{"paper_id":"fac32fe0-bf9c-4da5-bd58-6198c42ae050","body_text":"Unspecified Pain, Chronic Pain and High-Impact Chronic Pain in Lesotho, Southern Africa: a Population-based Cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Unspecified Pain, Chronic Pain and High-Impact Chronic Pain in Lesotho, Southern Africa: a Population-based Cross-sectional study Emmanuel Firima, Lucia Gonzalez, Molulela Manthabiseng, Mamoronts’ane P. Sematle, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5819163/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background . Pain and its associated disorders are among the most common causes of disability and contributors to healthcare costs globally. Pain is understudied in Africa and there are no data on high-impact chronic pain from this region. In a population-based survey in Lesotho, Southern Africa, we assessed the prevalence of unspecified pain, chronic pain and high-impact chronic pain, and their determinants. Method . We conducted a household-based, cross-sectional survey among adults ≥18 years old in 120 randomly sampled villages across Butha Buthe and Mokhotlong districts in Lesotho. Unspecified pain, chronic pain, and high-impact chronic pain were defined as current or recurrent pain regardless of duration; pain on most days of the week lasting for 3 or more months; and chronic pain with restriction of routine activities, respectively. Result . Among the 6039 adults included, the median age was 39 years (interquartile range: 27-58), 3153/6039 (52.2%) were female. Overall, 1194 (19.8%) had unspecified pain (95% confidence interval [CI]: 18.8 – 20.8); 909 (15.1%) had chronic pain (95% CI: 14.2 – 16.0); and 428 (7.1%) had high-impact chronic pain (95% CI: 6.5 – 7.8) corresponding to 47.1% among the participants with chronic pain. Higher age groups were associated with increasing odds of unspecified pain, chronic pain and high-impact chronic pain. Male participants were less likely to have unspecified pain (adjusted odds ratio [aOR], 0.68; 95% CI: 0.56 – 0.82; p < 0.001). There was no association between sex and chronic pain or high-impact chronic pain. Participants living in less wealthy households had higher odds of high-impact chronic pain. Furthermore, high-impact chronic pain was associated with hypertension (aOR, 1.47; 95% CI: 1.14 – 1.90; p = 0.003), diabetes mellitus (aOR, 1.86; 95% CI: 1.27 – 2.74; p = 0.002), moderate to high risk of depression (aOR, 4.93; 95% CI: 2.75 – 8.86; p < 0.001), and moderate to high risk of generalized anxiety disorder (aOR, 2.85; 95% CI: 1.18 – 6.92; p = 0.023). Conclusion . Prevalence of chronic pain, including high impact chronic pain was high in this population-based survey in Lesotho. Its association with further non-communicable chronic conditions, such as hypertension and diabetes, supports the need for health systems to provide integrated chronic care, including the management of chronic pain. Epidemiology Anesthesiology & Pain Medicine Chronic pain High-impact chronic pain Lesotho Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Background Pain and its associated disorders are among the most frequent causes of disability globally 1 , 2 . A recent analysis of unspecified pain among adults using data across 52 countries estimated the prevalence of pain to be 27.5% on average, ranging from 9.9–50.3% between countries 3 . The burden of pain is reportedly greater in low- and middle-income countries due to manual labor, accidents, violence, low availability of potent analgesics, and is expected to grow as life-expectancy increases 1 , 2 . Chronic pain, defined as the presence of pain that lasts or recurs for more than three months 5 , affects 20% of individuals worldwide 6 , 7 , with 1 in 10 adults newly affected every year 8 . It exerts substantial pressures on health systems 8 – 11 and is the leading cause of years lived with disability 12 , 13 , resulting in an annual loss of 149 million workdays. 14 , 15 Chronic pain has been linked to restrictions in daily activities, dependence on opioids, anxiety and depression, and overall poor quality of life 5 , 7 , 16 – 19 . High-impact chronic pain is defined as the presence of chronic pain, accompanied with restrictions in activity and/or participation in daily life 22 , 25 . Estimates of high-impact chronic pain distinguish individuals with limitations in such domains as work, social, recreation, and self-care activities from individuals who continue to lead a normal life despite chronic pain. 19 Although the burden of pain-related disorders is estimated to be higher in low- and middle-income countries 1 , 26 , 27 , good prevalence data from these countries are extremely limited. 