The WHO ILAR COPCORD (community oriented program for control of rheumatic diseases) was launched in 1980s to obtain data on musculoskeletal (MSK) pain and disability through a structured validated questionnaire administered to a well defined population (usually >3500 persite) and included a rheumatology evaluation for all respondents with current/past pain. The focus was to be on developing economies, and the model was to use a low cost infrastructure and regional facilities. The model advocated largely a clinical approach; target was to be common disorders and not uncommon diseases like lupus. The model envisaged Stage I (population survey), Stage II (incidence, risk factors) and Stage III (health education, prevention and control strategies). Stage I cross sectional surveys, often non randomized selection, have been completed in 22 countries-Australia, Brazil, Bangladesh, China, Cuba, Chile, Egypt, Guatemala, India, Indonesia, Iran, Kuwait, Lebanon, Malaysia, Mexico, Pakistan, Philippines, Peru, Thailand, Taiwan, Tunisia, Vietnam. Several countries (China, India, Mexico, and Iran) have completed surveys in several sites (urban and rural). India recently completed survey of over 95,000 populations in 16 sites to generate a national evaluation of the burden of MSK. Mexico completed a co-ordinated survey of over 19,000 subjects in 5 provinces and published their results (J Rheumatol 2011: 38 suppl). Several COPCORD surveys in China, Indonesia, Bangladesh and India have been followed into Stages II & III; the longest follow up of rural Bhigwan India population is in the 17th year. In a crude approximation, an average 24% (range in surveys 11 to 47%; >40% in Peru, Cuba and Iran) of the COPCORD World wide surveyed population suffered from MSK pain. Least 95 COPCORD publications can be found in peer review literature. The crude prevalence of clinical RA has varied from ∼0.3 (several surveys) to ∼1.5 (Mexico); a large extent of undifferentiated inflammatory arthritis was reported from COPCORD India. COPCORD studies have unequivocally confirmed- MSK is the predominant self reported community ailment and that the commonest cause of MSK pain is soft tissue rheumatism and ill defined aches and pains; both are neglected rheumatology problems. Functional physical disability has been addressed by several COPCORD using modified validated versions of Stanford HAQ. Though a core questionnaire was used by all, several regional variations (and often dictated by logistics) need to be considered when comparing survey results. Currently, COPCORD is trying to expand its global reach and relevance by initiating surveys in Africa. It is generally believed that the ILAR COPCORD needs to be better recognized for its merit and content in measuring the burden of MSK disease. It is ideally suited to capture issues that are most dear to the community. A COPCORD World website (www.copcord.org) was launched in 2011 to demonstrate the essential features of the program and evolving repository for universal access- history, questionnaires, survey methods, publications, presentations.
Disclosure of Interest None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.