Clinical Rheumatology

, Volume 34, Issue 3, pp 535–543 | Cite as

WHO-ILAR COPCORD study (stage 1, urban study) in Sanandaj, Iran

  • Nasrin Moghimi
  • Fereydoun DavatchiEmail author
  • Ezat Rahimi
  • Afshin Saidi
  • Naser Rashadmanesh
  • Solmaz Moghimi
  • Hoshyar Ghafori
  • Peiman Zandi
  • Negin Ahmadi
  • Hamed Ghafori
  • Mohsen Moghimi
  • Marjan hajiheshmati
Original Article


This study aims to conduct an urban Community Oriented Program for Control Of Rheumatic Diseases (COPCORD) study in Sanandaj (Kurdistan, Iran). Sanandaj with a population of 311,446 (2006 census), Caucasian of Kurdish subgroup, was selected as the field. Sanandaj was divided into 100 clusters and subjects were randomly selected from them (50 subjects from each cluster). The COPCORD study started on July 2011 and ended on June 2012. Of the households, 1,631 was visited and 5,830 persons were interviewed. The male to female ratio was 0.8–1 (44.5 % males, 55.5 % females). Musculoskeletal complaints during the past 7 days were detected in 42.8 % of the interviewed subjects (36.3 % males, 48.1 % females). The distribution was 16.7 % shoulder, 10 % wrist, 9.7 % hands and fingers, 7.7 % hip, 26.3 % knee, 9.9 % ankle, 6.4 % toes, 9.5 % cervical spine, and 21.5 % dorsal and lumbar spine. Degenerative joint diseases were detected in 19.4 % of the subjects: 1.8 % neck, 18.9 % knee, 3.9 % hands, and 0.51 % hip. Low back pain was detected in 16.5 %, sciatica in 1.2 %, cervical nerve root pain in 0.24 %, and soft tissue rheumatism in 5.5 %. Inflammatory disorders were 0.51 % rheumatoid arthritis, 0.22 % seronegative spondyloarthropathy, 0.10 % ankylosing spondylitis, 0.05 % systemic lupus erythematosus, and 0.10 % Behcet’s disease . Fibromyalgia was detected in 0.62 % and gout in 0.12 % of the studied population. Disability was reported by 28.3 %. It was present at the study time in 21.4 %. Comparing the four COPCORD studies of Iran, the figures (numbers) obtained by COPCORD Sanandaj are much the same as the COPCORD study in Tehran. Joint complaints were seen less frequently than in the COPCORD urban study of Zahedan and rural study of Tuyserkan. Osteoarthritis was higher than in Tehran, but the same as the two others. Soft tissue rheumatism was rather the same. Rheumatoid arthritis was higher than Tehran and Tuyserkan, but lower than Zahedan.


Community-based epidemiology COPCORD Iran Musculoskeletal complaints Rheumatic diseases 



Special thanks are given to Tohid Hospital (Sanandaj), Doctor Bayan Sharifi and Doctor Zohreh Na’imi (residents of the hospital), personnel of the Internal Medicine ward, personnel of the Laboratory Department, and personnel of the Imaging Department of the Tohid Hospital for their valuable help.




Grant was from the Council for Science, Research, and Technology Kurdistan.