28 In Lesotho, Southern Africa, there is limited data on chronic pain, and no data on high-impact chronic pain to inform the design, implementation and scale up of relevant population-wide interventions 13 , 14 , 19 , 29 . Here, we present the prevalence of unspecified pain, chronic pain and high-impact chronic pain, and their determinants in a population-based survey in two districts in Lesotho. Method Design, setting and participants selection This cross-sectional study was conducted during a large household-based survey to assess the prevalence and determinants of several chronic conditions in two districts in Northern Lesotho 30 . The two districts have an estimated population of about 220,000 people in an area of over 6,000 km2. The major occupations are subsistence farming, mining and construction 31 . This study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines 32 . A detailed description of the survey has been published elsewhere 30 . To summarize, we used two-stage cluster sampling where population clusters were primary sampling units and household members secondary sampling units. From a list containing 785 clusters with at least 30 households each, 120 clusters were randomly selected (60 in each district), stratified by settlement type (urban vs rural), and accessibility with respect to the closest health facility (hard-to-reach vs easy-to-reach areas). All households in a sampled cluster were eligible if consent was provided by the head of household. Household members ≥ 18 years old were randomly selected by an algorithm based on age, sex and settlement (rural vs urban), programmed in the Open Data Kit data collection tool 33 . The sampled individuals were then approached to be included in the study. Procedure and measurements The study was conducted from November 2, 2021 to August 31, 2022. The study staff interviewed consenting household members using a detailed questionnaire, collecting sociodemographic and medical history data. Variables included age, sex, settlement (rural or urban), district (Butha Buthe or Mokhotlong), educational level, marital status, employment status. Additionally, we collected lifestyle variables such as level of physical activity, smoking and alcohol consumption in the three months before survey, as well as daily consumption of fruit and vegetables. Furthermore, the patient health questionnaire (PHQ-9) 34 and the general anxiety disorder-7 questionnaire (GAD-7) 35 were used to screen for risk of depression and generalized anxiety disorders, respectively. We used the Demographic and Health Survey program questionnaire for Lesotho to assess household wealth. This wealth index questionnaire assesses housing construction characteristics, household assets and utility services, as well as country-specific assets. Using principal component analysis, the questionnaire responses are analyzed to indicate the household’s economic status in Lesotho which is subsequently categorized into five quintiles ranging from poorest to wealthiest 30 , 36 . Assessment of unspecified pain, chronic pain, high-impact chronic pain Unspecified pain and chronic pain were assessed using a semi-structured questionnaire 28 . Participants were asked: 1. Are you currently affected by pain either all the time or on and off? (Yes/No); 2. Have you had this pain for more than 3 months? (Yes/No); 3. Where do you feel this pain? (options included back pain; neck and shoulder pain; chest pain; headache, facial, or dental pain; stomachache or abdominal pain; pain in the limbs; and other). A positive response to question 1 indicated the presence of unspecified pain. Affirmative responses to both questions 1 and 2 indicated the presence of chronic pain. To assess high-impact chronic pain, participants were questioned about the level of incapacity to carry out routine activities on account of pain. They were asked to state if there was no interference with any routine activity; mild interference where most routine activities could still be undertaken; moderate interference where only routine activities judged to be of importance could be undertaken; and severe interference where participants could not undertake any activities except assisted. To assess severity of pain, participants were asked to determine how intense their pain was on a scale of 1 to 10, 1 being the lowest and 10 being the most severe pain. Severity of pain was classified according to a 10-point Numerical Rating Scale (NRS) where mild pain corresponded to NRS 1–3; moderate pain NRS 4–6; and severe pain NRS 7–10. Participants with chronic pain and moderate to severe restriction of activities or severe pain intensity were considered to have high-impact chronic pain. 19 Data collection and statistical analysis Data was collected using KoboCollect ( https://www.kobotoolbox.org/ ). Statistical analyses were conducted in Stata (16,1, StataCorp LLC, College Station, TX). Descriptive statistics, such as mean and standard deviation; median and interquartile range were used for continuous variables, while