Work-related musculoskeletal disorder prevalence among African nurses: systematic review and meta-analysis

Abstract

Background: Nurses perform many daily care tasks that expose them to work-related musculoskeletal disorders (WMSDs). Many studies have reported a high prevalence worldwide. Analyses by continent have provided a better understanding of the WMSD occurrence, but none have yet been conducted among African nurses. The aim was to conduct a systematic review analysis with meta-analysis of the overall WMSD prevalence and the prevalence by body area among nurses in Africa.

Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method was used to present the results in the form of a systematic review analysis with meta-analysis. PubMed/Medline, ScienceDirect, Google Scholar, Mendeley, and Science.gov were explored between August 20 and 29, 2025 to identify studies that investigated the overall and body area WMSD prevalence among African nurses of any specialty without a date limit. Studies were included if they were cross sectional survey assessing the WMSD prevalence among nurses of any specialty or department working in Africa. Any study that was not a peer-reviewed cross-sectional survey published in English, that did not involve African nurses, or that did not report, or sufficiently detail data on the prevalence was excluded. The quality of each article included was assessed using the cross-sectional study assessment tool (AXIS). A meta-analysis with quantification of heterogeneity (Cochran’s Q test and I² statistic) was conducted. Based on these parameters, a fixed or random effects model was selected to estimate the prevalence. Forest plots were used to summarize the overall, neck, upper back, lower back, shoulder, elbow, wrist, hip, knee, and ankle WMSD prevalence.

Results: Nineteen cross-sectional studies were selected from the 4,305 identified studies, involving 4,670 African nurses from 10 countries. A significant heterogeneity was highlighted between studies (Cochran’s Q test and I² statistic). Lower back [59.5%, 95% confidence interval (CI): 52.8–66.2%, 4,670 participants], neck (35.4%, 95% CI: 28.0–42.8%, 4,670 participants), and knee (34.4%, 95% CI: 27.2–41.6%, 4,601 participants) were the most exposed areas. The overall WMSD prevalence was pooled at 74.6% (95% CI: 67.0−82.3%, 4,266 nurses).

Discussion: Comparison of these results with the literature showed that African nurses were less affected than those on other continents. However, the data were highly heterogeneous. Due to the numerous risk factors associated with nursing work, it is necessary to continue research projects and educational activities, as well as the development of health policies aimed at improving quality of life at work, specifically by expanding the investigation using subgroup analysis.

Keywords

musculoskeletal disorders / body area / nurse / occupational health / safety / healthcare professionals / quality of life

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