Skip to main content
Erschienen in: Clinical Rheumatology 1/2021

05.06.2020 | Original Article

Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community

verfasst von: Vicente Juárez, Rosana Quintana, María Elena Crespo, Mariana Aciar, Emilio Buschiazzo, Natalia L. Cucchiaro, Eugenia Picco, Mario Ruiz, José Adolfo Sánchez, Rodolfo Franco, Natalia Estrella, Silvia Jorge, Cinthya Retamozo, Adriana M. R. Silvestre, Vanina García, Ingris Pelaez-Ballestas, Bernardo A. Pons Estel

Erschienen in: Clinical Rheumatology | Ausgabe 1/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina.

Methods

This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment.

Results

A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5 years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7 days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4).

Conclusion

RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients’ early referral to a specialist.
Key Points
• The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America.
• The patients with RA had high percentage of familiar history of RA.
• The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral.
• The mean of the delay in the diagnosis was 5.8 years. In this community, the lack of the “migration health” phenomenon may be a social determinant that negatively impacts their health.
Literatur
1.
Zurück zum Zitat Brooks PM (2006) The burden of musculoskeletal disease--a global perspective. Clin Rheumatol 25(6):778–781CrossRef Brooks PM (2006) The burden of musculoskeletal disease--a global perspective. Clin Rheumatol 25(6):778–781CrossRef
2.
Zurück zum Zitat Hurd K, Barnabe C (2017) Systematic review of rheumatic disease phenotypes and outcomes in the indigenous populations of Canada, the USA, Australia and New Zealand. Rheumatol Int 37(4):503–521CrossRef Hurd K, Barnabe C (2017) Systematic review of rheumatic disease phenotypes and outcomes in the indigenous populations of Canada, the USA, Australia and New Zealand. Rheumatol Int 37(4):503–521CrossRef
3.
Zurück zum Zitat Loyola-Sanchez A, Hurd K, Barnabe C (2017) Healthcare utilization for arthritis by indigenous populations of Australia, Canada, New Zealand, and the United States: a systematic review(). Semin Arthritis Rheum 46(5):665–674CrossRef Loyola-Sanchez A, Hurd K, Barnabe C (2017) Healthcare utilization for arthritis by indigenous populations of Australia, Canada, New Zealand, and the United States: a systematic review(). Semin Arthritis Rheum 46(5):665–674CrossRef
4.
Zurück zum Zitat Darmawan J, Muirden KD (2003) WHO-ILAR COPCORD perspectives past, present, and future. J Rheumatol 30(11):2312–2314PubMed Darmawan J, Muirden KD (2003) WHO-ILAR COPCORD perspectives past, present, and future. J Rheumatol 30(11):2312–2314PubMed
5.
Zurück zum Zitat Goycochea-Robles MV, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M et al (2011) Validity of the COPCORD core questionnaire as a classification tool for rheumatic diseases. J Rheumatol Suppl 86:31–35CrossRef Goycochea-Robles MV, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M et al (2011) Validity of the COPCORD core questionnaire as a classification tool for rheumatic diseases. J Rheumatol Suppl 86:31–35CrossRef
6.
Zurück zum Zitat Moreno-Montoya J, Alvarez-Nemegyei J, Trejo-Valdivia B, Pelaez-Ballestas I, Geema (2014) Assessment of the dimensions, construct validity, and utility for rheumatoid arthritis screening of the COPCORD instrument. Clin Rheumatol 33(5):631–636CrossRef Moreno-Montoya J, Alvarez-Nemegyei J, Trejo-Valdivia B, Pelaez-Ballestas I, Geema (2014) Assessment of the dimensions, construct validity, and utility for rheumatoid arthritis screening of the COPCORD instrument. Clin Rheumatol 33(5):631–636CrossRef
7.
Zurück zum Zitat Montenegro RA, Stephens C (2006) Indigenous health in Latin America and the Caribbean. Lancet. 367(9525):1859–1869CrossRef Montenegro RA, Stephens C (2006) Indigenous health in Latin America and the Caribbean. Lancet. 367(9525):1859–1869CrossRef