  1. 1.
    Muirden KD, Valkenburg HA, Hopper J, Guest C (1992) The epidemiology of rheumatic diseases in Australia. In: Nasution AR, Darmawan J, Isbagio H (eds) APLAR rheumatology. Churchill Livingstone, Tokyo, pp 409–410Google Scholar
  2. 2.
    Minaur N, Sawyers S, Parker J, Darmawan J (2004) Rheumatic disease in an Australian aboriginal community in North Queensland, Australia. A WHO-ILAR COPCORD survey. J Rheumatol 31:965–972PubMedGoogle Scholar
  3. 3.
    Haq SA, Darmawan J, Islam MN et al (2005) Prevalence of rheumatic diseases and associated outcomes in rural and urban communities in Bangladesh: a COPCORD study. J Rheumatol 32:348–353PubMedGoogle Scholar
  4. 4.
    Haq SA, Darmawan J, Islam N et al (2008) Incidence of musculoskeletal pain and rheumatic disorders in Bangladeshi rural community: a WHO-APLAR-COPCORD study. Int J Rheum Dis 11:216–223CrossRefGoogle Scholar
  5. 5.
    Haq SA, Davatchi F, Dahaghin S et al (2010) Development of a questionnaire for identification of the risk factors for osteoarthritis of the knees in developing countries. A pilot study in Iran and Bangladesh. An ILAR-COPCORD phase III study. Int J Rheum Dis 13:203–214CrossRefPubMedGoogle Scholar
  6. 6.
    Senna ER, De Barros AL, Silva EO, Costa IF et al (2004) Prevalence of rheumatic diseases in Brazil: a study using the COPCORD approach. J Rheumatol 31:594–597PubMedGoogle Scholar
  7. 7.
    Bennett K, Cardiel MH, Ferraz MB, Riedermann P, Goldsmith CH, Tugwell P (1997) Community screening for rheumatic disorder: cross cultural adaptation and screening characteristics of the COPCORD Core Questionnaire in Brazil, Chile, and Mexico. The PANLAR-COPCORD Working Group. Pan American League of Associations for Rheumatology. Community Oriented Program for the Control of Rheumatic Disease. J Rheumatol 24:160–168PubMedGoogle Scholar
  8. 8.
    Zeng QY, Chen R, Darmawan J et al (2008) Rheumatic diseases in China. Arthritis Res Ther 10:R17CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Zeng QY, Darmawan J, Xiao ZY et al (2005) Risk factors associated with rheumatic complaints: a WHO-ILAR COPCORD study in Shantou, Southeast China. J Rheumatol 32:920–927PubMedGoogle Scholar
  10. 10.
    Zeng QY, Chen R, Xiao ZY et al (2004) Low prevalence of knee and back pain in southeast China; the Shantou COPCORD study. J Rheumatol 31:2439–2443PubMedGoogle Scholar
  11. 11.
    Dai SM, Han XH, Zhao DB, SHI YQ, LIU Y, MENG JM (2003) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD Study. J Rheumatol 30:2245–2251PubMedGoogle Scholar
  12. 12.
    Wigley RD, Zhang NZ, Zeng QY et al (1994) Rheumatic disease in china: ILAR-China study comparing the prevalence of rheumatic symptoms in northern and southern rural populations. J Rheumatol 21:1484–1490PubMedGoogle Scholar
  13. 13.
    Reyes Llerena GA, Guibert Toledano M, Hernandez Martinez AA, Gonzales Otero ZA, Alcocer Varela J, Cardiel MH (2000) Prevalence of musculoskeletal complaints and disability in Cuba. A community-based study using the COPCORD core questionnaire. Clin Exp Rheumatol 18:739–742PubMedGoogle Scholar
  14. 14.
    Chopra A, Saluja M, Patil J, Tandale HS (2002) Pain and disability, perceptions and beliefs of a rural Indian population: a WHO-ILAR COPCORD study. WHO-International League of Associations for Rheumatology. Community Oriented Program for Control of Rheumatic Diseases. J Rheumatol 29:614–621PubMedGoogle Scholar
  15. 15.
    Chopra A, Patil J, Billampelly V, Relwani J, Tandle HS (2001) Prevalence of rheumatic diseases in rural population in western India: a WHO-ILAR COPCORD study. J Assoc Physicians India 49:240–246PubMedGoogle Scholar
  16. 16.
