Prevalence of musculoskeletal conditions and related disabilities in Bangladeshi adults: a cross-sectional national survey

Ahmad Zahid-Al-Quadir, M Mostafa Zaman, Shamim Ahmed, Mahfuzur Rahman Bhuiyan, Md Mujibur Rahman, Ismail Patwary, Bidhu Bhushan Das, Shaikh Amir Hossain, Sujat Paul, Abu Shahin, Moshiur Rahman, Syed Atiqul Haq, Ahmad Zahid-Al-Quadir, M Mostafa Zaman, Shamim Ahmed, Mahfuzur Rahman Bhuiyan, Md Mujibur Rahman, Ismail Patwary, Bidhu Bhushan Das, Shaikh Amir Hossain, Sujat Paul, Abu Shahin, Moshiur Rahman, Syed Atiqul Haq

Abstract

Background: Nationally representative data on burden of musculoskeletal conditions (MSK) in Bangladesh are not available. The objective of this study was to determine the prevalence of MSK conditions and related disabilities in the adult population of Bangladesh.

Methods: A total of 2000 individuals aged 18 years or older were targeted from 20 primary sampling units (urban and rural) of all former seven divisions of Bangladesh in 2015. Structured interviews were done using the modified Community Oriented Program for Control of Rheumatic Disorders questionnaire to detect positive respondents. Standard criteria were used for diagnosing MSK conditions by rheumatology residents. In case of uncertainty, opinion was taken from senior rheumatologists. A Bangla version of the Health Assessment Questionnaire was used to determine disability.

Results: A total of 1843 (92.1%) participated. Among them, 892 men and 951 women participated from rural (n = 716) and urban (n = 1127) areas. Their mean age was 40.5 (standard deviation 14.7) years. Almost a third did not have any formal schooling. Overall, 30.4% (95% confidence interval, 28.3-32.5) had MSK conditions. Low back pain (18.6%, 16.9-20.5), knee osteoarthritis (7.3%, 6.1-8.5) and soft tissue rheumatism 3.8% (2.9-4.7) were the three top-ranking MSK conditions. Rheumatoid arthritis (1.6%, 1.0-2.1), spondyloarthritis (1.2%, 7-1.8) and adhesive capsulitis (1.4%, 0.9-1.9) were relatively uncommon. Among those who had MSK conditions, 24.8% (21.3-28.6) had some degree of disability. Of them, 24.4% (21.0-28.1) had history of work loss during last 12 months.

Conclusions: The high burden of MSK conditions and related disabilities in Bangladesh warrants greater attention of the health system. Further studies are needed to estimate the impact of this group of conditions particularly addressing related disabilities and loss of work.

Keywords: Bangladesh; Disability; MSK conditions; Prevalence.

Conflict of interest statement

The authors declare no competing interests. The authors alone are responsible for views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.

Figures

Fig. 1
Fig. 1
Flowchart for subject selection of the cross-sectional national survey on musculoskeletal conditions in Bangladesh, 2015. *Eight divisions from Sept 2015. PPS indicates population proportion to size. **Two recall visits were done if the selected house was locked, and selected person was not available at home at the time of interviewer’s visit. In case of non-particiaption after the second recall visit, the targeted household/individual was declared non-respondents
Fig. 2
Fig. 2
Prevalence of musculoskeletal conditions in adults according to age, educational achievement, economic status* and occupation, national cross-sectional survey in Bangladesh, 2015. *Wealth quartiles were created using household assets using principle component analysis
Fig. 3
Fig. 3
Prevalence of musculoskeletal conditions in adults according to urban-rural residence locations, cross-sectional national survey in Bangladesh, 2015. §includes osteoarthritis of hip, osteoarthritis of hand, traumatic arthritis, traumatic fracture related condition, trauma of ligament and soft issue, vague symptoms of myalgia and muscle spasm, vertebral spine related sciatica, vertebral scoliosis, ill-defined rheumatic syndromes; ¶includes monoarthritis, oligoarthritis, polyarthritis, gout, palindromic rheumatism

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