frequency and percentage were used for categorical variables. The prevalence of unspecified pain, chronic pain, and high-impact chronic pain are presented graphically using a nested area chart. We used a multivariable logistic regression model to assess the factors associated with each of unspecified pain, chronic pain, and high-impact chronic pain. Variables with a p-value < 0.25 in univariate logistic regression were included in the final multivariable model. Participants with missing data were excluded from the regression analyses. Ethics statement All procedures were carried out in line with the ethical standards laid out in the Declaration of Helsinki 37 . Participants received information on all research procedures in Sesotho and provided written informed consent. Illiterate participants gave consent by thumbprint and a witness who was not involved in the study co-signed the form. Once the informed consent process was completed, a signed copy of the form was retained by study staff and a copy was given to the participant. This study was reviewed by the Ethics Committee Northwest and Central Switzerland (ID AO_2021-00056) and approved by the National Health Research Ethics Committee in Lesotho (ID 139–2021). Patient and public involvement This survey is part of the Community-Based chronic Care project Lesotho (ComBaCaL; www.combacal.org ). It was designed together with the ComBaCaL steering committee that includes a community representative, as well as representatives from the Ministry of Health of Lesotho. The survey was discussed with local authorities (village chiefs, local Ministry of Health leaders), who were engaged throughout the study. Results Figure 1 displays the study flow. Out of 7412 participants surveyed, 6039 were ≥ 18 years old, eligible and included in this analysis. Participants’ sociodemographic characteristics and prevalence of unspecified pain, chronic pain and high-impact chronic pain for each characteristic are shown in Table 1 (and S1 table in the supplementary material). The overall median age of participants was 39 years (interquartile range [IQR]: 27–58), 3153/6039 (52.2%) were female. As depicted in Table 2 (and displayed for each pain category in the supplementary material, S2 table), 1302/6039 (21.5%) of the study population had arterial hypertension, 257/6039 (4.3%) had diabetes mellitus, 98/6039 (1.6%) were at moderate to high risk of depression, 43/6039 (0.7%) were at moderate to high risk of generalized anxiety disorder, and 923/6039 (15.3%) reported to live with HIV. Overall, 1194/6039 (19.8%) had unspecified pain (95% confidence interval [CI]: 18.8–20.8); 909/6039 (15.1%) had chronic pain (95% CI: 14.2–16.0); and 428/6039 (7.1%) had high-impact chronic pain (95% CI: 6.5–7.8) corresponding to 47.1% (428/909) among the participants who had chronic pain. For participants with unspecified pain, chronic pain and high-impact chronic pain, the median age ranged from 58 years to 61 years. All pain categories increased with rising age and were higher among females than males (Fig. 2). The prevalence of unspecified pain, chronic pain and high-impact chronic pain were higher among participants with hypertension, diabetes mellitus, risk of depression or risk of anxiety disorder (Table 2 ). Table 1 Prevalence of unspecified pain, chronic pain and high-impact chronic pain, by sociodemographic characteristics. Variables Enrolled N = 6039 n(%) Unspecified pain %(95%CI) Chronic pain %(95%CI) High-impact chronic pain %(95%CI) Age, years 18–24 1162(19.2) 6.5 (5.1-8.0) 3.9(2.8-5.0) 1.5(1.0-2.3) 25–34 1362(22.6) 10.6 (9.0-12.3) 7.1(5.8–8.5) 3.0(2.1–3.9) 35–44 996(16.5) 15.2 (12.9–17.4) 10.4(8.5–12.3) 5.1(3.8–6.5) 45–54 778(12.9) 22.2(19.3–25.2) 16.3(13.7–18.9) 6.7(4.9–8.4) 55–64 726(12.0) 30.3(27.0-33.6) 24.4(21.3–27.5) 11.8(9.5–14.2) ≥ 65 1015(16.8) 42.3(39.2–45.3) 35.4(32.4–38.3) 17.7(15.4–20.1) Median age, (IQR) 39 (27–58) 58(41–69) 60(43–71) 61(44–73) Sex Female 3153(52.2) 22.4(20.9–23.8) 16.3(15.0-17.6) 7.8(6.9–8.8) Male 2886(47.8) 16.9(15.5–18.3) 13.7(12.5–15.0) 6.3(5.4–7.2) BMI, Kg/m 2 < 18 533(8.8) 20.1(16.7–23.5) 16.9(13.7–20.1) 8.6(6.2–11.0) 18–24.9 3057(50.6) 17.6(16.3–19.0) 13.3(12.1–14.5) 6.4(5.6–7.3) 25–29.9 1300(21.5) 19.8(17.7–22.0) 15.5(13.6–17.5) 6.5(5.1–7.8) ≥ 30 1092(18.1) 23.9(21.4–26.4) 17.1(14.9–19.4) 7.9(6.3–9.5) Missing 57(0.9) - - - Median BMI, (IQR) 23.4(20.5–27.9) 24.2(21.0-29.2) 24.0(20.8–28.9) 23.8(20.7–29.1) Settlement Rural 2888(47.8) 20.4(19.0-21.9) 15.3(14.0-16.7) 7.4(6.5–8.4) Urban 3151(52.2) 19.2(17.8–20.5) 14.8(13.5–16.0) 6.8(5.9–7.6) District Butha Buthe 3162(52.4) 14.3(13.0-15.5) 9.8(8.8–10.8) 5.7(4.9–6.5) Mokhotlong 2877(47.6) 25.8(24.2–27.4) 20.8(19.3–22.3) 8.6(7.6–9.6) Education None 607(10.1) 30.6(27.0-34.3) 25.5(22.1–29.0) 13.2(10.5–15.9) Primary 2817(46.6) 23.4(21.8–24.9) 18.1(16.6–19.5) 8.7(7.7–9.7) Secondary 2172(36.0) 