03484nas a2200421   4500000000100000008004100001260001300042653001500055653001000070653002100080653000900101653001000110653002100120653002000141653002300161653001100184653001100195653001000206653001100216653000900227653001600236653001500252653002300267653001700290653001700307653002100324100001300345700001200358700001800370700001400388700001500402700015000417245010300567300001000670490000700680520236100687022001403048       2001                            d  c2001 Feb10aAdolescent10aAdult10aAge Distribution10aAged10aChild10aChild, Preschool10aData Collection10aEducational Status10aFemale10aHumans10aIndia10aInfant10aMale10aMiddle Aged10aPrevalence10aRheumatic Diseases10aRisk Factors10aRural Health10aSex Distribution1 aChopra A1 aPatil J1 aBillempelly V1 aRelwani J1 aTandle H S1 aWHO-ILAR COPCORD Study. WHO International League of Associations from Rheumatology Community Oriented Program from Control of Rheumatic Diseases 00aPrevalence of rheumatic diseases in a rural population in western India: a WHO-ILAR COPCORD Study.  a240-60 v493 a<p><b>BACKGROUND: </b>COPCORD (Community oriented program from control of rheumatic diseases) is a global initiative of the WHO/International League of Associations from Rheumatology (ILAR). The prevalence data from the first Indian COPCORD survey (Stage 1), carried out in village Bhigwan (Dist. Pune), in 1996, is presented.</p><p><b>AIM: </b>To study the rural prevalence of rheumatic-musculoskeletal symptoms/diseases (RMSD).</p><p><b>METHODS: </b>A cross-sectional survey of the village (non-randomised selection) was completed in five weeks, using validated questionnaires, served by 21 trained volunteers. 746 patients (18.2%, 95% CI: 17-1-19-4) were identified (Phase 1) from 4092 adults (response 89%), and systematically evaluated (Phase 2 and 3) by a medical team, including a rheumatologist; limited investigations were carried out and diagnosis confirmed during a planned 12 week initial follow-up. Standard clinical criteria were used for the diagnosis; point prevalence estimates (prev)/confidence interval (CI) are shown in parenthesis.</p><p><b>RESULTS: </b>There was a dominant distribution of 'pain at all sites' (articular/soft tissues) in the females; painful neck (9.5%), back (17.3%), and calf (8.5%) appeared significant when compared to the Bhigwan males and the Indonesian and the Chinese rural COPCORD results. 55% RMSD were due to soft tissue rheumatism (5.5%) and an ill-defined/unclassifiable symptom-related-diagnosis (7.1%). Osteoarthritis (5.8%) and inflammatory arthritis (IA) were seen in 29% and 10% patients respectively. 240 patients (5.9%) with chronic knee pains did not show any clinical evidence of OA. The prev of rheumatoid arthritis (0.5%, 95% CI: 0.3-0.7), as classified by the American College of Rheumatology, was the highest ever reported from an Asian rural COPCORD study. Though unclassifiable IA (0.9%, 95% CI: 0.6-1.1) was seen, well defined reactive arthritis, TB, leprosy and connective tissue disorders were not observed. Gout was diagnosed in five patients (0.12%).</p><p><b>CONCLUSIONS AND DISCUSSION: </b>The Bhigwan COPCORD survey demonstrates a significant rural spectrum of RMSD. It provides a reasonable speculation about the Indian rheumatological burden. Further, an eight year prospective study is in progress to identify new cases and risk factors, and educate people (Stages 2 and 3).</p>  a0004-5772