Prevalence and correlates of pain and pain treatment in a western Kenya referral hospital

J Palliat Med. 2013 Oct;16(10):1260-7. doi: 10.1089/jpm.2013.0080. Epub 2013 Sep 13.


Background: Pain is often inadequately evaluated and treated in sub-Saharan Africa (SSA).

Objective: We sought to assess pain levels and pain treatment in 400 hospitalized patients at a national referral hospital in western Kenya, and to identify factors associated with pain and pain treatment.

Design: Using face-validated Kiswahili versions of two single-item pain assessment tools, the Numerical Rating Scale (NRS) and the Faces Pain Scale-Revised (FPS-R), we determined patients' pain levels. Additional data collected included patient demographics, prescribed analgesics, and administered analgesics. We calculated mean pain ratings and pain management index (PMI) scores.

Results: Averaged between the NRS and FPS-R, 80.5% of patients endorsed a nonzero level of pain and 30% of patients reported moderate to severe pain. Older patients, patients with HIV, and cancer patients had higher pain ratings. Sixty-six percent of patients had been prescribed analgesics at some point during their hospitalization, the majority of which were nonopioids. A majority of patients (66%) had undertreated pain (negative scores on the PMI).

Conclusion: This study shows that hospitalized patients in Kenya are experiencing pain and that this pain is often undertreated.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kenya / epidemiology
  • Male
  • Middle Aged
  • Pain / epidemiology*
  • Pain Management / methods*
  • Pain Measurement
  • Prevalence