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Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community

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Abstract

Objective

To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina.

Methods

This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment.

Results

A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5 years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7 days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4).

Conclusion

RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients’ early referral to a specialist.

Key Points

• The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America.

• The patients with RA had high percentage of familiar history of RA.

• The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral.

• The mean of the delay in the diagnosis was 5.8 years. In this community, the lack of the “migration health” phenomenon may be a social determinant that negatively impacts their health.

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Acknowledgments

The authors thank the Argentine Society of Rheumatology for supporting the study with a grant through CONUPRO; Salta-Jujuy Society of Rheumatology for supporting the study through a grant; HSBC Foundation for a grant; Hospital Señor del Milagro; Circulo Médico from the Province of Salta; Misión Chaqueña “el Algarrobal” Health Center; Municipality of Embarcación for their support in accommodation and transfer of patients, doctors, and interviewers; and Clínica Mayo of Embarcación for being in charge of additional studies. The authors also thank the Ministry of Indigenous Affairs and Social Development of Salta; Hospital San Roque; Health Workers from Operating Area 9, Fermín Camilo Collado, Miguel Humberto Vega, Jorge Daniel Paz, Torres Bernabé, Faustino Rodríguez, Ubaldina Tolaba, and Eduardo Velázquez and drivers Ernesto Aranda from Human Development of the Province of Salta; Emilia Peloc, Cecilia Mabel Zapana, Lía Vides, and Gloria Singraff from the Social Emergency Subsecretariat, dependent on the Ministry of Indigenous Affairs and Social Development of Salta; Misión Chaqueña facilitators Andrea Gutiérrez and Noemí Patricio Romero for data entry and Valentina Juárez. Special acknowledgments are also given to Raquel Gómez and Gumercindo Rey and to all the Misión Chaqueña community for letting us perform the study.

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Author notes

  1. Vicente Juárez, Rosana Quintana and María Elena Crespo contributed equally to this work.

Authors and Affiliations

  1. Hospital Señor del Milagro, Salta, Argentina

    Vicente Juárez, María Elena Crespo, Mariana Aciar, Emilio Buschiazzo, Natalia L. Cucchiaro, Eugenia Picco & Natalia Estrella

  2. Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Santa Fe, Argentina

    Rosana Quintana, Adriana M. R. Silvestre, Vanina García & Bernardo A. Pons Estel

  3. Hospital Arturo Oñativia, Salta, Argentina

    Mario Ruiz

  4. Centro Artros, Salta, Argentina

    José Adolfo Sánchez

  5. Centro de Salud Misión Chaqueña el Algarrobal, Embarcación, Salta, Argentina

    Rodolfo Franco

  6. Hospital San Bernardo de Salta, Salta, Argentina

    Silvia Jorge

  7. Centro Privado de Reumatología, Oran, Salta, Argentina

    Cinthya Retamozo

  8. Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, Mexico

    Ingris Pelaez-Ballestas

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  1. Vicente Juárez
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  2. Rosana Quintana
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Correspondence to Rosana Quintana.

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Juárez, V., Quintana, R., Crespo, M.E. et al. Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community. Clin Rheumatol 40, 75–83 (2021). https://doi.org/10.1007/s10067-020-05130-3

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