    Joshi VL, Chopra A (2009) Is there an urban–rural divide? Population surveys of rheumatic musculoskeletal disorders in the Pune region of India using the COPCORD Bhigwan model. J Rheumatol 36:614–622CrossRefPubMedGoogle Scholar
  17. 17.
    Mathew AJ, Chopra A, Thekkemuriyil DV, George E, Goyal V, Nair JB, Trivandrum COPCORD Study Group (2011) Impact of musculoskeletal pain on physical function and heath-related quality of life in rural community in south India: A WHO-ILAR-COPCORD-BJD India study. Clin Rheumatol 30:1491–1497CrossRefPubMedGoogle Scholar
  18. 18.
    Darmawan J, Valkenburg HA, Muirden KD, Wigley RD (1992) Epidemiology of rheumatic diseases in rural and urban populations in Indonesia; a World Health Organisation International League Against Rheumatism COPCORD study, stage I, phase 2. Ann Rheum Dis 51:525–528CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    Darmawan J, Valkenburg HA, Muirden KD, Wigley RD (1993) The epidemiology of rheumatoid arthritis in Indonesia. Brit J Rheum 32:537–540CrossRefGoogle Scholar
  20. 20.
    Darmawan J, Muirden KD, Valkenburg HA, Wigley RD (1995) The prevalence of soft tissue rheumatism in Indonesia—a WHO ILAR COPCORD Study. Rheumatol Int 15:121–124CrossRefPubMedGoogle Scholar
  21. 21.
    Darmawan J, Ferraz MB, Muirden KD et al (1995) Case study: World Health Organization-International League of Associations for Rheumatology Community-Oriented Programme for the Control of Rheumatic Diseases (WHO-ILAR COPCORD) in Indonesia and Brazil. Int J Technol Assess Health Care 11:700–708CrossRefPubMedGoogle Scholar
  22. 22.
    Davatchi F, Jamshidi A, Tehrani Banihashemi A et al (2006) WHO-ILAR COPCORD pilot study in Tehran, Iran. J Rheumatol 33:1714PubMedGoogle Scholar
  23. 23.
    Davatchi F (2006) Rheumatic diseases in the APLAR region. APLAR J Rheumatol 9:5–10CrossRefGoogle Scholar
  24. 24.
    Davatchi F, Jamshidi AR, Tehrani Banihashemi A et al (2007) Prevalence of Behcet’s disease in Iran: a WHO-ILAR COPCORD stage I study. APLAR J Rheumatol 10:239–243CrossRefGoogle Scholar
  25. 25.
    Davatchi F, Jamshidi AR, Tehrani Banihashemi A et al (2008) WHO-ILAR COPCORD study (stage 1, urban study) in Iran. J Rheumatol 35:1384–1390PubMedGoogle Scholar
  26. 26.
    Davatchi F, Tehrani Banihashemi A, Gholami J et al (2009) The prevalence of musculoskeletal complaints in a rural area in Iran: a WHO-ILAR COPCORD study (stage I, rural study) in Iran. Clin Rheumatol 28:1267–1274CrossRefPubMedGoogle Scholar
  27. 27.
    Davatchi F, Jamshidi AR, Tehrani Banihashemi A et al (2009) Effect of ethnic origin (Caucasians versus Turks) on the prevalence of rheumatic diseases: a WHO-ILAR COPCORD urban study in Iran. Clin Rheumatol 28:1275–1282CrossRefPubMedGoogle Scholar
  28. 28.
    Dahaghin S, Tehrani Banihashemi A, Faezi ST, Jamshidi AR, Davatchi F (2009) Squatting, sitting on the floor, or cycling: are life-long daily activities risk factors for clinical knee osteoarthritis? Stage III results of a community-based study. Arthritis Rheum 61:1337–1342CrossRefPubMedGoogle Scholar
  29. 29.
    Sandooghi M, Zakeri Z, Tehrani Banihashemi A et al (2013) Prevalence of musculoskeletal disorder in Southeast of Iran: A WHO-ILAR COPCORD Study (stage 1, urban study). Int J Rheum Dis. doi: 10.1111/1756-185X.12110 Google Scholar
  30. 30.
    Al-Awadhi AM, Olusi SO, Moussa M et al (2004) Musculoskeletal pain, disability and health-seeking behavior in adult Kuwaitis using a validated Arabic version of the WHO-ILAR COPCORD Core Questionnaire. Clin Exp Rheumatol 22:177–183PubMedGoogle Scholar
  31. 31.
    Veerapen K, Wigley RD, Valkenburg H (2007) Musculoskeletal pain in Malaysia: a COPCORD survey. J Rheumatol 34:207–213PubMedGoogle Scholar
  32. 32.
