Background: Low back pain (LBP) is the most prevalent musculoskeletal condition found among both developed and developing nations. An update of a 2007 systematic review was required. However several challenges exist in synthesising and analysing epidemiological information from Africa.

Objectives:To conduct an updated search of the literature into the prevalence of low back pain (LBP) among African nations and highlight the specific challenges faced in retrieving epidemiological information in Africa and on conducting meta-analyses of LBP data.
Methods: A comprehensive search of all accessible bibliographic databases via the Stellenbosch University’s Medical and Health Sciences Library website was conducted. All population-based studies into the prevalence of LBP among children, adolescents and adults living in Africa were included. Methodological appraisal of included studies was conducted using the adapted tool for LBP prevalence studies. A meta-analysis of the data, as well as meta-regression and sensitivity analyses were conducted.
Results: Lifetime, 1-year and point prevalence of LBP among African populations was found to be higher than recently reported estimates for global LBP prevalence. The review process, however, highlighted a number of challenges related to conducting, sourcing and pooling relevant epidemiological data in Africa. One of the first methodological challenges, was the uncertainty of whether all relevant data was included in the review. Another challenge in conducting this review is the fact that Africa is riddled by huge economic inequality between countries. The poor methodological quality of included studies posed another challenge in conducting this review. Although measures were taken to ensure that the heterogeneity among studies was considered during meta-analyses, the summary estimates provided in this review should still be viewed with caution.
Conclusions: Finding ways in which to address these challenges experienced when conducting research in Africa is warranted. Future African LBP and epidemiological researchers should conduct methodologically robust studies and report their findings in accessible resources.