5%, back 6.2%, ankle/feet 3.8%,shoulder 3.2%, elbow 2.9%, hand/wrist 2.9%, neck 1.5%. The frequency of pain at several sites and overall in rural was nearly twice urban. Self reported MSK pain was the predominant ailment in the community.
Table shows the point prevalence of selected clinical disorders.

Conclusion:

In this 1.2 billion population country, the prevalence of MSK pain and several rheumatic disorders reported by this first ever national COPCORD survey confers a huge burden in millions of patients and paves way for a national prevention and control program.