Community Oriented Program for the Control of Rheumatic Diseases: studies of rheumatic diseases in the developing world.

PURPOSE OF REVIEW: The Community Orientated Program for the Control of Rheumatic Diseases (COPCORD) is based on collecting community data on rheumatic complaints and disability. After identifying significant problems, a search for disease risk factors is made, and control and treatment measures are recommended. This review covers the results of surveys in five countries-China, Brazil, Kuwait, Vietnam, and Australia-published in the last 18 months. RECENT
FINDINGS: Musculoskeletal pain is a major health problem in all surveys undertaken in both developed and developing countries. Knee and low back pain are the most frequent complaints, and osteoarthritis is the most common arthritic disease identified, particularly affecting the knees. The prevalence of rheumatoid arthritis is generally lesser in these studies compared with published surveys of white patients. However, the prevalence of gout varied widely, possibly because of changes in lifestyle and racial factors. Septic arthritis and rheumatic fever were rarely seen except in an Australian aboriginal community, pointing to improvement in standards of living and health care, at least in the urban settings, according to the Vietnamese authors.
SUMMARY: Population data are required on musculoskeletal complaints as a basis for decisions on health control and treatment programs. Surveys in five countries have identified the frequency of especially knee and low back pain, the prevalence of knee osteoarthritis, and the wide variability in the prevalence of gout, partly because of lifestyle and thus potentially correctable risk factors. Self-medication with potent pharmaceutical products in countries where doctors' prescriptions are not required is a recognizable health hazard.