12.6(11.2–14.0) 8.7(7.5–9.8) 3.8(3.0-4.6) Tertiary 442(7.3) 17.2(13.7–20.7) 12.7(9.6–15.8) 4.5(2.6–6.5) Refused to say 1(0.02) - - - Marital status Single 1325(21.9) 8.6(7.1–10.1) 6.5(5.2–7.8) 2.6(1.7–3.4) In a committed relationship 3529(58.4) 19.1(17.8–20.4) 13.8(12.7–14.9) 6.7(5.9–7.5) Divorced/separated/widowed 1181(19.6) 34.2(31.5–36.9) 28.4(25.8–30.9) 13.2(11.3–15.1) Refused to say 4(0.1) - - - Employment Employed 3063(50.7) 17.7(16.3–19.0) 13.6 (12.4–14.8) 6.1(5.3-7.0) Not employed 2952(48.9) 21.8(20.3–23.3) 16.5(15.1–17.8) 8.1(7.1–9.1) Missing 24(0.4) - - - Wealth index First quintile 1230(20.4) 18.1(16.0-20.3) 14.3(12.4–16.3) 6.8(5.4–8.2) Second quintile 1211(20.1) 21.6(19.2–23.9) 16.4(14.3–18.4) 7.8(6.3–9.4) Third quintile 1220(20.2) 21.4(19.1–23.7) 16.1(14.1–18.2) 7.8(6.3–9.3) Fourth quintile 1197(19.8) 19.5(17.3–21.8) 15.0(13.0-17.1) 8.0(6.5–9.6) Fifth quintile 1164(19.3) 18.5(16.2–20.7) 13.4(11.6–15.5) 5.0(3.7–6.2) Missing 17(0.3) - - - Physically active* Yes 4180(69.2) 16.9(15.7–18.0) 13.3(12.2–14.3) 6.2(5.4–6.9) No 1851(30.7) 26.4(24.4–28.4) 19.1(17.3–20.9) 9.2(7.9–10.5) Missing 8(0.1) - - - Smoker # Yes 1509(25.0) 24.8(22.6–27.0) 19.7(17.7–21.8) 9.3(7.8–10.7) No 4525(74.9) 18.1(17.0-19.2) 13.5(12.5–14.5) 6.4(5.7–7.1) Missing 5(0.1) - - - Alcohol $ Yes 1575(26.1) 20.4(18.5–22.4) 16.5(14.7–18.3) 7.8(6.5–9.1) No 4464(73.9) 19.5(18.4–20.7) 14.5(13.5–15.6) 6.8(6.1–7.6) Fruits and vegetables consumption β Yes 468(7.8) 15.8(12.5–19.1) 10.9(8.1–13.7) 7.7(5.3–10.1) No 5563(92.1) 20.1(19.1–21.2) 15.4(14.5–16.4) 7.0(6.4–7.7) Missing 8(0.1) - - - CI: confidence interval IQR: interquartile range BMI: body mass index * at least 30 minutes of moderate to vigorous activity a minimum of five days a week # any history of smoking $ use in the three months before study β at least five servings weekly. Table 2 Prevalence of unspecified pain, chronic pain and high-impact chronic pain, by clinical characteristics. Variable Enrolled Pain Chronic pain High-impact chronic pain N = 6039 % (95% CI) % (95% CI) % (95% CI) Arterial hypertension Yes 1302(21.5) 35.3(32.8–38.0) 29.0(26.6–31.5) 14.4(12.6–16.4) No 4726(78.3) 15.5(14.5–16.5) 11.2(10.3–12.1) 5.1(4.5–5.7) Missing 11(0.2) - - - Diabetes mellitus Diabetes 257(4.3) 35.8(30.2–41.8) 28.8(23.6–34.6) 17.9(13.7–23.1) Prediabetes 36(0.6) 36.1(22.3–52.7) 30.6(17.8–47.2) 16.7(7.5–33.1) No 5210(86.3) 19.1(18.9–20.2) 14.3(13.4–15.3) 6.6(6.0-7.3) Missing 536(8.9) - - - Depression (PHQ-9) Moderate/high risk 98(1.6) 48.0(38.3–57.8) 39.8(30.6–49.8) 32.7(24.0-42.6) Minimal to low risk 5930(98.2) 19.3(18.3–20.3) 14.6(13.7–15.5) 6.7(6.1–7.3) Missing 11(0.2) - - - Anxiety (GAD-7) Moderate/high risk 43(0.7) 48.8(34.4–63.4) 41.9(28.2–56.9) 34.9(21.9–50.5) Minimal to low risk 5990(99.2) 19.5(18.6–20.6) 14.9(14.0-15.8) 6.9(6.3–7.5) Missing 6(0.1) - - - Living with HIV Yes 923(15.3) 22.6(20.1–25.5) 16.5(14.2–19.0) 6.9(5.5–8.8) no 5113(84.7) 19.3(18.2–20.4) 14.8(13.9–15.8) 7.1(6.4–7.9) Missing 3(0.1) - - - GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus. For all pain categories, the most common locations were the limbs, followed by the back (see Fig. 3 and S1 figure in the supplementary material). Results of univariate and multivariable logistic regression models for the pain categories are given in Table 3 and Figs. 4 to 6 . Compared to participants 18–24 years old, older participants had higher odds of unspecified pain. Similarly, participants living in Mokhotlong district (adjusted odds ratio [aOR], 2.41; 95% CI: 2.07–2.81; p < 0.001), who smoked (aOR, 1.41; 95% CI: 1.18–1.69; p < 0.001), had hypertension (aOR, 1.41; 95% CI: 1.18–1.68; p < 0.001), or were at high/moderate risk of depression (aOR, 2.98; 95% CI: 1.76–5.04; p < 0.001), had higher odds of having unspecified pain. Conversely, participants who were male (aOR, 0.68; 95% CI: 0.56–0.82; p < 0.001), or who were physically active (aOR, 0.64; 95% CI: 0.55–0.75; p < 0.001) were less likely to have unspecified pain. As seen with unspecified pain, higher age groups were associated with higher odds of chronic pain. Living in Mokhotlong district (aOR, 2.78; 95% CI: 2.34–3.30; p < 0.001), smoking (aOR, 1.33; 95% CI: 1.07–1.64; p = 0.008), hypertension (aOR, 1.53; 95% CI: 1.26–1.85; p < 0.001), and moderate to high risk of depression (aOR, 2.74; 95% CI: 1.52–4.79; p < 0.001), were associated with higher odds of chronic pain. Physically active participants (aOR, 0.82; 95% CI: 0.69–0.98; p = 0.0252), were less likely to have chronic pain. Like unspecified pain and chronic pain, older participants were more likely to experience high-impact chronic pain. Also, participants living in Mokhotlong district had higher odds of high-impact chronic pain (aOR, 1.53; 95% CI: 1.22–1,91; p < 0.001). Compared to the fifth (highest) wealth quintile, other wealth quintiles had higher odds of high-impact chronic pain. Hypertension (aOR, 