Objectives To determine, through a systematic review and meta-analysis, the prevalence of back pain (BP) and spondyloarthritis (SpA) in the adult general population and explore the heterogeneity between studies in and out Latin America (LATAM).
Methods MEDLINE, Embase, BIREME, LILLACS and Web of Science were searched using a strategy combining key words and related database-specific subject terms to identify relevant cross-sectional studies based on COPCORD methodology published since 2006. Included articles were assessed for risk of bias and quality based on the STROBE statement. Prevalence figures for BP and SpA (European Spondyloarthropathy Study Group criteria) were analyzed according to female percentage of sampled individuals, mean age and sample size. A mixed effect model was used to obtain the combined prevalence and a meta-regression to estimate the effects of these variables. Prevalence stratified values were obtained according to its geographical location.
Results 44 out of 127 papers in English, Spanish or Portuguese were selected. Of them, 16 contained BP or SpA prevalence data. Estimates for any Spa prevalence ranged from 0,1% to 2%, with an average of 0,3% (95% CI: 0,01%>0,05%). The random-effects pooled prevalence was 0,18% (0,06%>0,36%). The prevalence of BP was 6.54% (3.8%>9.2%) with a pooled value of 5.24% (2.6%>8.7%). In both cases the heterogeneity was significant (p<0.01). No effect was associated to SpA heterogeneity, but an increase in the prevalence of BP was associated to sample size (random effect coefficient: 0,045, p=0.04). The stratified analysis did not show differences in terms of heterogeneity or prevalence for BP (Pooled prevalence for BP: 5.4%; 2.9%>8.5%, p=0.9); on the contrary, for Spa, for non-LATAM studies, the pooled proportion was significant bigger (prevalence in LATAM 0.05%, 0.01%>0.012%; non-LATAM: 0.35%, 0.09%>0.78%, p=0.03)
Conclusions We found significant variations in prevalence across this review. In particular, they related to sample size of BP studies. Similarly, there was a significant variation between LATAM versus other latitudes respect to the prevalence of SpA. The limited number of studies included in this meta-analysis however, prevents clear explanations of the mechanisms underlying these results.
Disclosure of Interest None declared
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