8.
Zurück zum Zitat Pelaez-Ballestas I, Pons-Estel BA, Burgos-Vargas R (2016) Epidemiology of rheumatic diseases in indigenous populations in Latin-Americans. Clin Rheumatol 35(Suppl 1):1–3CrossRef Pelaez-Ballestas I, Pons-Estel BA, Burgos-Vargas R (2016) Epidemiology of rheumatic diseases in indigenous populations in Latin-Americans. Clin Rheumatol 35(Suppl 1):1–3CrossRef
9.
Zurück zum Zitat Guevara-Pacheco S, Feican-Alvarado A, Sanin LH, Vintimilla-Ugalde J, Vintimilla-Moscoso F, Delgado-Pauta J et al (2016) Prevalence of musculoskeletal disorders and rheumatic diseases in Cuenca, Ecuador: a WHO-ILAR COPCORD study. Rheumatol Int 36(9):1195–1204CrossRef Guevara-Pacheco S, Feican-Alvarado A, Sanin LH, Vintimilla-Ugalde J, Vintimilla-Moscoso F, Delgado-Pauta J et al (2016) Prevalence of musculoskeletal disorders and rheumatic diseases in Cuenca, Ecuador: a WHO-ILAR COPCORD study. Rheumatol Int 36(9):1195–1204CrossRef
10.
Zurück zum Zitat Pelaez-Ballestas I, Granados Y, Quintana R, Loyola-Sanchez A, Julian-Santiago F, Rosillo C et al (2018) Epidemiology and socioeconomic impact of the rheumatic diseases on indigenous people: an invisible syndemic public health problem. Ann Rheum Dis 77(10):1397–1404CrossRef Pelaez-Ballestas I, Granados Y, Quintana R, Loyola-Sanchez A, Julian-Santiago F, Rosillo C et al (2018) Epidemiology and socioeconomic impact of the rheumatic diseases on indigenous people: an invisible syndemic public health problem. Ann Rheum Dis 77(10):1397–1404CrossRef
11.
Zurück zum Zitat Quintana R, Silvestre AM, Goni M, Garcia V, Mathern N, Jorfen M et al (2016) Prevalence of musculoskeletal disorders and rheumatic diseases in the indigenous Qom population of Rosario, Argentina. Clin Rheumatol 35(Suppl 1):5–14CrossRef Quintana R, Silvestre AM, Goni M, Garcia V, Mathern N, Jorfen M et al (2016) Prevalence of musculoskeletal disorders and rheumatic diseases in the indigenous Qom population of Rosario, Argentina. Clin Rheumatol 35(Suppl 1):5–14CrossRef
13.
Zurück zum Zitat Sevini F, Yao DY, Lomartire L, Barbieri A, Vianello D, Ferri G, Moretti E, Dasso MC, Garagnani P, Pettener D, Franceschi C, Luiselli D, Franceschi ZA (2013) Analysis of population substructure in two sympatric populations of Gran Chaco, Argentina. PLoS One 8(5):e64054CrossRef Sevini F, Yao DY, Lomartire L, Barbieri A, Vianello D, Ferri G, Moretti E, Dasso MC, Garagnani P, Pettener D, Franceschi C, Luiselli D, Franceschi ZA (2013) Analysis of population substructure in two sympatric populations of Gran Chaco, Argentina. PLoS One 8(5):e64054CrossRef
14.
Zurück zum Zitat Messineo C, Cúneo P (2011) ECiTILotGCRTGaMM-M, Anthropological linguistics, vol. 53. Trustees of Indiana UniversityAnthropological Linguistics, pp 132–169 Messineo C, Cúneo P (2011) ECiTILotGCRTGaMM-M, Anthropological linguistics, vol. 53. Trustees of Indiana UniversityAnthropological Linguistics, pp 132–169
15.
Zurück zum Zitat Pelaez-Ballestas I, Granados Y, Silvestre A, Alvarez-Nemegyei J, Valls E, Quintana R et al (2014) Culture-sensitive adaptation and validation of the community-oriented program for the control of rheumatic diseases methodology for rheumatic disease in Latin American indigenous populations. Rheumatol Int 34(9):1299–1309CrossRef Pelaez-Ballestas I, Granados Y, Silvestre A, Alvarez-Nemegyei J, Valls E, Quintana R et al (2014) Culture-sensitive adaptation and validation of the community-oriented program for the control of rheumatic diseases methodology for rheumatic disease in Latin American indigenous populations. Rheumatol Int 34(9):1299–1309CrossRef
16.
Zurück zum Zitat Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324CrossRef Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324CrossRef
17.
