Risk factors for incident symptomatic knee osteoarthritis: a population-based case control study in Lebanon.

OBJECTIVES: To identify risk factors for symptomatic knee osteoarthritis (OA) and explain the geographical disparities in its occurrence. METHODS: A population-based case control study used data from a national Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) study conducted in Lebanon in 2009. The sample included 59 incident cases of symptomatic knee OA with no past knee injury, knee pain for a period of < 12 months, and were examined by rheumatologists. One hundred and eighteen randomly sampled population-based controls were frequency matched with cases by age and gender. RESULTS: Obesity, overweight and area of residence were significant risk factors for knee OA, after adjusting for type of job, monthly income and family history of joint problems. CONCLUSION: Determinants of symptomatic knee OA in Lebanon may differ by geographical location, potentially reflecting differences in social conditions, biological elements and environmental factors. The geographical differences remained significant even after accounting for investigated factors. Thus, further research is needed to explore other potential determinants, such as living conditions, biomechanical and hormonal factors.

High burden of rheumatic diseases in Lebanon: a COPCORD study.

AIM: To estimate the prevalence of rheumatic diseases in Lebanon and to explore their distribution by geographic location, age, and gender. METHOD: Using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology, a random sample of 3530 individuals aged 15 and above was interviewed from the six Lebanese governorates. Positive respondents were evaluated by rheumatologists using the internationally accepted classification criterion of the American College of Rheumatology for the diagnosis of rheumatic diseases. RESULTS: Prevalence rates of current and past musculoskeletal problems were 24.4% and 8.4%, respectively. Shoulder (14.3%), knee (14.2%) and back (13.6%) were the most common pain sites. Point prevalence of rheumatic diseases was 15.0%. The most frequent types of rheumatic diseases were of mechanical origin, namely soft tissue rheumatism (5.8%) and osteoarthritis (4.0%). Rheumatoid arthritis (1.0%) and spondylathropathies (0.3%) constituted the most common inflammatory diseases. Coastal areas had the lowest prevalence of all diseases except for fibromyalgia. All diseases showed an increasing prevalence pattern with age and a higher prevalence among women than men. CONCLUSION: This is the first study to give population-based estimates of rheumatic diseases in Lebanon. The high burden calls for public health attention for early detection, control and prevention of these conditions. Point prevalence of individual diseases was within the range of results from other COPCORD surveys with some variations that can be attributed to differences in methodology and geo-ethnic factors.

High burden of musculoskeletal conditions: a problem that has only recently come to recognition.

OBJECTIVES: Musculoskeletal conditions have only recently been acknowledged and research on their burden is scarce in the Middle East and North African (MENA) region. For the first time, a population based study was conducted in Lebanon to assess the prevalence, level of disability, and health seeking behaviours related to musculoskeletal pain and rheumatic disorders. METHODS: A random sample of 500 participants aged ≥ 15 years from Southern Lebanon was interviewed using the COPCORD (Community Oriented Program for Control of Rheumatic Diseases) questionnaire. RESULTS: The prevalence of current musculoskeletal pain was 31.2% [CI (27.0-35.2%)]. Being a female [OR=1.8, CI (1.2-2.8)] and of advancing age [OR=1.03, CI (1.01-1.05)] were the only significant factors associated with current musculoskeletal pain. Prevalence of current functional disability was 6.4% [CI (4.2-8.5%)]. Around quarter (26.0%) [CI (22.3-30.1%)] of our sample sought some kind of treatment. The overall prevalence rate of rheumatic disease was 17.0% [CI (13.7-20.3%)]. DISCUSSION: Our findings indicate that musculoskeletal conditions are common in Lebanon. This is a timely public health issue that needs further investigation and solid recognition by health authorities. Community-based interventions should target patients to prompt them to seek early help in order to prevent the development of musculoskeletal pain into disorders.

Coping and disability: evidence from a developing country.

AIM: In view of the increasing burden of musculoskeletal-related disability, the growing number of older persons and the scarcity of research on musculoskeletal conditions in the Eastern Mediterranean region, coping with musculoskeletal problems deserves special attention. This paper examines how good coping links to musculoskeletal-related disability among Lebanese citizens aged 15 years and older. METHODS: The sample included 200 people living in southern Lebanon and who participated in the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) survey. Disability and coping were assessed using self-reported questions. Covariates included demographics, musculoskeletal pain variables, and body mass index (BMI). RESULTS: Around one-third of the sample had lifetime functional disability due to musculoskeletal problems and 62% were coping well with their problems. Adjusted data showed that the odds of musculoskeletal-related disability among individuals who were not coping well was 2.35 times the odds of disability among individuals who were coping well with 95% CI = 1.10-5.02. CONCLUSION: This study provides evidence of the importance of complementing pharmacological treatment with a cognitive-behavioral approach for management of musculoskeletal problems.