Prevalence of the major rheumatic disorders in the adult population of north Pakistan

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The prevalence of rheumatic diseases in developing countries
is largely unknown. Studies which allow comparison of data
within the contrasting communities of the Third World and the
developed world have the potential to provide insights into
disease aetiologies. The current study compared the frequency
of rheumatic symptoms (point prevalence) amongst 1997 adults
distributed evenly between poor rural and poor urban
communities and relatively affluent urban people. Comparisons
were also made with similarly but previously derived
prevalence rates of rheumatic symptoms and rheumatoid
arthritis (RA) in south Pakistan and Pakistanis in England. A
significantly higher prevalence of joint pain was seen in the
north compared with the south. RA was more common in the north
and similar to the frequency amongst Pakistanis resident in
England. Ethnic and genetic susceptibility might have
accounted for this. There was significantly more soft-tissue
rheumatism and back pain in the northern rural population
compared with those in the city. Fibromyalgia was almost
completely absent from the urban affluent, but osteoarthritis
of the knee was significantly more common in this community,
perhaps due to relative obesity. RA was least in the urban
poor, a phenomenon that might be attributable to earlier death
of females or other undetermined factors.

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