Prevalence and factors related to rheumatic musculoskeletal disorders in rural south India: WHO-ILAR-COPCORD-BJD India Calicut study

Aims: To assess the prevalence and factors related to rheumatic musculoskeletal disorders (RMSD) in a rural population of south India. Methods: The cross-sectional study included all individuals, 15 years and above, in a rural unit of Calicut District in North Kerala. Data were collected using the validated World Health Organization - International League of Associations for Rheumatology -Community Oriented Program for the Control of Rheumatic Diseases Bhigwan model questionnaire by trained volunteers. In Phase 1 details of demographic characteristics, major co-morbidities and perceived musculoskeletal aches and pains were elicited. Phases 2 and 3 further evaluated and diagnosed the subjects. Predictors for RMSD were assessed using binary logistic regression analysis. Results: There were 4999 individuals in the study. The prevalence of RMSD was 24.9% (95% CI 23.73; 26.12%). Females constituted 50.7% of the population; 5.1% of the respondents were illiterate; 80.9% belonged to low-income groups. Diabetes mellitus and hypertension affected 4.1% and 5.4% of the subjects respectively. The predictors for RMSD in the population were female sex, age, illiteracy, married status, low-income group, vegetarian diet, current alcohol consumption, current tobacco use, history of injury or accidents, diabetes and hypertension. Symptom-related ill-defined rheumatism (10.39%) followed by osteoarthritis (3.85%) were the most prevalent in the Phase 3 rheumatological evaluation. Conclusion: There is an urgent need to introduce lifestyle modifications in high-risk groups and start rehabilitation for those affected. Community rheumatology in primary health care settings in rural areas needs to be strengthened by introducing national programs addressing RMSD at the grassroots level.