AB1342 Rheumatic diseases prevalence and quality of life in saraguro indigenous populations of ecuador: a cross-sectional community-based study
Authors: S. Guevara-Pacheco, A. Feican-Alvarado, W. Valdiviezo-Vicuña, G. Molina-Alvarado, N. Ortega-Mendoza, J. Delgado-Pauta, M. Montaleza-Neira, L. Chimbo-Pullaguari, M. Hernandez, R. Cervera-Segura, L.H. Sanin, I. Pelaez-Ballestas
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Rheumatic diseases are more prevalent and aggressive in indigenous population groups, in which providing medical attention poses a challenge for the rheumatologist. <h3>Objectives</h3> To estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Saraguro indigenous people and their impact on the quality of life. <h3>Methods</h3> Cross-sectional analytical study carried out in the community of Saraguro using the COPCORD methodology. Mixed and randomised sampling techniques were employed. The following validated questionnaires were administered: 1. Screening for musculoskeletal (MSK) disorders and rheumatic diseases. 2. A sociodemographic questionnaire. 3. A functional capacity questionnaire (HAQ-DI) and an instrument to measure workload and repetitive movements. 4. Quality of life (EQ-5D3L). Cases with MSK disorders were reviewed by rheumatologists within the community. <h3>Results</h3> A total of 2687 individuals over 18 years of age participated, with an average age of 44 (SD 19.9) years; 1690 (62.9%) were women, 872 (32.4%) were Kwichua speakers; 2108 (78.4%) were employed, of these 32.5% were farm workers. MSK pain was reported in 1244 (46.3%); pain was severe in 448 (36%); 868 (69.7%) used some medical treatment and 1013 (81.4%) used traditional medicine. The most prevalent self-reported comorbidities were anxiety (55.5%) and depression (46.8%). Rheumatic diseases were diagnosed in 861/1244 (69.2%), with the following most prevalent conditions: Low back pain 9.3%, hand osteoarthritis 7.2%, knee osteoarthritis 6.5%, RRPS (rheumatic regional pain syndrome) 5.8%, fibromyalgia 1.8%, rheumatoid arthritis (RA) 1.3%. Disability (HAQ &gt;0.8) was observed in 356 (28.6%), whereas loading and pushing objects heavier than 20 kg and shaking hands was significantly associated with MSK pain. The regression models showed a significant association with a lower quality of life in those with lower education levels (OR=0.89; 95% CI 0.88 to 0.91, p&lt;0.001), physically demanding jobs (OR=0.54; 95% CI 0.42 to 0.69,p&lt;0.001), cooking with firewood (OR=1.55; 95% CI 1.05 to 2.30, p=0.02), high blood pressure (OR=2.31; 95% CI 1.73 to 3.10, p&lt;0.001), and rheumatic diseases, especially RA (OR=5.52; 95% CI 2.48 to 12.27, p&lt;0.001) and hands OA (OR=2.05; 95% CI 1.44 to 2.91, p&lt;0.001). One finding is that having RA was associated with cooking with firewood, and that smoking was almost nonexistent in this population. This suggests that wood smoke pollutants play a similar role to that described with tobacco smoke. <h3>Conclusions</h3> A high prevalence of MSK disorders, rheumatic diseases and RA was found. The prevalence of rheumatic diseases was associated with a lower education level, cooking with firewood, and physically demanding jobs. The greatest impact on the quality of life in all dimensions was on the individuals with RA and hand OA. <h3>Acknowledgements</h3> Funding: Research Dept. Universidad de Cuenca, Ecuador <h3>Disclosure of Interest</h3> None declared