Prevalence of Knee Osteoarthritis in Rural Adults of District Swat, KPK: A Cross-Sectional Study

Abstract

Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease causing significant disability, particularly in rural populations with limited healthcare access and physically demanding lifestyles. Objective: This study aimed to estimate the prevalence of KOA among adults aged 40 and above in rural Swat, Khyber Pakhtunkhwa (KPK), Pakistan, and identify associated demographic, occupational, and lifestyle risk factors. Methods: A cross-sectional community-based study was conducted with a sample size of 361 participants, selected through stratified random sampling. Data were collected using a self-structured questionnaire for demographic and lifestyle information and clinical assessments based on the American College of Rheumatology (ACR) criteria and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scale. Statistical analysis was performed using SPSS, with chi-square tests to assess associations. Results: The overall prevalence of KOA was 70%, with 80% in females (n=105/130) and 64% in males (n=148/231). Key risk factors included female gender (p=0.001), higher body mass index (BMI) (p<0.001), older age (p<0.001), lower education levels (p<0.001), and occupations involving heavy physical labor (p<0.001). Rural residency was associated with higher prevalence (58% in villages vs. 43% in towns). Conclusion: KOA is highly prevalent in rural Swat, particularly among females, older adults, and those with higher BMI and labor-intensive occupations. Targeted interventions, such as mobile joint care units and community education, are recommended to address this burden.
Keywords: Knee osteoarthritis, prevalence, risk factors, rural population, ACR criteria, WOMAC score