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Running head: LBP among working Ethiopian population
Prevalence of low back pain among working Ethiopian
population: A systematic review and meta-analysis
Amanuel Godana Arero
1
, Godana Arero
2
, Shimels Hussien Mohammed
3
, Sahar Eftekhari
4
1. Students’ Scientific Research Center ,Tehran University of Medical Sciences, Tehran,
Iran
2. Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
3. Department of Community Nutrition, School of Nutritional Sciences and Dietetics,
Tehran University of Medical Sciences, Tehran, Iran
4. School of Medicine- International Campus, Tehran University of Medical Sciences
(TUMS), Tehran, Iran
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The copyright holder for thisthis version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.29.20238170doi: medRxiv preprint
NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
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LBP among working Ethiopian population
Abstract
Background and objective
Low back pain (LBP) as musculoskeletal disorder remains a common health problem and is one
of the most prevalent occupational injuries affecting adults living in both developed and
developing countries. To increase the power and improve the estimates of the prevalence of LBP
among the working Ethiopian population, a comprehensive meta-analysis was carried out.
Methods
A comprehensive systematic literature search was conducted in multiple international electronic
bibliographic databases such as Web of Science, Pub Med, EMBASE, Scopus, and Google
Scholar. Population-based Studies into the Prevalence of LBP among the working population
living in Ethiopia were included. Methodological quality for included studies was appraised
using an adapted tool. Meta-analyses, Meta-regression, and sensitivity analysis were
conducted. Funnel plot symmetry visualization followed by Begg’s rank correlation and Egger’s
regression asymmetry test methods were performed to detect the existence of publication
bias. Heterogeneity between studies was assessed by using the Cochrane Q and I2-statistics.
Results
In all 719 articles were identified and 13 articles with 6513 participants met the inclusion criteria
for meta-analyses after filtering. The pooled point and twelve-month prevalence of LBP among
working Ethiopian population was 49% (95% CI 40; 58) and 56% (95% CI 49; 62) respectively.
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
The copyright holder for thisthis version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.29.20238170doi: medRxiv preprint
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LBP among working Ethiopian population
Conclusion
The results showed a high prevalence of LBP among working Ethiopian population, especially
among Teachers. We believe that Prevention strategies addressing the early onset of LBP
among the working population would most likely be the answer to the burden of LBP on future
economies in Ethiopia.
Keywords
; Low back pain, Epidemiology, Occupational injury,
Working population,
Ethiopia
Introduction
It is believed that Lower back pain (LBP) is one of the most prevalent musculoskeletal
conditions affecting adults living in both developed and developing nations (1-4) . Broadly
defined as pain or discomfort in the lumbar region of the spine between the lower costal margins
and the inferior gluteal folds with or without leg pain (i.e., sciatica) (1-4). LBP remains one of
the most common health problems that 50–80% of adults of working age population experience
at some point in the course of their lifetime and its prevalence or incidence has been found to
increase with an increase in age(3, 4). It is estimated that 46% of workers in European
countries(5) and about 20% of workers in US (6, 7) report LBP at any given time. LBP is the
major cause of work absence and activity restriction throughout much of the world, imposing a
high economic burden on individuals, families, communities, industries and governments(8,
9).Direct costs for LBP in US are estimated between $20 billion and $98 billion, with indirect
annual costs included the total cost estimates are as high as $200 billion(10, 11).
According to the Global Burden of Disease (GBD) 2010 study, the overall burden of LBP arising
from workplace exposure was estimated at 21.8 million [95% CI (14.5–30.5)] disability-adjusted
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
The copyright holder for thisthis version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.29.20238170doi: medRxiv preprint
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LBP among working Ethiopian population
life years (DALYs) and is currently, the sixth-highest burden and is the cause of more years lived
with disability (YLDs) globally than any other condition (12-14). Despite the fact that the
literature on the prevalence of low back pain is accumulating, but for the most part studies are
restricted and only available for developed countries, which comprise less than 20% of the
world's population. Understanding the prevalence of LBP in the working population in
developing countries such as Ethiopia may assist in the understanding of the global LBP burden
and its management. Thus, the purpose of this review aims to systematically appraise published
Disease prevalence studies conducted in Ethiopia and estimate LBP prevalence in the working
population, in order to ascertain whether LBP is of concern in Ethiopia, as it is globally.
Methods
This systematic review and meta-analysis was conducted Based on the recommendations of
Meta-analysis of Observational Studies in Epidemiology guideline(15), and PRISMA(Preferred
Reporting Items for Systematic Reviews and Meta-Analysis) guideline (16).The work was
registered in PROSPERO(protocol registration number: CRD42020188523) .
Characteristics of studies
All studies conducted in the field of the prevalence of LBP in Ethiopia, regardless of the
publication period, we reviewed and included in our study. Studies could report on the
prevalence of musculoskeletal disorders as a whole, yet had to provide subgroup data for the
prevalence of LBP. Subjects included in the studies could be any race, gender, and age. All
Studies included are published in English.
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
The copyright holder for thisthis version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.29.20238170doi: medRxiv preprint
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LBP among working Ethiopian population
Data sources
A systematic literature search was conducted in multiple international electronic bibliographic
databases such as Web of Science, Pub Med, EMBASE, Scopus, and Google Scholar until 2020.
The main keywords used for this search were: low back pain, musculoskeletal pain, occupational
injury, prevalence, and Ethiopia. It should also be noted that articles published in journals and/or
Dissertations/theses, conference proceedings, reports, commentaries/letters, and other grey
literature and all other references to the relevant articles were included in our search. The First
Reviewer (AGA) searched independently and the second reviewer (GA) checked the finding.
Study selection
Inclusion criteria dealt with cross-sectional studies that present the prevalence of LBP among
Ethiopia working population and conducted in Ethiopia. Exclusion criteria included irrelevant
studies, articles without adequate data regarding observations, studies that linked LBP with other
diseases, duplicate studies and Dissertations, conference proceedings, commentaries/letters, and
other grey literature were excluded from this review.
Data extraction and study quality assessment
Data extraction and quality assessment were done by two independent reviewers (AGA and GA).
Cases of a discrepancy were resolved by consensus between two reviewers. For all included
articles, a form was designed using a data extraction sheet in EXCEL software that include the
following variables: Author names, city/region, study design, year of publication, study setting,
data collection period, population, age, gender, working experience, Body mass index, type of
standard questionnaire, sample size, responsive rate, the prevalence of LBP, and study quality
score. The methodological quality critical appraisal tool used in a systematic and meta-analysis
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
The copyright holder for thisthis version posted November 30, 2020. ; https://doi.org/10.1101/2020.11.29.20238170doi: medRxiv preprint
