The epidemiology of neck pain within the indigenous African population in Harare, Zimbabwe

Abstract

Background Musculoskeletal disorders are the leading cause of disability and can impair the quality of life. Of these musculoskeletal disorders, neck pain is one of the most common. Some of the risk factors for neck pain among the African population include low level of education, high-stress levels, low income and motor vehicle accidents. In the international arena, a broad range of risk factors contribute to chronic neck pain. These include female gender, increasing age, poor posture and work habits, twisting and bending of the neck and trunk, low–co-worker support, low socio-economic status and psychosocial factors such as stress and depression. Neck pain presents differently in different populations.

The epidemiology of neck pain has not been investigated in Zimbabwe. In this country factors such as economic instability, disruption of social trust, uncertainty about income, high crime rate, unstable healthcare and low morale in the working population have led to the development of psychological disorders such as stress, anxiety, and depression. Furthermore, there has also recently been an increase of vehicle use in Zimbabwe, with concomitant motor vehicle accidents. All of these factors may predispose this population to musculoskeletal pain such as neck pain. However, this requires investigation.

This study aimed to estimate the prevalence, risk factors and impact of neck pain in the indigenous African population in Harare, Zimbabwe.

Methodology This was a quantitative cross-sectional study based on a previously validated questionnaire sourced from Smith (2016) and conducted in Harare, Zimbabwe. Participants (n = 461) answered a self-administered questionnaire after providing informed consent. The data collected from the questionnaires were captured into an excel spreadsheet and subsequently statistically analysed using SPSS.

Standard deviation and mean reports are represented by (mean ± SD) within the text. Where standard deviation is represented by (SD). Tables, graphs and charts were used to present the data.

The Inferential analysis was conducted using cross tabulations (interpreted using the Pearson chi- Squared test). The bivariate analysis was done using a Chi-Squared test (Interpreted using the Pearson`s chi-squared test). Odds ratios (OR) were calculated using binary logistic

regression, This calculation was used to find dependant variables on an existent independent variable (Willemse 2009: 121). The 95% confidence intervals (CI) were calculated for Odds Ratios and for prevalence (Johnson and Bhattacharyya 2000: 331). A significance of a p- value less than 0.05 was used throughout.

Results A total of 461 questionnaires were completed by participants in Harare, Zimbabwe. The point prevalence and 12-month prevalence was 16.4% (95% CI: 0.13 – 0.20) and 26.9% (95% CI: 0.22 – 0.31) respectively. The lifetime prevalence of neck pain was 49% (95% CI: 0.44 – 0.53).

Within this population, age was significantly associated with neck pain (p < 0.001) with a larger prevalence within the age group 20 – 35 years. The odds of self-reported neck pain are 2.5 times greater for those with the exposure of self-reported stress compared to the participants without the exposure of self-reported stress (Odds Ratio = 2.5; 95%CI: 1.121 – 5.734; p = 0.025). Lack of finances (22.6%, n =104), work (18%, n =83) and poor living conditions (5.6%, n =26) were the main stressors identified among the participants. Other associations found for neck pain in this population were motor vehicle accidents (p < 0.001) and poor eyesight (p < 0.001). There was an association of neck pain with headaches (p = 0.023), shoulder pain (p < 0.001) and low back pain (p < 0.001).

Conclusion Neck pain was prevalent within the indigenous population of Harare, Zimbabwe. Factors that were associated with neck pain in the sample population included stress, age, headaches, shoulder pain, low back pain, motor vehicle accidents, and poor eyesight.