EPIDEMIOLOGY OF RHEUMATIC DISEASE IN RURAL THAILAND - A WHO-ILAR COPCORD STUDY

Objective. To determine the prevalence rates of musculoskeletal disord ers in a rural population of Thailand. Methods. Nurses applied the WHO -ILAR COPCORD Core Questionnaire to 2463 rural subjects 15 years of ag e and over. Respondents who had current musculoskeletal pain were exam ined 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%, respectiv ely. Musculoskeletal pain ever by interview was found in 36.2% of resp ondents. 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%) wh o had musculoskeletal pain within 7 days of the interview were examine d 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 wo men, 65.7% in men. Therapy was by physician 52.1%, paramedics 9.7%, an d 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 spondyloarthropat hy each 0.12%, and mixed connective tissue disease and unclassified au toimmune disease each 0.04%. Conclusion. Back and knee pain caused the greatest burdens of disease, resulting mostly from joint degeneration .