Prevalence of musculoskeletal disorders and rheumatic disease in the Warao, Kari'ña, and Chaima indigenous populations of Monagas State, Venezuela.

This study aimed to estimate the prevalence of musculoskeletal disorders and rheumatic diseases in the Warao, Kari'ña, and Chaima indigenous populations of Monagas State, Venezuela. A cross-sectional, analytical, community-based study was conducted in 1537 indigenous subjects ≥18 years old (38.6 % male, mean age 41.4 ± 17.5 years). The cross-culturally validated Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) diagnostic questionnaire was applied. Subjects with a positive COPCORD diagnosis (either historic or current pain) were evaluated by primary care physicians and rheumatologists. A descriptive analysis was performed and comparisons made using analysis of variance and the chi-square test. Pain in the last 7 days was reported by 32.9 %, with pain intensity, according to a Likert-type scale [no pain, 195 (38.5 %); minimal pain, 231 (45.6 %); strong pain, 68 (13.4 %); intense pain, 5 (0.9 %)], 38.0 % reported historical pain, and 641 (41.7 %) had either historic or current pain. Of the COPCORD-positive subjects, pain most frequently occurred in the knee, back, and hands. Musculoskeletal and rheumatic diseases included osteoarthritis (14.1 %), back pain (12.4 %), rheumatic regional pain syndromes (RRPS) (9.7 %), undifferentiated arthritis (1.5 %), rheumatoid arthritis (1.1 %), and fibromyalgia (0.5 %). Chaima (18.3 %) and Kari'ña (15.6 %) subjects had a high prevalence of osteoarthritis, and Warao subjects had a high prevalence of low back pain (13.8 %). The prevalence of RRPS was high in all three ethnic groups. The Chaima group had the highest prevalence of rheumatic diseases, with 2.0 % having rheumatoid arthritis. This study provides useful information for health care policy-making in indigenous communities.

Culture-sensitive adaptation and validation of the community-oriented program for the control of rheumatic diseases methodology for rheumatic disease in Latin American indigenous populations.

The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0-10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.

An analysis of 372 patients with anterior uveitis in a large Ibero-American cohort of spondyloarthritis: the RESPONDIA Group.

OBJECTIVES: This study analysed the frequency of anterior uveitis (AU) and its correlations in a large cohort of patients with spondyloarthritis (SpA). METHODS: A common protocol of investigation was prospectively applied to 2012 SpA patients in 85 centres from 10 Ibero-American countries. Clinical and demographic variables and disease indexes were investigated. Categorical variables were compared by χ2 and Fisher's exact test, and continuous variables were compared by ANOVA or Kruskal-Wallis test. A value of p<0.05 was considered significant. RESULTS: AU was referred by 372 SpA patients (18.5%). AU was statistically associated with inflammatory low back pain (p<0.001), radiographic sacroiliitis (p<0.001), enthesopathies (p=0.004), urethritis/acute diarrhoea (p<0.001), balanitis (p=0.002), hip involvement (p=0.002), HLA-B27 (p=0.003), and higher C-reactive protein (p=0.001), whilst it was negatively associated with the number of painful (p=0.03) and swollen (p=0.005) peripheral joints, psoriatic arthritis (p<0.001), psoriasis (p<0.001), nail involvement (p<0.001), and dactilitis (p=0.062; trend). No association with gender, race, and indices (disease activity, functionality and quality of life) was observed. Logistic regression showed that ankylosing spondylitis (p=0.001) and HLA-B27 (p=0.083; trend) was significantly associated with AU, while extra-articular manifestations (predominantly psoriasis) were negatively associated (p=0.016). CONCLUSIONS: Anterior uveitis is a frequent extra-articular manifestation in SpA patients, positively associated with axial involvement and HLA-B27 and negatively associated with peripheral involvement and psoriatic arthritis.