CORRELATES OF SELF-REPORTED ARTHRITIS IN ADULT PAKISTANI POPULATION

Abstract

Osteoarthritis is a common joint disease with highmorbidity and adverse economic impact on societies1.The most common risk factors include age andobesity2. To describe, age gender, literacy andresidency status associated with self reported arthritisin adults and its prevalence in Pakistan, we used datafrom the National Health Survey of Pakistan (NHSP)1990-94; with written permission from the federalMinistry of Health, Islamabad. We selected all theadults aged 26 and above who responded to thequestion “Have you ever had Arthritis?” individualsresponding affirmatively to this question wereidentified as having arthritis. A two-stage stratifiedsample design was adopted for NHSP3. Design-basedanalysis with SUDAAN 9.01 was done usingLogistic regression, Odds Ratios (OR) werecomputed for the association of arthritis with variousdemographic variables.The overall prevalence of arthritis 39%, and95% Confidence Interval (CI) was 34%, 43% (n =5851). In males arthritis prevalence was 30% 95% CI25%, 34%, while prevalence in females was 47% CI41%, 53%. Adults with arthritis were more likely tobe in the age group of 41 to 55 years (OR 1.58, 95%CI 1.37, 1.82), and 56 years and above group (OR1.84, 95% CI 1.60, 2.1) compared to 26-40 year agegroup. Males were almost half as likely to reportarthritis compared to females (OR 0.52, 95% CI 0.40,0.66). Arthritic adults were more likely to be ruraldwellers (OR 1.53, 95% CI 1.12, 2.08) compared tourban dwellers, and compared to literate adults(defined as being able to read and write) adults whowere not literate were more likely to report arthritis(OR 1.73, 95% CI 1.41, 2.12). While compared tosingle adults, married adults were more likely toreport arthritis (OR 1.61, 95% CI 1.36, 2.28), nostatistically significant association was foundbetween reporting arthritis and being in the othercategory comprising of divorced, widowed andseparated adults. Results of Hosmer-Lemeshowgoodness-of-fit tests using Wald F and Chi-Squareconclude that the model was a good fit for the data.The results of this unique survey,demonstrate that rural women above the age of 40years were most likely to report arthritis; healtheducation efforts at early diagnosis and treatmentwould be particularly beneficial for this group.