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Landscape of paediatric pain in Sub-Saharan Africa: a scoping review
Anisa Bhettay1, Kotie Bester1, Romy Parker1
1Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
Insights
Research on pediatric pain in Sub-Saharan Africa is scarce. This review highlights significant gaps in pain assessment and management, emphasizing the need for improved healthcare provider training and evidence-based guidelines to reduce children's pain burden.
Area of Science:
- Medical Research
- Public Health
- Pediatrics
Background:
- Biopsychosocial factors significantly influence pain perception and experience.
- Children in Sub-Saharan Africa face a high burden of pain due to unique diseases.
- There is a notable lack of robust scientific research on pediatric pain in Sub-Saharan Africa.
Purpose of the Study:
- To conduct a scoping review of pediatric pain in Sub-Saharan Africa.
- To describe pain prevalence, management practices, and health system factors.
- To map the existing research landscape on pediatric pain in the region.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (e.g., PubMed, Scopus, Cochrane Library).
- Studies published between 2000 and 2022, focusing on children (0-18 years) in Sub-Saharan Africa, were included.
- A thematic approach was used for data synthesis, with results presented narratively.
Main Results:
- 68 studies were included, revealing a high prevalence of acute and procedural pain in hospitalized children, especially neonates.
- Evidence-based pain assessment and management were often lacking, despite the validation of some local tools.
- Healthcare worker knowledge deficits and resource limitations significantly impede effective pain management; chronic pain data is scarce.
Conclusions:
- There is a critical need for targeted resources to address deficits in pediatric pain management in Sub-Saharan Africa.
- Training healthcare providers and developing evidence-based guidelines are essential for improving pain control.
- Further robust research is required to inform interventions and reduce the pediatric pain burden in the region.
Introduction:
Pain is impacted by various biopsychosocial factors, including context and culture. Children in Sub-Saharan Africa present with unique diseases with a high pain burden. Robust scientific research on paediatric pain in Sub-Saharan Africa is lacking.
Methods:
A scoping review was conducted to describe the pain prevalence, pain management practices and health system factors impacting pain management and to map the relevant research landscape in sub-Saharan Africa. The search strategy combined pain, location and age-related terms. Studies from 2000 to 2022 from countries in Sub-Saharan Africa pertaining to acute, procedural and chronic pain in children from birth to 18 years were included. Searches were conducted in African-Wide EBSCO, CINAHL, Epistemonikos, PubMed, Scopus, Web of Science, Scielo and the Cochrane Library. A thematic approach was applied for data synthesis through an iterative process, and results presented narratively.
Results:
After applying eligibility criteria, 68 studies were included. Studies demonstrated a high prevalence of acute and procedural pain in hospitalised children, with neonates a particularly vulnerable group. While various tools were validated for local populations, evidence-based pain assessment and management was lacking. Demonstrated knowledge deficits among healthcare workers translated into inadequate pain management. Utilisation of non-pharmacological strategies was varied. Resource limitations pose substantial obstacles to effective pain control. Data on chronic pain remains scant.
Conclusion:
This review presents a comprehensive synthesis of the evidence on paediatric pain management in Sub-Saharan Africa. It highlights the need to direct resources towards addressing deficits in paediatric pain management. Training of healthcare providers and developing evidence-based guidelines is imperative. Robust research on paediatric pain in Sub-Saharan Africa is needed to inform targeted interventions to improve pain management, reducing the pain burden in children in the region.
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