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Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013
  1. Maziar Moradi-Lakeh1,2,
  2. Mohammad H Forouzanfar1,
  3. Stein Emil Vollset1,3,4,
  4. Charbel El Bcheraoui1,
  5. Farah Daoud1,
  6. Ashkan Afshin1,
  7. Raghid Charara1,
  8. Ibrahim Khalil1,
  9. Hideki Higashi5,
  10. Mohamed Magdy Abd El Razek6,
  11. Aliasghar Ahmad Kiadaliri7,
  12. Khurshid Alam8,9,10,
  13. Nadia Akseer11,12,
  14. Nawal Al-Hamad13,
  15. Raghib Ali14,
  16. Mohammad AbdulAziz AlMazroa15,
  17. Mahmoud A Alomari16,
  18. Abdullah A Al-Rabeeah15,
  19. Ubai Alsharif17,
  20. Khalid A Altirkawi18,
  21. Suleman Atique19,
  22. Alaa Badawi20,
  23. Lope H Barrero21,
  24. Mohammed Basulaiman15,
  25. Shahrzad Bazargan-Hejazi22,23,
  26. Neeraj Bedi24,
  27. Isabela M Bensenor25,
  28. Rachelle Buchbinder26,27,
  29. Hadi Danawi28,
  30. Samath D Dharmaratne29,
  31. Faiez Zannad30,
  32. Maryam S Farvid31,32,
  33. Seyed-Mohammad Fereshtehnejad33,
  34. Farshad Farzadfar34,
  35. Florian Fischer35,
  36. Rahul Gupta36,
  37. Randah Ribhi Hamadeh37,
  38. Samer Hamidi38,
  39. Masako Horino39,40,
  40. Damian G Hoy41,
  41. Mohamed Hsairi42,
  42. Abdullatif Husseini43,
  43. Mehdi Javanbakht44,
  44. Jost B Jonas45,
  45. Amir Kasaeian46,47,
  46. Ejaz Ahmad Khan48,
  47. Jagdish Khubchandani49,
  48. Ann Kristin Knudsen50,
  49. Jacek A Kopec51,
  50. Raimundas Lunevicius52,53,
  51. Hassan Magdy Abd El Razek54,
  52. Azeem Majeed55,
  53. Reza Malekzadeh56,
  54. Kedar Mate57,
  55. Alem Mehari58,
  56. Michele Meltzer59,
  57. Ziad A Memish15,60,
  58. Mojde Mirarefin61,
  59. Shafiu Mohammed62,63,
  60. Aliya Naheed64,
  61. Carla Makhlouf Obermeyer65,
  62. In-Hwan Oh66,
  63. Eun-Kee Park67,
  64. Emmanuel Kwame Peprah68,
  65. Farshad Pourmalek51,
  66. Mostafa Qorbani69,
  67. Anwar Rafay70,71,
  68. Vafa Rahimi-Movaghar72,
  69. Rahman Shiri73,
  70. Sajjad Ur Rahman74,
  71. Rajesh Kumar Rai75,
  72. Saleem M Rana70,71,
  73. Sadaf G Sepanlou76,
  74. Masood Ali Shaikh77,
  75. Ivy Shiue78,79,
  76. Abla Mehio Sibai80,
  77. Diego Augusto Santos Silva81,
  78. Jasvinder A Singh82,
  79. Jens Christoffer Skogen3,83,
  80. Abdullah Sulieman Terkawi84,85,86,
  81. Kingsley N Ukwaja87,
  82. Ronny Westerman88,89,
  83. Naohiro Yonemoto90,
  84. Seok-Jun Yoon91,
  85. Mustafa Z Younis92,
  86. Zoubida Zaidi93,
  87. Maysaa El Sayed Zaki54,
  88. Stephen S Lim1,
  89. Haidong Wang1,
  90. Theo Vos1,
  91. Mohsen Naghavi1,
  92. Alan D Lopez1,94,
  93. Christopher J L Murray1,
  94. Ali H Mokdad1
  1. 1 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  2. 2 Department of Community Medicine, Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  3. 3 Norwegian Institute of Public Health, Bergen, Norway
  4. 4 Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  5. 5 Japan International Cooperation Agency, Lusaka, Zambia
  6. 6 Ophthalmology resident in Aswan University Hospital, Aswan, Egypt
  7. 7 Clinical Epidemiology Unit, Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
  8. 8 Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
  9. 9 The University of Melbourne, Melbourne, Victoria, Australia
  10. 10 The University of Sydney, Sydney, New South Wales, Australia
  11. 11 Hospital for Sick Children, Toronto, Ontario, Canada
  12. 12 University of Toronto, Toronto, Ontario, Canada
  13. 13 Food and Nutrition Administration, Ministry of Health, Safat, Kuwait
  14. 14 University of Oxford, Oxford, UK
  15. 15 Saudi Ministry of Health, Riyadh, Saudi Arabia
  16. 16 Division of Physical Therapy, Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
  17. 17 Charité Universitätsmedizin, Berlin, Germany
  18. 18 King Saud University, Riyadh, Saudi Arabia
  19. 19 Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan
  20. 20 Public Health Agency of Canada, Toronto, Ontario, Canada
  21. 21 Department of Industrial Engineering, School of Engineering, Pontificia Universidad Javeriana, Bogota, Colombia
  22. 22 Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
  23. 23 David Geffen School of Medicine, University of California at Los Angeles (UCLA), California, USA
  24. 24 College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
  25. 25 University of São Paulo, São Paulo, Brazil
  26. 26 Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Victoria, Australia
  27. 27 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  28. 28 Walden University, Minneapolis, Minnesota, USA
  29. 29 Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  30. 30 Clinical Investigation Centre INSERM (the National Institute for Health and Medical Research), Université de Lorraine, Vandoeuvre les Nancy, France
  31. 31 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  32. 32 Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA
  33. 33 Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
  34. 34 Non-Communicable Diseases Research Center, Endocrine and Metabolic Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  35. 35 Bielefeld University, Bielefeld, Germany
  36. 36 West Virginia Bureau for Public Health, Charleston, West Virginia, USA
  37. 37 Arabian Gulf University, Manama, Bahrain
