• Kristin T L Huang, Claudio Owino, Gregory P Gramelspacher, Patrick O Monahan, Rebeka Tabbey, Mildred Hagembe, Robert M Strother, Festus Njuguna, and Rachel C Vreeman.
• 1 USAID - Academic Model Providing Access to Healthcare (AMPATH) , Eldoret, Kenya .
• J Palliat Med. 2013 Oct 1; 16 (10): 1260-7.

BackgroundPain is often inadequately evaluated and treated in sub-Saharan Africa (SSA).ObjectiveWe 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.DesignUsing 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.ResultsAveraged 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).ConclusionThis study shows that hospitalized patients in Kenya are experiencing pain and that this pain is often undertreated.

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