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Abstract Number: 59

A Staggering Burden of Pain and Rheumatic Disorders in India: A National Bone & Joint Decade India Community Oriented Program for Control of Rheumatic Disease Survey 2006-2011

Arvind Chopra1, R. Ghorpade1, S. Sarmukkadam2, VL Joshi1, AJ. Mathews3, L. Gauri4, A. Rahim5, K. Datta6, S. Chaturvedi7, B. Thakuria8, A. Mahajan9, R. Singh10, A. Ghosh11, R. Handa12, Manjit Saluja13, A. Venugopalan14, V. Kunjeer14, B. Paul5, S. Pal6, K. Wangjam10, T. Kumar15, CP Rajendran16, V. Gajalakshmi17 and K. Mahendranath18, 1Rheumatology, Center for Rheumatic Diseases, Pune, India, 2Biostatistics, B J Medical College, Pune, India, 3Government Medical College Hospital, Trivandrum, India, 4SP Medical College, Bikaner, India, 5Calicut Medical College, Calicut, India, 6Advance Rheumatology Clinic, Hyderabad, India, 7FRCH, Pune, India, 8Guwahati Medical College & Hospital, Guwahati, India, 9Government Medical College, Jammu, India, 10Regional Institute of Medical Sciences, Imphal, Manipur, India, 11Rheumatology, Institute of Post Graduate Medical Education and Research, Kolkata, India, 12Department of Rheumatology, AIIMS, New Delhi, India, 13Clinical care, Center for Rheumatic Diseases, Pune, India, 14Center for Rheumatic Diseases, Pune, India, 15Institute of Post Graduate Medical Education and Research, Kolkata, India, 16Madras Medical College, Chennai, India, 17ERC Unit, Chennai, India, 18Rheumatology clinic, Bangalore, India

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Rheumatic disease

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Session Information

Session Title: Epidemiology and Health Services Research: Epidemiology and Outcomes of Rheumatic Disease I

Session Type: Abstract Submissions (ACR)

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.

Disorder

Prevalence

Rheumatoid arthritis

0.34 (0.08, 0.79)

Undifferentiated inflammatory arthritis

0.22 (0.05,0.68)

Seronegative Spondyloarthritis

0.23 (0.05,0.68)

Ankylosing Spondylitis

0.03 (0.02, 0.05)

Osteoarthritis, any form

4.39 (3.30,5.61)

Osteoarthritis knee

3.34 (2.43, 4.47)

Gout

0.04 (0.03, 0.05)

Soft tissue rheumatism, any form

1.31 (0.77, 2.11)

Ill defined symptoms, non specific arthralgias

4.25 (3.23, 5.53

Lupus & other  connective tissue disorders

0.02 (0.01, 0.03)

 

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.

 

    

 


Disclosure:

A. Chopra,
None;

R. Ghorpade,
None;

S. Sarmukkadam,
None;

V. Joshi,
None;

A. Mathews,
None;

L. Gauri,
None;

A. Rahim,
None;

K. Datta,
None;

S. Chaturvedi,
None;

B. Thakuria,
None;

A. Mahajan,
None;

R. Singh,
None;

A. Ghosh,
None;

R. Handa,
None;

M. Saluja,
None;

A. Venugopalan,
None;

V. Kunjeer,
None;

B. Paul,
None;

S. Pal,
None;

K. Wangjam,
None;

T. Kumar,
None;

C. Rajendran,
None;

V. Gajalakshmi,
None;

K. Mahendranath,
None.

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