1.47; 95% CI: 1.14–1.90; p = 0.003), diabetes mellitus (aOR, 1.86; 95% CI: 1.27–2.74; p = 0.002), moderate to high risk of depression (aOR, 4.93; 95% CI: 2.75–8.86; p < 0.001), and moderate to high risk of generalized anxiety disorder (aOR, 2.85; 95% CI: 1.18–6.92; p = 0.023), were associated with higher odds of high-impact chronic pain. Table 3 Univariate logistic regression models for unspecified pain, chronic pain, and high-impact chronic pain. Variable Pain Chronic pain High-impact chronic pain OR (CI) P OR (CI) P OR (CI P Age, years, n(%) 18–24 Ref - Ref - Ref - 25–34 1.70 (1.27–2.27) < 0.001 1.90(1.32–2.74) 0.001 1.97(1.13–3.45) 0.017 35–44 2.55(1.91–3.41) < 0.001 2.89(2.02–4.15) < 0.001 3.43(1.99–5.91) < 0.001 45–54 4.09(3.07–5.45) < 0.001 4.84(3.40–6.90) < 0.001 4.55(2.64–7.84) < 0.001 55–64 6.21(4.69–8.23) < 0.001 8.00(5.68–11.27) < 0.001 8.54(5.09–14.32) < 0.001 ≥ 65 10.46(8.04–13.62) < 0.001 13.58(9.82–18.79) < 0.001 13.70(8.37–22.42) < 0.001 Sex Female Ref - Ref - Ref Male 0.71(0.62–0.80) < 0.001 0.82(0.71–0.94) 0.006 0.79(0.65–0.96) 0.018 BMI, Kg/m 2 < 18 0.80(0.62–1.03) 0.084 0.98(0.75–1.30) 0.904 1.10(0.76–1.61) 0.601 18–24.9 0.68(0.58–0.81) < 0.001 0.74(0.61–0.90) 0.002 0.81(0.62–1.05) 0.108 25–29.9 0.79(0.65–0.96) 0.017 0.89(0.72–1.11) 0.295 0.81(0.59–1.10) 0.181 ≥ 30 Ref - Ref - Ref - Settlement Rural Ref - Ref - Ref - Urban 0.92(0.81–1.05) 0.219 0.96(0.83–1.10) 0.550 0.90(0.74–1.10) 0.300 District Butha Buthe Ref - Ref - Ref - Mokhotlong 2.09(1.84–2.38) < 0.001 2.42(2.09–2.80) < 0.001 1.55(1.27–1.89) < 0.001 Education None Ref - Ref - Ref - Primary 0.69(0.57–0.84) < 0.001 0.64(0.52–0.79) < 0.001 0.63(0.48–0.82) 0.001 Secondary 0.33(0.26–0.40) < 0.001 0.28(0.22–0.35) < 0.001 0.26(0.19–0.36) < 0.001 Tertiary 0.47(0.35–0.64) < 0.001 0.42(0.30–0.59) < 0.001 0.31-0.19-0.52) < 0.001 Marital status Single Ref - Ref - Ref - In a committed relationship 2.5(2.04–3.10) < 0.001 2.31(1.82–2.93) < 0.001 2.73(1.90–3.94) < 0.001 Divorced/separated/widowed 5.52(4.40–6.93) < 0.001 5.70(4.43–7.34) < 0.001 5.78(3.40–8.45) < 0.001 Employment Employed Ref - Ref - Ref - Not employed 1.30(1.15–1.48) < 0.001 1.25(1.09–1.44) 0.002 1.36(1.12–1.66) 0.002 Wealth index First quintile 0.98(0.79–1.20) 0.829 1.06(0.84–1.34) 0.604 1.40(0.99–1.97) 0.057 Second quintile 1.21(0.99–1.48) 0.061 1.24(0.99–1.56) 0.058 1.62(1.16–2.27) 0.005 Third quintile 1.20(0.98–1.47) 0.075 1.23(0.98–1.54) 0.078 1.61(1.15–2.26) 0.006 Fourth quintile 1.07(0.87–1.32) 0.505 1.13(0.89–1.42) 0.310 1.66(1.19–2.33) 0.003 Fifth quintile Ref - Ref - Ref - Physically active* No Ref - Ref - Ref - Yes 0.57(0.50–0.64) < 0.001 0.65(0.56–0.75) < 0.001 0.65(0.53–0.80) < 0.001 Smoker # No Ref - Ref - Ref - Yes 1.49(1.30–1.71) < 0.001 1.58(1.35–1.84) < 0.001 1.50(1.22–1.86) < 0.001 Alcohol $ No Ref - Ref - Ref - Yes 1.06(0.92–1.22) 0.435 1.16(0.99–1.36) 0.060 1.16(0.93–1.44) 0.194 Fruits and vegetables β No Ref - Ref - Ref - Yes 0.75(0.58–0.96) 0.025 0.67(0.50–0.91) 0.009 1.10(0.77–1.57) 0.601 Arterial hypertension No Ref - Ref - Ref - Yes 2.99(2.60–3.43) < 0.001 3.23(2.78–3.75) < 0.001 3.15(2.57–3.85) < 0.001 Diabetes mellitus No Ref - Ref - Ref - Diabetes 2.36(1.82–3.08) < 0.001 2.43(1.83–3.21) < 0.001 3.07(2.19–4.31) < 0.001 Prediabetes 2.40(1.21–4.75) 0.012 2.64(1.29–5.39) 0.008 2.82(1.17–6.82) 0.021 Depression (PHQ-9) Minimal to low risk Ref - Ref - Ref - Moderate/high risk 3.86(2.58–5.76) < 0.001 3.86(2.56–5.82) < 0.001 6.79(4.40-10.49) < 0.001 Anxiety (GAD-7) Minimal to low risk Ref - Ref - Ref - Moderate/high risk 3.93(2.15–7.17) < 0.001 4.13(2.24–7.59) < 0.001 7.25(3.84–13.69) < 0.001 Living with HIV No Ref - Ref - Ref - Yes 1.23(1.04–1.45) 0.018 1.13(0.94–1.37) 0.194 0.97(0.74–1.28) 0.840 CI: confidence interval; IQR: interquartile range; BMI: body mass index; Ref: reference group; * at least 30 minutes of moderate to vigorous activity a minimum of five days a week; # any history of smoking; $ use in the three months before study; β at least five servings weekly. GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus. Discussion This population-based survey assessed the prevalence of unspecified pain, chronic pain and high-impact chronic pain in the general population in Lesotho. It is the first to evaluate high-impact chronic pain in Africa. The prevalence of unspecified pain, chronic pain and high-impact chronic pain were 19.8%, 15.1%, and 7.1% respectively. Unspecified pain and chronic pain were associated with increasing age, living in the more mountainous Mokhotlong district, smoking, hypertension and moderate to high risk of depression. In addition to its association with increasing age, high-impact chronic pain was also associated with hypertension, diabetes mellitus, moderate to high risk of depression, and moderate to high risk of generalized anxiety disorder. Furthermore, participants from lower wealth quintiles were more likely to have high-impact chronic pain compared to those in the highest wealth quintile. Our findings indicate that a fifth of adults in the study area experience pain disorder. Almost half of those with chronic pain have high-impact chronic pain. Recent data on unspecified pain within Africa are scant. However, a global prevalence of pain study across 52 countries using data from the World Health Survey 2002 to 2004 presents prevalence figures in 14 countries from Africa including South Africa, Zambia, Namibia, Zimbabwe and Malawi. 