Unspecified pain, chronic pain, and high-impact chronic pain in Lesotho: a population-based cross-sectional study

Pain is understudied in Africa, and there are no data on high-impact chronic pain from this region. In this study, we assessed the prevalence of unspecified pain, chronic pain, and high-impact chronic pain, and their determinants in Lesotho, Southern Africa.

We conducted a household-based, cross-sectional survey among adults aged 18 years or older in 120 randomly sampled villages across Butha-Buthe and Mokhotlong districts in Lesotho.

Among the 6039 adults included, the median age was 39 years (interquartile range: 27-58), and 3153 of 6039 participants (52.2%) were female. Overall, 1194 participants (19.8%) had unspecified pain (95% confidence interval [CI]: 18.8-20.8), 909 (15.1%) had chronic pain (95% CI: 14.2-16.0), and 428 (7.1%) had high-impact chronic pain (95% CI: 6.5-7.8) corresponding to 47.1% among the participants with chronic pain. Higher age groups were associated with increasing odds of unspecified pain, chronic pain, and high-impact chronic pain. Male participants were less likely to have unspecified pain (adjusted odds ratio [aOR], 0.65; 95% CI: 0.55-0.76; P < 0.001) and chronic pain (aOR, 0.79; 95% CI: 0.65-0.96; P = 0.019). There was no association between sex and high-impact chronic pain. Furthermore, high-impact chronic pain was associated with arterial hypertension, diabetes mellitus, moderate-to-high risk of depression, moderate-to-high risk of generalized anxiety disorder, and household wealth.

The prevalence of chronic pain and high-impact chronic pain was elevated in our study population. Associations with further noncommunicable chronic conditions, such as arterial hypertension and diabetes mellitus, support the need for health systems to provide integrated chronic care which includes pain management.