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One in seven has severe pain: a point-prevalence study of hospitalised patients across Africa.

Created on 11 Aug 2026

Authors

Gillian J Bedwell, Romy Parker, Victoria J Madden, Juan Scribante, Muhammed Elhadi, Adesoji O Ademuyiwa, Babatunde Osinaike, Christian Owoo, Daniel Sottie, Karima Khalid, Adam Hewitt-Smith, Arthur Kwizera, Fitsum Kifle Belachew, Degisew Dersso Mengistu, Yared Boru Firissa, Tirunesh Busha Gemechu, Gaudencia Dausab, Unotjari Kauta, Kaveto Sikuvi, Nahla Kechiche, Kelan Bertille Ki, Martin Mukenga, Dolly Munlemvo, Mustapha Bittaye, Abubacarr Jagne, Mohamed Abdinor Omar, Hassan Ali Daoud, Mohamed Faisal, Mahmoud Elfiky, Mpho Seleke, Tarig Fadalla, Alshaima Koko, Alemayehu G Bedada, Gilles Niengo Outsouta, Marie Elombila, Ahmed Rhassane El Adib, Meryem Essafti, Dino Lopes, Atilio Morais, Pisirai Ndarukwa, Newten Handireketi, Fred Bulamba, Busisiwe Mrara, Hyla-Louise Kluyts, Marian Kinnes, Abdullahi Said Hashi, Abigail Kusi Amponsah, Aderonke Omobonike Akinpelu, Andrew Amata, Aunel Mallier Peter, Elizabeth Nwasor, Jeremie Kalambay, Hellen N Kariuki, Nana Fening, Nomaqhawe Moyo, Patrick Mukuna, Sean Chetty, Sudarshanie Bechan, Tania Pretorius, Bamidele Victor Owoyele, Luyanduthando Mqadi, Hanél Duvenage, Gwendoline Arendse, Luke Hannan, Landon Myer, Carl Otto Schell, Tim Baker, Rupert M Pearse, Bruce M Biccard, African Critical Illness Outcomes Study (ACIOS) Investigators: Writing Committee

Published in

Pain. Aug 12, 2026. Epub Aug 12, 2026.

Abstract

Acute pain in hospitalised patients is common, yet African data are scarce. We conducted a prospective point-prevalence study of hospitalised adult patients across Africa to determine acute pain prevalence and severity and investigate associations of pain with critical illness and 7-day mortality. On a single day, investigators assessed patients' worst pain in the preceding 24 hours using a 0 to 10 visual-numerical scale and recorded vital signs. Critical illness was defined as ≥1 vital sign out of range, in line with an international consensus definition. In-hospital mortality was assessed at day 7. Data are presented as median [interquartile range], n (%), and odds ratios with 95% confidence intervals. Between September and December 2023, 19,438 patients from 180 hospitals in 22 African nations were included (age 40 [29; 59] years; 10,874 [56%] female). Pain prevalence [95% CI] was 67.9% [67.9-68.5], with 2795 (14.4%) patients reporting severe pain (≥7/10). Pain was more common among patients admitted for emergency or trauma care and in surgical and high-care wards. Pain severity did not differ meaningfully between sexes. There was no evidence of an association between pain severity and critical illness; however, increasing pain severity was associated with a higher likelihood of 7-day mortality. These findings are comparable to data from high-income countries despite substantial differences in healthcare resources, suggesting that acute pain remains a persistent and underaddressed problem globally. This study provides the first large-scale evidence of acute pain burden in African hospitals and lays a foundation for future research aimed at comprehensively characterising in-hospital pain.

PMID:
42578451
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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