RESUMEN

OBJECTIVE: To evaluate health-related quality of life (HRQoL) and its determinants in chronic low back pain (CLBP) patients in Cameroon. DESIGN: Observational cross-sectional study. SETTING: Tertiary hospital. PARTICIPANTS: There were 150 eligible adults with low back pain of at least 12 weeks who provided informed consent. Of these, 136 with complete questionnaires were analysed. OUTCOMES: HRQoL was measured using the WHO Quality of Life questionnaire (WHOQOL-BREF). Outcome measures included its four domain (physical health, psychological, social relationships and environmental) scores and two independent scores for overall quality of life (OQOL) and general health satisfaction (GH). RESULTS: Participants had a median age of 52 years, and median pain duration of 33 (IQR: 69) months. The median OQOL score was 50 (IQR: 25). After multivariable adjustment, tertiary education (ß=11.43, 95% CI 3.12 to 19.75), age (ß=0.49, 95% CI 0.12 to 0.87) and being a student (ß=23.07, 95% CI 0.28 to 45.86) contributed to better OQOL. Age (ß=0.57, 95% CI 0.10 to 1.04) and physical-type employment (ß=-14.57, 95% CI -25.83 to -3.31) affected GH. Smoking (ß=-20.49, 95% CI -35.49 to -5.48) and radiological anomalies (ß=-7.57, 95% CI -14.64 to -0.49) affected the physical health domain, while disability (ß=-0.67, 95% CI -1.14 to -0.20) and duration of pain (ß=-0.13, 95% CI -0.20 to -0.05) affected the psychological domain. Income (ß=14.94, 95% CI 4.06 to 25.81) affected the social domain, while education (ß=9.96, 95% CI 1.41 to 18.50) and disability (ß=-0.75, 95% CI -1.26 to -0.24) affected the environmental domain. CONCLUSIONS: Our findings suggest that CLBP affects HRQoL and multiple socioeconomic and clinical factors influence its impact on different domains of HRQoL. Multipronged management programmes, especially those that reduce disability, could improve HRQoL in patients with CLBP.

Asunto(s)

Dolor Crónico , Dolor de la Región Lumbar , Adulto , Camerún/epidemiología , Dolor Crónico/epidemiología , Estudios Transversales , Humanos , Dolor de la Región Lumbar/epidemiología , Persona de Mediana Edad , Calidad de Vida , Encuestas y Cuestionarios , Centros de Atención Terciaria

RESUMEN

BACKGROUND: Very little is known about the burden of chronic low back pain in Africa. This study aimed at assessing disability and associated factors in chronic low back patients in Cameroon. METHODS: We carried a hospital-based cross-sectional study including patients suffering from low back pain (LBP) of at least 12 weeks' duration. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ). RMDQ > 4 described persons with dysfunctional levels of disability. Multivariable linear regression was used to investigate factors associated with higher RMDQ scores hence greater disability. Variables investigated included; gender, age, marital status, employment status and type, smoking history, alcohol consumption, income, pain intensity, LBP duration, psychological wellbeing, sleep satisfaction, leg pain, numbness/paresthesia, bowel/bladder dysfunction symptoms (BBDS), body mass index (BMI), and days of work absence. RESULTS: A sample of 136 adults (64% female) with a mean age of 50.6 ± 12.2 years participated in the study. Median duration of LBP was 33 (25th - 75th percentile: 12-81) months. Mean RMDQ score was 12.8 ± 6. In multivariable linear regression, pain intensity (ß = 0.07, p = 0.002), longer days of work absence (ß = 0.15, p = 0.003) and BBDS (ß =2.33, p = 0.029) were associated with greater disability. Factors such as consumption of alcohol (ß = - 3.55, p = 0.005) and higher psychological wellbeing scores (ß = - 0.10, p = 0.004) significantly contributed to less disability (lower RMDQ scores). Dysfunctional levels of disability were present in 88.1% of patients. CONCLUSION: CLBP is associated with significant disability and this relationship is driven by several factors. Multidisciplinary management strategies especially those targeted to improve pain control, manage BBDS and improve psychological wellbeing could reduce disability and improve quality of life.

Asunto(s)

Dolor Crónico/epidemiología , Evaluación de la Discapacidad , Dolor de la Región Lumbar/epidemiología , Calidad de Vida , Centros de Atención Terciaria/estadística & datos numéricos , Absentismo , Adulto , Camerún/epidemiología , Dolor Crónico/diagnóstico , Dolor Crónico/psicología , Estudios Transversales , Femenino , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/psicología , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Encuestas y Cuestionarios/estadística & datos numéricos

RESUMEN

To the best of our knowledge there is no reported case of Meckel's diverticulum (MD) in Cameroon. The prevalence of MD in the general population is 2-3 %. The aim of this paper is to recapitulate the role of this pathology in acute abdomens and abdominal pain of uncertain aetiology in young patients and to review the medical literature.