Tropical rheumatology. Epidemiology and community studies: Asia/Pacific region.

It has been recognized that the remarkable decline in infant mortality and the extension in human lifespan involving both developing and developed countries alike, has been influenced by social and economic developments and public health orientated measures (such as clean water and sewerage) rather more than by developments in medical research. However, the identification of important disease risk factors for a number of common conditions such as smoking, solar exposure, dietary fat and alcohol has led to further reductions in disease prevalence and mortality, at least in some countries. The varied success of strategies to reduce the mortality from circulatory, nutritional and diseases due to infection has had the predictable result of leaving communities more exposed to the chronic non-communicable diseases, especially those affecting the elderly. The COPCORD community-based studies, carried out largely in tropical Asia/Pacific countries, have indicated that the burden of musculoskeletal conditions as far as pain and disability, as well as from an economic point of view, are substantial and WHO has called for increased research and educational activities into the causes and consequences of chronic disease and in particular rheumatic diseases. To the problems of an increasing ageing population can be added the rapid growth of urban populations, new occupational stresses, lifestyle changes and a number of other factors (WHO, 1984). The common community-based rheumatic diseases are not RA or SLE that dominate admissions to hospital arthritis clinics. Pain and disability are most often caused by osteoarthritis, especially knee OA, and various soft tissue rheumatic problems producing neck, back, shoulder and elbow pain. Viral and reactive arthritis cannot be ignored and the complications from osteoporosis (although not normally considered a rheumatic condition), are a significant threat to ageing populations worldwide. It is clear that for many of these conditions, certain risk factors have been identified and that preventative strategies are becoming available although far more detailed research is still required (Wigley, 1993). Community education is an essential part of prevention and treatment and the ILAR-sponsored publication Aches and Pains--Living with Arthritis and Rheumatism (Hampton, 1992) is available in at least 10 different languages and fills an important need. Education helps to influence not only knowledge but also skills and attitudes.(ABSTRACT TRUNCATED AT 400 WORDS)