3 This study found an average unspecified pain prevalence of 28% among included African countries, with a range of 25–37%. 3 Reasons that explain the lower prevalence of unspecified pain in our study compared to that in the global prevalence of pain study include that the latter study consisted of an older population, who were mostly female and who predominantly lived in rural areas- factors associated with higher prevalence of pain. 3 , 38 , 39 Nonetheless, the chronic pain prevalence of 15.1% in our study is similar to the 18% pooled prevalence of chronic pain from several low- and middle-income countries 40 . A study conducted in neighboring South Africa reports a chronic pain prevalence of 18% 28 . Interestingly, the South African study also displays prevalence figures for the country’s regions, and Free State and KwaZulu-Natal, the proximal provinces to our study area had 12% and 13% chronic pain prevalence respectively 28 . In our study, we found the prevalence of high-impact chronic pain to be 7.1%. There are no studies in Africa on high impact chronic pain with which to compare this finding. However, our results are consistent with the 6.9–8% of adults with high-impact chronic pain in the United States 19 , 41 , and 7.8% in the United Kingdom 42 . In Saudi Arabia, high-impact chronic pain was found to affect 4% of the adult population. 43 This low figure may be due to differences in the operationalized definition of high-impact chronic pain applied in the Saudi Arabian study. The most common pain locations for all pain categories were the limbs and the back. This is consistent with other studies. 28 , 44 We found that the odds of experiencing unspecified pain and chronic pain were higher with increasing age, among females, and among those living in the mountainous Mokhotlong region, similar to results from other studies. 3 , 28 , 45 – 47 In the current study, physically active participants were less likely to have unspecified pain and chronic pain, whereas smoking was associated with higher odds of pain. Regular physical activity prevents pain 48 , and a systematic review has shown evidence of an exercise program reducing the risk of pain. 49 Indeed, several guidelines advocate physical activity as an effective intervention to reduce pain 26 . Conversely, the relationship between pain and smoking is thought to be bidirectional with smoking increasing the risk of pain, and sufferers in turn relying on smoking as a coping mechanism 50 , 51 . High-impact chronic pain was higher among those in lower wealth index quintiles compared to the highest wealth index quintile. In their recent study, Weissman et. al. report similar findings in the United States of America where poorer participants, unable to afford the cost of medical care, had higher odds of high-impact chronic pain 52 . Several other studies have shown identical findings suggesting that higher odds of pain in low wealth groups could be due to poor access to health care. 3 , 19 , 28 A further interesting finding in our study is the number of comorbidities among participants with high-impact chronic pain where sufferers had higher likelihood of hypertension, diabetes mellitus, and higher risks of depression and anxiety disorder. Although mechanisms underlying this are not yet fully understood, other studies similarly reported multimorbidity among people experiencing high-impact chronic pain. 22 , 53 , 54 Multidisciplinary and multimodal approaches are required within pain medicine 44 , and appropriate pain classifications ensure that available resources are efficiently deployed for diagnosis, workup and treatment 55 . The effort to separate high-impact chronic pain from chronic pain without activity limitation/participation restriction represents such a classification attempt aimed at improving efficiency in pain management. Our study helps solve the need for more data within the African region to adequately characterize the pain burden within the general population and will be useful to stakeholders within pain medicine in the region. Important strengths in our study are the large sample size, a systematic sampling of the study population, and a high response rate of participants. Additionally, it is the first study in Africa to produce estimates on high-impact chronic pain. This study has