Prevalence, Severity, and Potential Risk Factors for Fibromyalgia in Rural Western Kenya
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Past studies in the United States and Canada have found that the prevalence for fibromyalgia (FM) is approximately 2%, but there are very few studies of this condition in developing countries. With the organic basis unknown, the diagnosis of FM rests on the subjective report of chronic pain, sleep and cognitive disturbances, and mood alteration. Since these experiences are partially culturally conditioned, it is possible that the prevalence of FM in a setting of high disease burden, drought, and famine may be different both for physiological and cultural reasons than in a developed country. The prevalence, severity, and factors associated with FM were investigated. A cross-sectional study of 128 Luo adults in rural Kenya consisted of interviews with patients presenting to an annual temporary clinic. A modified version of the 2010 American College of Rheumatology preliminary diagnostic criteria for FM was used to identify bodily points of pain and severity of symptoms in order to categorize subjects with FM. A Community Health Assessment Profile was used to record patient demographic and background information. The study yielded a prevalence of 20% for FM, and the significantly associated factors included age, education, malaria, stroke, and death of a family member. The high prevalence of fibromyalgia in this clinical sample raises questions about the role of increased physical and psychosocial stress in a developing country as a significant context in understanding the disease.