Prevalence of Rheumatic Disorders and Related Disabilities in Bangladeshi Adults: A Cross-Sectional National Survey

Abstract Objectives: To determine the prevalence of rheumatic disorders and related disabilities in the adult population of Bangladesh.Methods: A total of 2000 individuals aged 18 years or older were targeted where 1843 (92.1%) participated from 20 primary sampling units (urban and rural) of all former seven divisions of Bangladesh in 2015. Modified Community Oriented Program for Control of Rheumatic Disorders questionnaire was used to detect positive respondents. Standard criteria were used for diagnosing rheumatic disorders by residents of rheumatology and expert rheumatologists. A Bangla version of the Health Assessment Questionnaire was used to determine disability.Results: Among the respondents, 892 men and 951 women participated from rural (n=716) and urban (n=1127) areas. Their mean age was 40.5 (standard deviation 14.7) years. Almost a third did not have any formal schooling. Overall, 30.4% (95% confidence interval, 28.3-32.5) had rheumatic disorders. Nonspecific low back pain (12.7%, 11.2-14.2) and knee osteoarthritis (7.3%, 6.1-8.5) were the two top-ranking rheumatic disorders followed by lumbar spondylosis 6.0% (4.9-7.1) and soft tissue rheumatism 3.8% (2.9-4.7). Rheumatoid arthritis (1.6%, 1.0-2.1), spondyloarthritis (1.2%, 7-1.8) and frozen shoulder (1.4%, 0.9-1.9) are relatively uncommon. Among those who had rheumatic disorders, 24.8% (21.3-28.6) had some degree of disability. Of them, 24.4% (21.0-28.1) had history of work loss during last 12 months. Being overweight, having history of physical trauma and diabetes mellitus, age and female sex were positively but education was negatively associated with rheumatic disorders. Conclusions: The high burden of rheumatic disorders and related disabilities in Bangladesh warrants public health and clinical interventions.Highlights1. This is the first national level study using primary sampling units of Bangladesh Bureau of Statistics engaging rheumatology residents for data collection. The diagnoses have been validated or confirmed by rheumatologists in the field in partnership with divisional level medical college hospitals.2. Prevalence of rheumatological disorders (low back pain, knee osteoarthritis and lumbar spondylosis are commonly prevalent), associated pain, disability (as determined using B-HAQ) and work loss are so common that warrants public health and clinical intervention. Name of department(s) and institution(s) to which the work should be attributed:Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshThe source(s) of support in the form of grants or industrial support:This work was supported by World Health Organization, Bangladesh (Agreement Reference: SEBAN140895).