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Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Paediatric chronic pain prevalence in low- and middle-income countries: A systematic review and meta-analysis
Zi Wei Liao1, Chi Le1, J Matthew Kynes2
1224 Eskind Biomedical Library and Learning Center, Vanderbilt University School of Medicine, Nashville, TN 37240-7939, USA.
Insights
Paediatric chronic pain affects 8% of children in low- and middle-income countries, with higher prevalence in females for headache and abdominal pain. More research is needed due to data gaps.
Area of Science:
- Global Health
- Paediatric Medicine
- Epidemiology
Background:
- Chronic pain significantly impacts children's quality of life globally.
- This study is the first systematic review and meta-analysis on paediatric chronic pain in low- and middle-income countries (LMICs).
Purpose of the Study:
- To systematically review and analyze the prevalence of paediatric chronic pain in LMICs.
- To identify specific pain types and demographic differences in affected populations.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched multiple databases for studies published before January 7, 2022, including all languages.
- Included populations aged 19 and under in LMICs, defining chronic pain as present for ≥3 months.
Main Results:
- Analyzed 27 studies from 20 LMICs, with a pooled prevalence of 8% for chronic pain.
- Prevalence estimates: general/multi-site pain 20%, musculoskeletal pain 9%, abdominal pain 7%, headache 4%, fibromyalgia 3%.
- Females showed significantly higher prevalence for chronic headache, abdominal pain, and generalized/multi-site pain.
Conclusions:
- Characterization of paediatric chronic pain in LMICs is limited by data scarcity and heterogeneous assessment methods.
- Prioritizing research on the global burden of chronic pain in this demographic is crucial.
Background:
Chronic pain is a leading cause of morbidity in children and adolescents globally, with a significant impact on quality of life. This is the first systematic review and meta-analysis on paediatric chronic pain in low- and middle-income countries (LMICs).
Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE (via PubMed), Embase, CINAHL, PsycINFO, Web of Science, Cochrane Database of Systematic Reviews, and the WHO Global Index Medicus for all studies published prior to January 7, 2022. Articles published in all languages that included populations age 19 years and under living in LMICs were considered. Chronic pain was defined as persistent or recurrent pain that is present for ≥3 months, per the International Classification of Diseases (ICD-11) definition. Summary data were extracted from published reports and evaluated with mixed-effects regression analysis. PROSPERO Record ID: CRD42021227967.
Findings:
Of the 2875 studies identified, 70 articles were reviewed, with 27 studies representing 20 LMICs eligible for analysis. The average prevalence for each pain type reported with 95% confidence interval is as follows: general/multi-site/any 20% (16-25), musculoskeletal (MSK) pain 9% (7-13), abdominal pain 7% (5-10), headache 4% (2-10), and fibromyalgia per American College of Rheumatology or Yunus and Masi criteria 3% (1-10). Overall, a pooled mean of 8% chronic pain was estimated across all studies. A significantly high level of heterogeneity was found across all studies (I >90%). Chronic headache (OR=1·65, 95% CI 1·39-1·96), abdominal pain (OR=1·36, 95% CI 1·22-1·51), and generalized/multi-site pain (OR=1·54, 95% CI 1·31-1·81) were significantly more prevalent in females than males.
Interpretation:
The characterization of paediatric chronic pain in low- and middle-income countries suffers from a paucity of data and significant heterogeneity in the assessment methods. Understanding the global burden of chronic pain in this group should be prioritized.
Funding:
None.
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