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Culture-sensitive adaptation and validation of the Community-Oriented Program for the Control of Rheumatic Diseases methodology for rheumatic disease in Latin American indigenous populations

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Abstract

The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0–10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.

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Acknowledgments

Venezuela: We thank Gean Carlos Martinez (indigenous teacher), Dr. Celenia Rosillo, “Barrio adentro” Health program and Dr. Libya Cabello, Regional Director of Health, State of Monagas, Venezuela, for their technical support in the fieldwork. Argentina: Special thanks to Dr. Miguel Angel Cappiello, Ministry of Heath of the Santa Fé Province, Argentina, for his continuous support for the project. We would also like to thank Dr. Lelio Mangiaterra, statistician Alicia Aronna, and other authorities of the Public Health Secretary of the Municipality of Rosario, Santa Fe, Argentina; Dr. Marcela Nuccitelli and Dr. Gustavo Englander, Coordinators of “Nodo Rosario”; Dr. Esteban Ferrandini, Ignacio Gomez, Emilce Beletti and Eduardo Martinez, coordinators of Health District, Rosario, Santa Fe, Argentina; Professor Raul Britos, Dr. Guillermo Marconi, Ricardo Fernandez and Hugo Gordillo, Provincial Directorate of Original (native) Peoples and Equity and Ministry of Social Development of Santa Fe Province, Argentina; the team of the Primary Health Care Centers: Juana Azurduy and Juan B. Justo, Municipality of Rosario, and Caritas Guadalupe, Toba Nº 47 and Paulo VI, Santa Fe Province; Dr. Carlos Crisci and Dr. Damian Vercenazi, Faculty of Medical Sciences, National University of Rosario, Santa Fe, Argentina; Cecilia Aguado, Israel Albertario, Verónica Cattaneo, Luciano Heredia, medical students, Faculty of Medical Sciences, National University of Rosario, Santa Fe, Argentina; Dr. Julieta Milanesio and Dr. Mariano Palatnik, Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina; Dr. Guillermo A. Berbotto, Hospital Eva Perón, Granadero Baigorria, Santa Fe, Argentina; the Qom Community Center: QADHUOQTÉ, Barrio Los Pumitas, Rosario, Santa Fé, Argentina, and its president Ernesto Oscar Talero; the translators and cultural facilitators: Ana Maria Jerez, Ana Medina, Ezequiel Alvarez, Gertrudis Lazaro, Mirian Alonso, Hector Lopez and Ronaldo Sanchez; the data entry assistants: Antonella Vanucci, Leonardo Grasso and Jorge Melchiori; Maria Cecilia Caffaratti, anthropologist and Vanina García Bianco, psychologist. Mexico: We thank Diego Yeh Cen (Community facilitator of Chakom, Yucatán), Maria Lizbeth Escudero, Veronica Hernandez (Health Research assistant, Mexico City) and Mexican College of Rheumatology, Mexico. Ministry of Health of Santa Fe Province, Argentina (by resolution 0127/08 Feb, 2011) and Public Health Secretary, Municipality of Rosario, Rosario, Santa Fe, Argentina. This study was supported by the National Council for Science and Technology and Ministry of Health (Health CONACYT-2007-C01-162154) (Mexico).

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico

    Ingris Peláez-Ballestas

  2. Hospital “Dr. Manuel Núñez Tovar”, Maturín, Monagas, Venezuela

    Ysabel Granados, Yemina Figuera & Rosa González

  3. Fundación Artro-Muscular, Caracas, Venezuela

    Ysabel Granados & Rosa Chacón

  4. Ministerio de Salud, Gobierno de la Provincia de Santa Fe, Santa Fe, Argentina

    Adriana Silvestre

  5. Universidad Anáhuac-Mayab, Mérida, Mexico

    José Alvarez-Nemegyei

  6. Oficina de Coordinación de Asuntos Indígenas, Maturín, Monagas, Venezuela

    Evart Valls & Irais Brito

  7. Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina

    Rosana Quintana, Romina Nieto & Bernardo A. Pons-Estel

  8. Medicine Faculty, UNAM, Mexico City, Mexico

    Flor Julian Santiago

  9. Centro de Especialidades Médicas Ambulatorias de Rosario (CEMAR), Secretaría de Salud Pública, Municipalidad de Rosario, Santa Fe, Argentina

    Mario Goñi & Marisa Jorfen

  10. IMSS, Chihuahua, Mexico

    Natalia Santana

  11. Hospital de Especialidades, Oaxaca, Mexico

    Imelda García

  12. Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina

    Maria Cecilia Barrios, Fadua Midauar & Maria Celeste Martin

  13. Maturín Private Center, Maturín, Monagas, Venezuela

    Manuel Marcano

  14. McMaster University, Hamilton, ON, Canada

    Adalberto Loyola-Sánchez

  15. Hospital Universitario/Fundación Artro-Muscular, Caracas, Venezuela

    Ivan Stekman

  16. HGR1-IMSS, Mexico City, Mexico

    Maria Victoria Goycochea-Robles

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  1. Ingris Peláez-Ballestas
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  2. Ysabel Granados
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  22. Rosa Chacón
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  23. Maria Celeste Martin
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  24. Bernardo A. Pons-Estel
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Corresponding author

Correspondence to Bernardo A. Pons-Estel.

Additional information

Ingris Pelaez-Ballestas and Bernardo Pons-Estel equally contributed to this study.

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Peláez-Ballestas, I., Granados, Y., Silvestre, A. et al. Culture-sensitive adaptation and validation of the Community-Oriented Program for the Control of Rheumatic Diseases methodology for rheumatic disease in Latin American indigenous populations. Rheumatol Int 34, 1299–1309 (2014). https://doi.org/10.1007/s00296-014-2997-z

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