  38. 38 Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  39. 39 Nevada Division of Behavior and Public Health, Carson City, Nevada, USA
  40. 40 Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
  41. 41 Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
  42. 42 Salah Azaiz Institute, Tunis, Tunisia
  43. 43 Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
  44. 44 Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
  45. 45 Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
  46. 46 Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  47. 47 Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  48. 48 Health Services Academy, Islamabad, Pakistan
  49. 49 Ball State University, Muncie, Indiana, USA
  50. 50 Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway
  51. 51 University of British Columbia, Vancouver, British Columbia, Canada
  52. 52 Aintree University Hospital National Health Service Foundation Trust, Liverpool, UK
  53. 53 School of Medicine, University of Liverpool, Liverpool, UK
  54. 54 Mansoura Faculty of Medicine, Mansoura, Egypt
  55. 55 Imperial College London, London, UK
  56. 56 Digestive Disease Research Institute, Tehran Universities of Medical Sciences, Tehran, Iran
  57. 57 McGill University, Montreal, Quebec, Canada
  58. 58 College of Medicine, Howard University, Washington DC, USA
  59. 59 Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  60. 60 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
  61. 61 Hunger Action Los Angeles, Los Angeles, California, USA
  62. 62 Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  63. 63 Institute of Public Health, Heidelberg University, Heidelberg, Germany
  64. 64 International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
  65. 65 Faculty of Health Sciences, Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
  66. 66 Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
  67. 67 Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
  68. 68 National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
  69. 69 Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  70. 70 Contech International Health Consultants, Lahore, Pakistan
  71. 71 Contech School of Public Health, Lahore, Pakistan
  72. 72 Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  73. 73 Finnish Institute of Occupational Health, Helsinki, Finland
  74. 74 Sweidi Hospital, Riyadh, Saudi Arabia
  75. 75 Society for Health and Demographic Surveillance, Suri, India
  76. 76 Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  77. 77 Independent Consultant, Karachi, Pakistan
  78. 78 Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
  79. 79 Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
  80. 80 Department of Epidemiology & Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  81. 81 Federal University of Santa Catarina, Florianópolis, Brazil
  82. 82 University of Alabama at Birmingham, and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA
  83. 83 Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
  84. 84 Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
  85. 85 Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA
  86. 86 Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia
  87. 87 Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
  88. 88 Federal Institute for Population Research, Wiesbaden, Germany
  89. 89 German National Cohort Consortium, Heidelberg, Germany
  90. 90 Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  91. 91 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
  92. 92 Jackson State University, Jackson, Mississippi, USA
  93. 93 University Hospital, Setif, Algeria
  94. 94 Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Professor Ali Mokdad, Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121, USA; mokdaa{at}uw.edu

Abstract

Objectives We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR).

Methods The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs).

Results For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3–1703.4) in 1990 to 1606.0 (95% UI 1141.2–2130.4) in 2013. During 1990–2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7–3.0) in 1990 to 4.7% (95% UI 3.6–5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2–136.0 for low back pain, 27.3–49.7 for neck pain, 9.7–37.3 for osteoarthritis (OA), 0.6–2.2 for rheumatoid arthritis and 0.1–0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries.

Conclusions This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.

  • Epidemiology
  • Low Back Pain
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Gout

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Tore K Kvien

  • Contributors MM-L and AHM prepared the first draft. All other authors provided data, developed models, analysed data, reviewed results, provided guidance on methodology and/or reviewed the manuscript. MM-L and AHM finalised the draft based on comments from other authors’ feedback. MM-L, AHM, AA and MHF responded the comments of reviewers. AHM and CJLM accept full responsibility for the work, have access to the data and controlled the decision to publish.

  • Funding The global burden of disease study was funded by the Bill and Melinda Gates Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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