Zurück zum Zitat Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH, European Study Group on Classification Criteria for Sjögren's Syndrome (2002) Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61(6):554–558CrossRef Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH, European Study Group on Classification Criteria for Sjögren's Syndrome (2002) Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61(6):554–558CrossRef
18.
Zurück zum Zitat Rudwaleit M, Metter A, Listing J, Sieper J, Braun J (2006) Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 54(2):569–578CrossRef Rudwaleit M, Metter A, Listing J, Sieper J, Braun J (2006) Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 54(2):569–578CrossRef
19.
Zurück zum Zitat Altman RD, Block DA, Brandt KD, Cooke DV, Greenwald RA, Hochberg MC, Howell DS, Ike RW, Kaplan D, Koopman W (1990) Osteoarthritis: definitions and criteria. Ann Rheum Dis 49(3):201CrossRef Altman RD, Block DA, Brandt KD, Cooke DV, Greenwald RA, Hochberg MC, Howell DS, Ike RW, Kaplan D, Koopman W (1990) Osteoarthritis: definitions and criteria. Ann Rheum Dis 49(3):201CrossRef
20.
Zurück zum Zitat Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Michael Franklin C, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, Mccain GA, John Reynolds W, Romano TJ, Jon Russell I, Sheon RP (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33(2):160–172CrossRef Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Michael Franklin C, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, Mccain GA, John Reynolds W, Romano TJ, Jon Russell I, Sheon RP (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33(2):160–172CrossRef
21.
Zurück zum Zitat Alvarez-Nemegyei J, Pelaez-Ballestas I, Rodriguez-Amado J, Sanin LH, Garcia-Garcia C, Garza-Elizondo MA et al (2011) Prevalence of rheumatic regional pain syndromes in adults from Mexico: a community survey using COPCORD for screening and syndrome-specific diagnostic criteria. J Rheumatol Suppl 86:15–20CrossRef Alvarez-Nemegyei J, Pelaez-Ballestas I, Rodriguez-Amado J, Sanin LH, Garcia-Garcia C, Garza-Elizondo MA et al (2011) Prevalence of rheumatic regional pain syndromes in adults from Mexico: a community survey using COPCORD for screening and syndrome-specific diagnostic criteria. J Rheumatol Suppl 86:15–20CrossRef
22.
Zurück zum Zitat Pelaez-Ballestas I, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M et al (2011) Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl 86:3–8CrossRef Pelaez-Ballestas I, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M et al (2011) Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl 86:3–8CrossRef
23.
Zurück zum Zitat Pelaez-Ballestas I, Flores-Camacho R, Rodriguez-Amado J, Sanin LH, Valerio JE, Navarro-Zarza E et al (2011) Prevalence of back pain in the community. A COPCORD-based study in the Mexican population. J Rheumatol Suppl 86:26–30CrossRef Pelaez-Ballestas I, Flores-Camacho R, Rodriguez-Amado J, Sanin LH, Valerio JE, Navarro-Zarza E et al (2011) Prevalence of back pain in the community. A COPCORD-based study in the Mexican population. J Rheumatol Suppl 86:26–30CrossRef
24.
Zurück zum Zitat Paoin WYM, Yokobori Y, Endo H, Kim S (2018) Development of the ICD-10 simplified version and field test. Health Inf Manag 47(2):77–84PubMed Paoin WYM, Yokobori Y, Endo H, Kim S (2018) Development of the ICD-10 simplified version and field test. Health Inf Manag 47(2):77–84PubMed
25.
Zurück zum Zitat Quintana R, Goni M, Mathern N, Jorfen M, Conti S, Nieto R et al (2018) Rheumatoid arthritis in the indigenous Qom population of Rosario, Argentina: aggressive and disabling disease with inadequate adherence to treatment in a community-based cohort study. Clin Rheumatol 37(9):2323–2330CrossRef Quintana R, Goni M, Mathern N, Jorfen M, Conti S, Nieto R et al (2018) Rheumatoid arthritis in the indigenous Qom population of Rosario, Argentina: aggressive and disabling disease with inadequate adherence to treatment in a community-based cohort study. Clin Rheumatol 37(9):2323–2330CrossRef