several limitations. First, due to the cross-sectional nature of the survey, causality could not be established. As the presence of pain was self-reported, there is a potential for recall bias especially regarding unspecified pain. Furthermore, in grading the level of pain interference, mild interference and moderate interference were sometimes difficult to define, and participants occasionally could not distinguish routine activities from crucial activities. To conclude, we conducted a study to determine the prevalence of unspecified pain, chronic pain and high-impact chronic pain in a general population in Lesotho, and to assess their determinants. We found associations with increasing age, location, smoking, elevated blood pressure, moderate to high risk of depression, diabetes mellitus, and moderate to high risk of generalized anxiety disorder. Participants with high-impact chronic pain had the highest prevalence of co-morbidities. Furthermore, participants from less wealthier households had higher chances of having high-impact chronic pain compared to participants in the highest wealth quintile. These findings may encourage health systems in Lesotho and similar settings to integrate pain management into chronic care provision. Declarations Consent for publication Not applicable, included in consent to participate in survey. Competing interests The authors declare no conflicts of interest. Funding This study is part of the ComBaCaL project. The project is funded by the TRANSFORM grant of the Swiss Agency for Development and Cooperation (project number 7F-10345.01.01) and a grant by the World Diabetes Foundation (WDF-1778). NDL and AA are the Co-Principal investigators of ComBaCaL. EF received his salary from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement (No 801076), through the SSPH + Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS). Druing conduction of the study, NDL received his salary from the Swiss National Science Foundation (SNSF Eccellenza PCEFP3_181355); AA receives his salary from the postdoc mobility grant of the Swiss National Science Foundation (#P500PM_221961). Authors’ Contributions EF, LG, RG, AA and NDL conceptualized the study. EF, MM, MPS, MB, MK conducted the field work.TL oversaw routine data quality checks. EF performed the statistical analysis with support from TL and FC. SMC and MW provided important clinical, technical, and intellectual input. EF drafted the first version of the manuscript with input from NDL. NDL and AA acquired the funding. All authors reviewed the manuscript and approved the final version. 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J Pain 23(3):450–458 Bonezzi C, Fornasari D, Cricelli C, Magni A, Ventriglia G (2020) Not All Pain is Created Equal: Basic Definitions and Diagnostic Work-Up. Pain Ther 9(Suppl 1):1–15 Additional Declarations The authors declare no competing interests. Supplementary Files supplementarymaterialPain.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-5819163\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":401416505,\"identity\":\"00fd2d4d-4ed5-4c77-a111-6788fbd96b8e\",\"order_by\":0,\"name\":\"Emmanuel Firima\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYLCCCgMGHgYG5gNApoQMcVrOgLWwJYC08BCpBUzyGIBJgqr5xQ4/e3Cg4J6MbvuZz69u1FjwMLAfProBnxbJ2WnmBgcMinnMzuRus845BnQYT1raDXxaDG4nmEl/MEjgMTuQu804hw2oRYLHDK8W+9vp3yQOgLScf/PMOOcfEVoMpHPMIFpu5DA/zm0jQovE7ZwyqJZnZsy5fRI8bIT8wj87fZvEgT8J9mbnkx9/zvlWJ8fPfvgYXi3IgE0CTBKrHASYP5CiehSMglEwCkYOAAA0+kYevtCLyAAAAABJRU5ErkJggg==\",\"orcid\":\"https://orcid.org/0000-0002-5797-2607\",\"institution\":\"University of Sheffield\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Emmanuel\",\"middleName\":\"\",\"lastName\":\"Firima\",\"suffix\":\"\"},{\"id\":401425309,\"identity\":\"4064587e-ae6a-4ef8-b409-520607bc3c54\",\"order_by\":1,\"name\":\"Lucia Gonzalez\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Lucia\",\"middleName\":\"\",\"lastName\":\"Gonzalez\",\"suffix\":\"\"},{\"id\":401425310,\"identity\":\"cec1351c-cfda-4293-8b47-6411e27759e9\",\"order_by\":2,\"name\":\"Molulela Manthabiseng\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Solidarmed Lesotho\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Molulela\",\"middleName\":\"\",\"lastName\":\"Manthabiseng\",\"suffix\":\"\"},{\"id\":401425311,\"identity\":\"e268650a-c4cb-48f2-8cf3-435af0f031b1\",\"order_by\":3,\"name\":\"Mamoronts’ane P. Sematle\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Solidarmed Lesotho\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Mamoronts’ane\",\"middleName\":\"P.