Background Osteoarthritis is well reported in literature as being a major health and social problem for disadvantaged middle age women. These women suffer from joint pain, stiffness and decreased levels of physical activity and may experience difficulties associated with other chronic diseases. A lack of data is found on the impact of osteoarthritis and chronic diseases in women at primary health care level in South Africa
Objectives The aim was to establish the extent and impact of osteoarthritis and chronic diseases of lifestyle (CDL) on health and functional outcomes in women. This information will assist in understanding the burden of disease and the possible interactions with chronic diseases.The results could inform the need for effective chronic disease management to address health and functional problems.
Methods Women older than 18 attending the Community Health Centres (CHCs) for treatment of diseases were included. Data was collected using COPCORD, Brief Pain Inventory, WHODASII 12 items, EQ-5D, IPAQ questionnaires, and BMI. MAGPI was used with 3G enabled tablets to gather, record and send data to central database. Descriptive statistics was used to describe the sample. Comparisons were made between those who screen positive and negative for disease through the use of chi-square, Mann-Whitney U and the t-test.
Results There were 535 women with a mean age of 58.2 years (SD=11.0), where 306 (57.4%) had OA, 390 (73.2%) hypertension and 171 (32%) diabetes mellitus type 2. BMI was tested on 324 women with a mean value of 31.4 (SD=7.51) and was significantly higher in hypertension (p=0.002), diabetes mellitus type 2 (p=0.047), and osteoarthritis (p=0.012). The mean HRQOL score measured by EQ-5D was 0.72 (0.1) in 517 women, and was significantly lower in women with osteoarthritis (0.67, SD 0.1; N=298; p=0.00) compared to those with or without CDL. The mean functional ability score measured by WHODAS II was18.3 (7.2) in 533 women and no significant difference was found in groups. According to the IPAQ, 39% (209) of all women (N=535) reported high physical activity levels, 30% (158) were moderately active and 29% (155) were inactive. Furthermore, women with no hypertension had significantly lower levels of physical activity (N=145; p=0.00) compared to women with no other disease and those with hypertension, diabetes mellitus type 2 and osteoarthritis.
Conclusions A high proportion rate of chronic diseases was found in middle-aged women in Cape Town. Majority of women had reported moderate to low physical activity levels and have obesity, which in turn could have an impact on their health related quality of life. These preliminary findings could suggest that middle-aged women attending CHCs in Cape Town suffer from multiple chronic diseases, obesity and decreased physical activity levels, which could impact their overall functional ability.
Omariba DW. Gender differences in functional limitations among Canadians with arthritis: the role of disease duration and comorbidity. Health Rep. 2011 Dec;22(4):7-14
Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bulletin of the World Health Organization. 2003;81(9):646-56.
Acknowledgements NRF Thuthuka grant and University of Cape Town for funding the project.
Prof J Jelsma, Prof M Harris and Dr R Parker for their contributions toward the study
Disclosure of Interest None declared