26.
Zurück zum Zitat Granados Y, Rosillo C, Cedeno L, Martinez Y, Sanchez G, Lopez G et al (2016) Prevalence of musculoskeletal disorders and rheumatic disease in the Warao, Kari’na, and Chaima indigenous populations of Monagas State, Venezuela. Clin Rheumatol 35(Suppl 1):53–61CrossRef Granados Y, Rosillo C, Cedeno L, Martinez Y, Sanchez G, Lopez G et al (2016) Prevalence of musculoskeletal disorders and rheumatic disease in the Warao, Kari’na, and Chaima indigenous populations of Monagas State, Venezuela. Clin Rheumatol 35(Suppl 1):53–61CrossRef
27.
Zurück zum Zitat Ferucci ED, Templin DW, Lanier AP (2005) Rheumatoid arthritis in American Indians and Alaska natives: a review of the literature. Semin Arthritis Rheum 34(4):662–667CrossRef Ferucci ED, Templin DW, Lanier AP (2005) Rheumatoid arthritis in American Indians and Alaska natives: a review of the literature. Semin Arthritis Rheum 34(4):662–667CrossRef
28.
Zurück zum Zitat Loyola-Sanchez A, Richardson J, Wilkins S, Lavis JN, Wilson MG, Alvarez-Nemegyei J, Pelaez-Ballestas I (2016) Barriers to accessing the culturally sensitive healthcare that could decrease the disabling effects of arthritis in a rural Mayan community: a qualitative inquiry. Clin Rheumatol 35(5):1287–1298CrossRef Loyola-Sanchez A, Richardson J, Wilkins S, Lavis JN, Wilson MG, Alvarez-Nemegyei J, Pelaez-Ballestas I (2016) Barriers to accessing the culturally sensitive healthcare that could decrease the disabling effects of arthritis in a rural Mayan community: a qualitative inquiry. Clin Rheumatol 35(5):1287–1298CrossRef
29.
Zurück zum Zitat Rodriguez-Polanco E, Al Snih S, Kuo YF, Millan A, Rodriguez MA (2011) Lag time between onset of symptoms and diagnosis in Venezuelan patients with rheumatoid arthritis. Rheumatol Int 31(5):657–665CrossRef Rodriguez-Polanco E, Al Snih S, Kuo YF, Millan A, Rodriguez MA (2011) Lag time between onset of symptoms and diagnosis in Venezuelan patients with rheumatoid arthritis. Rheumatol Int 31(5):657–665CrossRef
30.
Zurück zum Zitat Kaliski S, Bustos L, Artigas C, Alarcon C, Vega MA, Cardenas C (2001) Rheumatoid arthritis among Mapuche aborigines. A 16 years experience in the IX region of the Chile. Rev Med Chil 129(3):253–258CrossRef Kaliski S, Bustos L, Artigas C, Alarcon C, Vega MA, Cardenas C (2001) Rheumatoid arthritis among Mapuche aborigines. A 16 years experience in the IX region of the Chile. Rev Med Chil 129(3):253–258CrossRef
31.
Zurück zum Zitat Correa MDLALV, Chaparro del Moral R et al (2012) Impacto de las guías de práctica clínica para el tratamiento de la artritis reumatoidea. Rev Argent Reumatol 23:18–23 Correa MDLALV, Chaparro del Moral R et al (2012) Impacto de las guías de práctica clínica para el tratamiento de la artritis reumatoidea. Rev Argent Reumatol 23:18–23
32.
Zurück zum Zitat Leon-Perez G (2019) Internal migration and the health of indigenous Mexicans: a longitudinal study. SSM Popul Health 8:100407CrossRef Leon-Perez G (2019) Internal migration and the health of indigenous Mexicans: a longitudinal study. SSM Popul Health 8:100407CrossRef
33.
Zurück zum Zitat Obregon-Ponce A, Iraheta I, Garcia-Ferrer H, Mejia B, Garcia-Kutzbach A (2012) Prevalence of musculoskeletal diseases in Guatemala, Central America: the COPCORD study of 2 populations. J Clin Rheumatol 18(4):170–174CrossRef Obregon-Ponce A, Iraheta I, Garcia-Ferrer H, Mejia B, Garcia-Kutzbach A (2012) Prevalence of musculoskeletal diseases in Guatemala, Central America: the COPCORD study of 2 populations. J Clin Rheumatol 18(4):170–174CrossRef
34.
Zurück zum Zitat Minaur N, Sawyers S, Parker J, Darmawan J (2004) Rheumatic disease in an Australian Aboriginal community in North Queensland, Australia. A WHO-ILAR COPCORD survey. J Rheumatol 31(5):965–972PubMed Minaur N, Sawyers S, Parker J, Darmawan J (2004) Rheumatic disease in an Australian Aboriginal community in North Queensland, Australia. A WHO-ILAR COPCORD survey. J Rheumatol 31(5):965–972PubMed
