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. 2021 Jan;40(1):75-83.
doi: 10.1007/s10067-020-05130-3. Epub 2020 Jun 5.

Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community

Vicente Juárez  1 , Rosana Quintana  2 , María Elena Crespo  1 , Mariana Aciar  1 , Emilio Buschiazzo  1 , Natalia L Cucchiaro  1 , Eugenia Picco  1 , Mario Ruiz  3 , José Adolfo Sánchez  4 , Rodolfo Franco  5 , Natalia Estrella  1 , Silvia Jorge  6 , Cinthya Retamozo  7 , Adriana M R Silvestre  8 , Vanina García  8 , Ingris Pelaez-Ballestas  9 , Bernardo A Pons Estel  8
Affiliations

Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community

Vicente Juárez et al. Clin Rheumatol. 2021 Jan.

Abstract

Objective: To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina.

Methods: This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment.

Results: A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5 years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7 days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4).

Conclusion: RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients' early referral to a specialist. Key Points • The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America. • The patients with RA had high percentage of familiar history of RA. • The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral. • The mean of the delay in the diagnosis was 5.8 years. In this community, the lack of the "migration health" phenomenon may be a social determinant that negatively impacts their health.

Keywords: COPCORD methodology; Indigenous peoples; Prevalence; Rheumatic diseases; Wichi.

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