    Cardiel MH, Rojas-Serrano J (2002) Community Based Study to estimate prevalence, burden of illness and help seeking behaviour in rheumatic diseases in Mexico City. COPCORD Study. Clin Exp Rheumatol 20:617–624PubMedGoogle Scholar
  33. 33.
    Alvarez-Nemegyei J, Peláez-Ballestas I, Sanin LH et al (2011) Prevalence of musculoskeletal pain and rheumatic diseases in the Southeastern region of Mexico. A COPCORD-based community survey. J Rheumatol 38:21–30CrossRefGoogle Scholar
  34. 34.
    Peláez-Ballestas I, Sanin LH, Moreno-Montoya J et al (2011) Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol 38:3–8CrossRefGoogle Scholar
  35. 35.
    Peláez-Ballestas I, Flores-Camacho R, Rodriguez-Amado J et al (2011) Prevalence of back pain in the community. A COPCORD based study in the Mexican population. J Rheumatol 38:26–35Google Scholar
  36. 36.
    Rodriguez-Amado J, Peláez-Ballestas I, Sanin LH et al (2011) Epidemiology of rheumatic diseases. A community-based study in urban and rural populations in the state of Nuevo Leon, Mexico. J Rheumatol 38:9–14CrossRefGoogle Scholar
  37. 37.
    Farooqi A, Gibson T (1998) Prevalence of the major rheumatic disorders in the adult population of North Pakistan. Br J Rheumatol 37:491–495CrossRefPubMedGoogle Scholar
  38. 38.
    Manahan L, Caragay R, Muirden KD, Allander E, Valkenburg HA, Wigley RD (1985) Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD Study. Rheumatol Int 5:149–153CrossRefPubMedGoogle Scholar
  39. 39.
    Wigley R, Manahan L, Muirden KD et al (1991) Rheumatic disease in a Philippine village. II: a WHO-ILAR-APLAR COPCORD study, phases II and III. Rheumatol Int 11:157–161CrossRefPubMedGoogle Scholar
  40. 40.
    Dans LF, Tankeh-Torres S, Amante CM, Penserga EG (1997) The prevalence of rheumatic diseases in a Filipino urban population: a WHO-ILAR COPCORD study. World Health Organization. International League of Associations for Rheumatology. Community Oriented Program for the Control of the Rheumatic Diseases. J Rheumatol 24:1814–1819PubMedGoogle Scholar
  41. 41.
    Chou CT, Pei L, Chang DM, Lee CF, Schumacher HR, Liang MH (1994) Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol 21:302–306PubMedGoogle Scholar
  42. 42.
    Chaiamnuay P, Darmawan J, Muirden KD, Assawatanabodee P (1998) Epidemiology of rheumatic disease in rural Thailand: a WHO-ILAR COPCORD study. Community Oriented program for the control of rheumatic disease. J Rheumatol 25:1382–1387PubMedGoogle Scholar
  43. 43.
    Minh Hoa TT, Darmawan J, Chen SL, Van Hung N, ThiNhi C, Ngoc An T (2003) Prevalence of the rheumatic diseases in urban Vietnam: a WHO-ILAR COPCORD study. J Rheumatol 30:2252–2256PubMedGoogle Scholar
  44. 44.
    Chopra A (2013) The COPCORD world of musculoskeletal pain and arthritis. Rheumatology 52:1925–1928CrossRefPubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Nasrin Moghimi
    • 1
  • Fereydoun Davatchi
    • 2
    • 6
    Email author
  • Ezat Rahimi
    • 3
  • Afshin Saidi
    • 4
  • Naser Rashadmanesh
    • 4
  • Solmaz Moghimi
    • 4
  • Hoshyar Ghafori
    • 4
  • Peiman Zandi
    • 5
  • Negin Ahmadi
    • 4
  • Hamed Ghafori
    • 4
  • Mohsen Moghimi
    • 4
  • Marjan hajiheshmati
    • 1
  1. 1.Department of Rheumatology, School of MedicineKurdistan University of Medical SciencesSanandajIran
  2. 2.Head Division of Rheumatology, Rheumatology Research CenterTehran University of Medical SciencesTehranIran
  3. 3.Department of Internal Medicine, School of MedicineKurdistan University of Medical SciencesSanandajIran
  4. 4.Liver & Digestive Research CenterKurdistan University of Medical SciencesSanandajIran
  5. 5.Social Security HospitalSanandajIran
  6. 6.Rheumatology DepartmentShariati HospitalTehranIran

Personalised recommendations