35.
Zurück zum Zitat Pelaez-Ballestas I, Alvarez-Nemegyei J, Loyola-Sanchez A, Escudero ML (2016) Prevalence and factors associated with musculoskeletal disorders and rheumatic diseases in indigenous Maya-Yucateco people: a cross-sectional community-based study. Clin Rheumatol 35(Suppl 1):15–23CrossRef Pelaez-Ballestas I, Alvarez-Nemegyei J, Loyola-Sanchez A, Escudero ML (2016) Prevalence and factors associated with musculoskeletal disorders and rheumatic diseases in indigenous Maya-Yucateco people: a cross-sectional community-based study. Clin Rheumatol 35(Suppl 1):15–23CrossRef
36.
Zurück zum Zitat Loyola-Sanchez A, Richardson J, Pelaez-Ballestas I, Alvarez-Nemegyei J, Lavis JN, Wilson MG, Wilkins S (2016) The impact of arthritis on the physical function of a rural Maya-Yucateco community and factors associated with its prevalence: a cross sectional, community-based study. Clin Rheumatol 35(Suppl 1):25–34CrossRef Loyola-Sanchez A, Richardson J, Pelaez-Ballestas I, Alvarez-Nemegyei J, Lavis JN, Wilson MG, Wilkins S (2016) The impact of arthritis on the physical function of a rural Maya-Yucateco community and factors associated with its prevalence: a cross sectional, community-based study. Clin Rheumatol 35(Suppl 1):25–34CrossRef
37.
Zurück zum Zitat Guevara-Pacheco SV, Feican-Alvarado A, Delgado-Pauta J, Lliguisaca-Segarra A, Pelaez-Ballestas I (2017) Prevalence of disability in patients with musculoskeletal pain and rheumatic diseases in a population from Cuenca, Ecuador. J Clin Rheumatol 23(6):324–329CrossRef Guevara-Pacheco SV, Feican-Alvarado A, Delgado-Pauta J, Lliguisaca-Segarra A, Pelaez-Ballestas I (2017) Prevalence of disability in patients with musculoskeletal pain and rheumatic diseases in a population from Cuenca, Ecuador. J Clin Rheumatol 23(6):324–329CrossRef
38.
Zurück zum Zitat Marrone S (2007) Understanding barriers to health care: a review of disparities in health care services among indigenous populations. Int J Circumpolar Health 66(3):188–198CrossRef Marrone S (2007) Understanding barriers to health care: a review of disparities in health care services among indigenous populations. Int J Circumpolar Health 66(3):188–198CrossRef
39.
Zurück zum Zitat Holveck JC, Ehrenberg JP, Ault SK, Rojas R, Vasquez J, Cerqueira MT, Ippolito-Shepherd J, Genovese MA, Periago MR (2007) Prevention, control, and elimination of neglected diseases in the Americas: pathways to integrated, inter-programmatic, inter-sectoral action for health and development. BMC Public Health 7:6CrossRef Holveck JC, Ehrenberg JP, Ault SK, Rojas R, Vasquez J, Cerqueira MT, Ippolito-Shepherd J, Genovese MA, Periago MR (2007) Prevention, control, and elimination of neglected diseases in the Americas: pathways to integrated, inter-programmatic, inter-sectoral action for health and development. BMC Public Health 7:6CrossRef
40.
Zurück zum Zitat Colmenares-Roa T, Pelaez-Ballestas I (2019) Indigenous identification by health professionals in a Mexican hospital setting. Med Anthropol 1–16 Colmenares-Roa T, Pelaez-Ballestas I (2019) Indigenous identification by health professionals in a Mexican hospital setting. Med Anthropol 1–16
Metadaten
Titel
Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community
verfasst von
Vicente Juárez
Rosana Quintana
María Elena Crespo
Mariana Aciar
Emilio Buschiazzo
Natalia L. Cucchiaro
Eugenia Picco
Mario Ruiz
José Adolfo Sánchez
Rodolfo Franco
Natalia Estrella
Silvia Jorge
Cinthya Retamozo
Adriana M. R. Silvestre
Vanina García
Ingris Pelaez-Ballestas
Bernardo A. Pons Estel
Publikationsdatum
05.06.2020
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 1/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-020-05130-3

Weitere Artikel der Ausgabe 1/2021

Clinical Rheumatology 1/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.