Community-based epidemiological study on the prevalence and health status of Spondyloarthritis in residents of Wuyuan County, China, 2023

Abstract Background and Objective The prevalence of Spondyloarthritis (SpA) in China is approximately 1%, with ankylosing spondylitis (AS) at 0.25%. However, community-based incidence data remain scarce and are subject to medical reporting bias. This study aimed to investigate the prevalence of SpA and the health status of patients in Wuyuan County, to provide evidence for the national “Rural Health Project for Ankylosing Spondylitis”. Methods A cross-sectional survey was conducted from August to December 2023 using the WHO COPCORD methodology. A multi-stage stratified random cluster sampling method was employed, including 16, 996 residents. A screening questionnaire based on assessment of Spondyloarthritis international society (ASAS) criteria was used, and SpA diagnoses were confirmed by rheumatologists. Data analysis included Poisson distribution sample size estimation, Mann-Whitney U test, and Bootstrap proportion estimation (SPSS v29.0 and R v4.3.2). Results The estimated prevalence of SpA among residents of Wuyuan County in 2023 was 0.14%. A total of 24 patients were diagnosed with SpA (16 males and 8 females). Half of these cases were previously undiagnosed and demonstrated a significant diagnostic delay ( P = 0.021). Male patients exhibited more severe functional impairment, as indicated by higher bath ankylosing spondylitis functional index (BASFI) scores compared to their female counterparts (3.29 vs . 1.44, P < 0.05). Conclusion Community screening revealed a significant burden of SpA in rural China, underscoring the need to strengthen primary healthcare resource allocation.