Up to five million Indians could be living with Rheutamoid Arthritis (RA), suggests perhaps the largest study ever undertaken to assess the burden of the painful disease of the joints in the country.
The WHO-ILAR COPCORD study covered over 55,000 individuals at 12 sites, and recorded a prevalence of 0.34 per cent — which seemingly tiny figure, when projected over a population of 1.25 billion, still produces the theoretical figure of 4.25 million RA patients across the country.
COPCORD, or Community Oriented Programme for Control of Rheumatic Diseases, was launched by the World Health Organisation (WHO) and International League for Associations of Rheumatology (ILAR) to collect data on the burden of the disease, especially in rural communities in developing countries.
“Our study has projected critical findings that there could be at least five million RA patients in the country,” said Pune-based rheumatologist Dr Arvind Chopra, author of the study, Disease Burden of Rheumatic Diseases in India: COPCORD Perspective, published in the June 2015 issue of the Indian Journal of Rheumatology.
While more population surveys are required to evaluate the spread and impact of RA in terms of socioeconomic and functional ability of sufferers, the numbers still appear to be very large, Dr Chopra said. Also, because several inflammatory rheumatic diseases cause premature atherosclerosis, vascular complications and early death — all of which are difficult to measure — the overall burden is likely to be underestimated, says the study.
The maiden WHO-ILAR COPCORD programme started at Bhigwan, a village near Pune, in 1996, and was subsequently replicated to collect information on the disease elsewhere.
“We initially surveyed 7,000 persons in Bhigwan, and followed it up by a long-term, planned programme of providing rheumatology services and collecting further incidence and risk-factor data,” Chopra said.
“Our study over 1996-2014 demonstrated that musculoskeletal (MSK) pain was the commonest self-reported ailment in the community, soft tissue rheumatism, ill-defined MSK symptoms and osteoarthritis (OA) were the predominant disorders, and in about 10 per cent of cases, respondents suffered from inflammatory arthritis.”
As part of the study, the India chapter of Bone and Joint Decade (BJD) — a UN-endorsed international alliance of medical professionals focused on MSK health — carried out multiple standardised and uniform surveys between 2004 and 2010 at the 12 chosen sites, and recorded the prevalence of a range of rheumatic disorders.