The burden of low back pain and its association with socio-demographic variables in the Middle East and North Africa region, 1990-2019

Abstract

Background: Low back pain (LBP) is the most common musculoskeletal disorder globally. Providing region- and national-specific information on the burden of low back pain is critical for local healthcare policy makers. The present study aimed to report, compare, and contextualize the prevalence, incidence and years lived with disability (YLDs) of low back pain in the Middle East and North Africa (MENA) region by age, sex and sociodemographic index (SDI), from 1990 to 2019.

Methods: Publicly available data were obtained from the Global Burden of Disease (GBD) study 2019. The burden of LBP was reported for the 21 countries located in the MENA region, from 1990 to 2019. All estimates were reported as counts and age-standardised rates per 100,000 population, together with their corresponding 95% uncertainty intervals (UIs).

Results: In 2019, the age-standardised point prevalence and incidence rate per 100,000 in MENA were 7668.2 (95% UI 6798.0 to 8363.3) and 3215.9 (95%CI 2838.8 to 3638.3), which were 5.8% (4.3 to 7.4) and 4.4% (3.4 to 5.5) lower than in 1990, respectively. Furthermore, the regional age-standardised YLD rate in 2019 was 862.0 (605.5 to 1153.3) per 100,000, which was 6.0% (4.2 to 7.7) lower than in 1990. In 2019, Turkey [953.6 (671.3 to 1283.5)] and Lebanon [727.2 (511.5 to 966.0)] had the highest and lowest age-standardised YLD rates, respectively. There was no country in the MENA region that showed increases in the age-standardised prevalence, incidence or YLD rates of LBP over the measurement period. Furthermore, in 2019 the number of prevalent cases were highest in the 35-39 age group, with males having a higher number of cases in all age groups. In addition, the age-standardised YLD rates for males in the MENA region were higher than the global estimates in almost all age groups, in both 1990 and 2019. Furthermore, the burden of LBP was not associated with the level of socio-economic development during the measurement period.

Conclusion: The burden attributable to LBP in the MENA region decreased slightly from 1990 to 2019. Furthermore, the burden among males was higher than the global average. Consequently, more integrated healthcare interventions are needed to more effectively alleviate the burden of low back pain in this region.

Keywords: Epidemiology; Incidence; Low back pain; Middle East and North Africa; Prevalence.

Fig. 1

Age-standardised point prevalence of low back pain (per 100,000 population) in the Middle East and North Africa region in 2019, by sex and country. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 2

The percentage change in the age-standardised point prevalence of low back pain in the Middle East and North Africa region from 1990 to 2019, by sex and country. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 3

Numbers of prevalent cases and prevalence of low back pain per 100,000 population in the Middle East and North Africa region, by age and sex in 2019; Dotted and dashed lines indicate 95% upper and lower uncertainty intervals for the point prevalence per 100,000 population, respectively. The solid lines represent the point estimation for the point-prevalence per 100,000 population (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 4

Ratio of the Middle East and North Africa region to the global low back pain YLD rate by age and sex, 1990 and 2019. YLD = years lived with disability. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 5

Age-standardised YLD rates of low back pain for 21 countries and territories, by SDI 1990–2019; Expected values based on the Socio-demographic Index and disease rates in all locations are shown as the black line. Each point shows the observed age-standardised YLD rate for each country during 1990–2019. YLD = years lived with disability. SDI = Socio-demographic Index (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)