The COPCORD world of musculoskeletal pain and arthritis
2013; Oxford University Press; Volume: 52; Issue: 11 Linguagem: Inglês
10.1093/rheumatology/ket222
ISSN1462-0332
Autores Tópico(s)Spine and Intervertebral Disc Pathology
ResumoThe COPCORD world of musculoskeletal pain and arthritis Deeply rooted in the communityMusculoskeletal (MSK) pain and arthritis are universal problems but pain is difficult to measure.In 1981 the ILAR and the World Health Organization (WHO) together launched the WHO ILAR Community Oriented Programme for Control of Rheumatic Diseases (COPCORD) to fill the gap in the lack of data about MSK pain and arthritis in developing countries.COPCORD is a low-cost, low-infrastructure programme based on regional resources.Using a fairly uniform approach and validated methods, the COPCORD stage I survey (three phases) was completed in Australia, Bangladesh, Brazil, Chili, China, Cuba, Egypt, Guatemala, India, Indonesia, Iran, Kuwait, Lebanon, Malaysia, Mexico, Pakistan, Peru, Philippines, Thailand, Tunisia and Vietnam [16].Details about the survey methods, countrywise results and publications are available on COPCORD's website [7].A representative convenient population sample (>1500) was recommended for each country.The emphasis was on a non-migrant population and areas with reasonably fair access to infrastructure and logistical support.Although not essential, several surveys used a randomized technique (Table 1).The population was screened (phase 1) in a house-to-house cross-sectional survey to identify respondents with current (past 7 days) or past pain, or both, and tenderness, swelling or stiffness in bones, muscles and joints, or all three.Pain and other relevant information were recorded in phase 2 and pain sites often shown on a human mannequin.Standard rheumatology examination was recorded in phase 3. A fast-track model [3] was introduced by Bhigwan (India), which essentially completed all three phases in parallel and reduced the survey period and cost: 7000 villagers were surveyed (>80% response) in about 5 weeks.Limited COPCORD stages II (risk factors, incidence cases and health education) and III (improved health care through preventive and control strategy) were completed by few countries [1].Although COPCORD survey questionnaires (CPD-Q) were customized for regional use, the core questions were mostly unchanged.Local translations and adaptations were validated a priori in pilot studies (using controls).Recently [6] the CPD-Q was reported to be a robust case detection tool (rheumatic diseases) to identify early rheumatology referral cases and thereby reduce the burden on specialist services [8].The point prevalence rates of MSK pain or symptoms in adults are shown in Fig. 1.Very few COPCORD surveys
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