Syndemic and syndemogenesis of low back pain in Latin-American population: a network and cluster analysis.

Autor: Strozzi AG; Instituto de Ciencias Aplicadas y Tecnología, Universidad Nacional Autónoma de México (ICAT-UNAM), 04510, Ciudad de México, Mexico., Peláez-Ballestas I; Rheumatology Unit. Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico. pelaezin@gmail.com., Granados Y; Centro Medico, Maturín, Venezuela., Burgos-Vargas R; Rheumatology Unit. Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico., Quintana R; Hospital Provincial de Rosario, Rosario, Santa Fe, Argentina., Londoño J; Universidad de La Sabana, Bogotá, Colombia., Guevara S; Universidad de Cuenca, Cuenca, Ecuador., Vega-Hinojosa O; Clínica Reumacenter, Juliaca, Hospital III, Essalud, Juliaca, Peru., Alvarez-Nemegyei J; Private practice, Mérida, Yucatán, Mexico., Juarez V; Hospital Señor del Milagro, Salta, Argentina., Pacheco-Tena C; Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Mexico., Cedeño L; Red Ambulatoria. Ministerio del Poder Popular para la Salud, Maturín, Venezuela., Garza-Elizondo M; Universidad Autónoma de Nuevo León, Monterrey, Mexico., Santos AM; Universidad de La Sabana, Bogotá, Colombia., Goycochea-Robles MV; Unidad de Investigación, HGR 1 IMSS, Mexico City, Mexico., Feicán A; Universidad de Cuenca, Cuenca, Ecuador., García H; Hospital Amerimed, Av. Tulum Sur 260, 7, 77500, Cancún, Q.R., Mexico., Julian-Santiago F; Universidad Nacional Autónoma de México, Mexico City, Mexico., Crespo ME; Hospital Señor del Milagro, Salta, Argentina., Rodriguez-Amado J; Universidad Autónoma de Nuevo León, Monterrey, Mexico., Rueda JC; Universidad de La Sabana, Bogotá, Colombia., Silvestre A; Ministerio de Salud, Gobierno de la Provincia de Santa Fe, Santa Fe, Argentina., Esquivel-Valerio J; Universidad Autónoma de Nuevo León, Monterrey, Mexico., Rosillo C; Red Ambulatoria. Ministerio del Poder Popular para la Salud, Maturín, Venezuela., Gonzalez-Chavez S; Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Mexico., Alvarez-Hernández E; Rheumatology Unit. Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico., Loyola-Sanchez A; Universidad de Alberta, Edmonton, Canada., Navarro-Zarza E; Hospital General de Chilpancingo 'Dr. Raymundo Abarca Alarcón', Chilpancingo de los Bravo, Mexico., Maradiaga M; Hospital General de Culiacan, Culiacán, Sinaloa, Mexico., Casasola-Vargas J; Rheumatology Unit. Hospital General de México 'Dr. Eduardo Liceaga', Mexico City, Mexico., Sanatana N; Instituto Mexicano del Seguro Social, Chihuahua, Mexico., Garcia-Olivera I; Rheumatology Department, Hospital Regional de Alta Especialidad, Oaxaca, Mexico., Goñi M; Centro de Especialidades Médicas Ambulatorias de Rosario, Secretaría de Salud Pública, Municipalidad de Rosario, Santa Fe, Argentina., Sanin LH; Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Mexico., Gamboa R; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru., Cardiel MH; Centro de Investigación Clínica de Morelia, Morelia, Mexico., Pons-Estel BA; Centro Regional de Enfermedades Autoinmunes y Reumáticas (CREAR), Grupo Oroño, Rosario, Santa Fe, Argentina.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2020 Sep; Vol. 39 (9), pp. 2715-2726. Date of Electronic Publication: 2020 Mar 30.
DOI: 10.1007/s10067-020-05047-x
Abstrakt: Introduction: Although low back pain (LBP) is a high-impact health condition, its burden has not been examined from the syndemic perspective.
Objective: To compare and assess clinical, socioeconomic, and geographic factors associated with LBP prevalence in low-income and upper-middle-income countries using syndemic and syndemogenesis frameworks based on network and cluster analyses.
Methods: Analyses were performed by adopting network and cluster design, whereby interrelations among the individual and social variables and their combinations were established. The required data was sourced from the databases pertaining to the six Latin-American countries.
Results: Database searches yielded a sample of 55,724 individuals (mean age 43.38 years, SD = 17.93), 24.12% of whom were indigenous, and 60.61% were women. The diagnosed with LBP comprised 6.59% of the total population. Network analysis showed higher relationship individuals' variables such as comorbidities, unhealthy habits, low educational level, living in rural areas, and indigenous status were found to be significantly associated with LBP. Cluster analysis showed significant association between LBP prevalence and social variables (e.g. Gender inequality Index, Human Development Index, Income Inequality).
Conclusions: LBP is a highly prevalent condition in Latin-American populations with a high impact on the quality of life of young adults. It is particularly debilitating for women, indigenous individuals, and those with low educational level, and is further exacerbated by the presence of comorbidities, especially those in the mental health domain. Thus, the study findings demonstrate that syndemic and syndemogenesis have the potential to widen the health inequities stemming from LBP in vulnerable populations. Key points • Syndemic and syndemogenesis evidence health disparities in Latin-American populations, documenting the complexity of suffering from a disease such as low back pain that is associated with comorbidities, unhealthy habits, and the social and regional context where they live. • The use of network and cluster analyses are useful tools for documenting the complexity and the multifaceted impact in health in large populations as well as the differences between countries. • The variability and impact of socioeconomic indicators (e.g., Gini index) related to low back pain and comorbidities could be felt through the use of cluster analysis, which generates evidence of regional inequality in Latin America. • Populations can be studied from different models (network and cluster analysis) and grouping, presenting new interpretations beyond geographical groupings, such as syndemic and inequity in health.
Databáze: MEDLINE
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