\",\"lastName\":\"Sematle\",\"suffix\":\"\"},{\"id\":401425312,\"identity\":\"3a6f7ce5-bc44-4c25-8443-90a7567a10c6\",\"order_by\":4,\"name\":\"Matumaole Bane\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Solidarmed Lesotho\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Matumaole\",\"middleName\":\"\",\"lastName\":\"Bane\",\"suffix\":\"\"},{\"id\":401425313,\"identity\":\"e00e80aa-6f35-4f14-856d-70ea1b8bdfbc\",\"order_by\":5,\"name\":\"Makhebe Khomolishoele\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Solidarmed Lesotho\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Makhebe\",\"middleName\":\"\",\"lastName\":\"Khomolishoele\",\"suffix\":\"\"},{\"id\":401425314,\"identity\":\"0197b536-239c-4304-8ef3-dbb069969640\",\"order_by\":6,\"name\":\"Tristan Lee\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Tristan\",\"middleName\":\"\",\"lastName\":\"Lee\",\"suffix\":\"\"},{\"id\":401425315,\"identity\":\"bab2a502-b17d-4dea-b6fd-ee9c2ff115e2\",\"order_by\":7,\"name\":\"Frédérique Chammartin\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Frédérique\",\"middleName\":\"\",\"lastName\":\"Chammartin\",\"suffix\":\"\"},{\"id\":401425316,\"identity\":\"c56ce930-cea5-4474-9a86-dea3488f3671\",\"order_by\":8,\"name\":\"Ravi Gupta\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Solidarmed Lesotho\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ravi\",\"middleName\":\"\",\"lastName\":\"Gupta\",\"suffix\":\"\"},{\"id\":401425317,\"identity\":\"bcf58548-083d-4268-b808-82f10f918015\",\"order_by\":9,\"name\":\"Stephen McCrosky\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Stephen\",\"middleName\":\"\",\"lastName\":\"McCrosky\",\"suffix\":\"\"},{\"id\":401425318,\"identity\":\"4416baba-bd26-4693-b1ec-41ded42b4eee\",\"order_by\":10,\"name\":\"Maja Weisser\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Maja\",\"middleName\":\"\",\"lastName\":\"Weisser\",\"suffix\":\"\"},{\"id\":401425319,\"identity\":\"e4ee98b7-e3ba-498f-9ef0-b2760e0d0b4d\",\"order_by\":11,\"name\":\"Alain Amstutz\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Alain\",\"middleName\":\"\",\"lastName\":\"Amstutz\",\"suffix\":\"\"},{\"id\":401425320,\"identity\":\"c1fb6eab-731c-45d9-9ccf-5874eb106a37\",\"order_by\":12,\"name\":\"Niklaus Daniel Labhardt\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIie3QvWrDMBDA8QsBZVHwKpPQZzhjUAop9FU0VYvbsVMwntylpWsepsOFA3Xpx5qhQ7p4MqVroIXKhQwpyF476L/oNPzQIYBY7B+GLEb0O4AU/hhDAtANFCSnLOCIqLQaIGf0lyANkUdhaF+XgJNnt9s/LMt8a5sdrN6CRLOgzV3NgPLKZreNVXpbLBBc00MmFU1r8osVWknijgg1qjhIck82391iSavTL0/ytW16SeYX42k9BlSFnnWvoDJ6iBiev7BE9XExm5NN10/tAo0LE3x12Xt7XZ6c31+6tKVlktz4H/tchckheXw1gyAWi8Viff0A0OdZlDkENbIAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Niklaus\",\"middleName\":\"Daniel\",\"lastName\":\"Labhardt\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-01-13 10:38:50\",\"currentVersionCode\":1,\"declarations\":{\"humanSubjects\":true,\"vertebrateSubjects\":false,\"conflictsOfInterestStatement\":false,\"humanSubjectEthicalGuidelines\":true,\"humanSubjectConsent\":true,\"humanSubjectClinicalTrial\":false,\"humanSubjectCaseReport\":false,\"vertebrateSubjectEthicalGuidelines\":false},\"doi\":\"10.21203/rs.3.rs-5819163/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-5819163/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":73869901,\"identity\":\"3c4a396f-c815-4e28-9a00-e999d60847c5\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:21\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":29916,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eStudy flow chart.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/cda22ead004e5412362ef022.png\"},{\"id\":73869904,\"identity\":\"e69b9306-fd1b-4888-b4d4-e4ba265f2b67\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"png\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":238084,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e(a) Nested area chart showing pain categories as age increases.\\u003c/p\\u003e\\n\\u003cp\\u003ePrevalence (and 95% confidence interval) of (b) unspecified pain, (c) chronic pain, and (d) high-impact chronic pain, for each age group stratified by sex.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"2.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/0bfbcd0ed761aed9617f13ce.png\"},{\"id\":73869903,\"identity\":\"d6cecc85-2cfa-4384-a965-c8079f412f57\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"png\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":27240,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eCommon body locations affected by unspecified pain.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"3.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/8354de3a691dabc2c7d2c7c8.png\"},{\"id\":73869907,\"identity\":\"811027e0-cbcd-454c-8439-4b350ee30ef7\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"png\",\"order_by\":4,\"title\":\"Figure 4\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":239077,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eMultivariable logistic regression model for unspecified pain. \\u003cem\\u003eaOR: adjusted odds ratio; CI: confidence interval; IQR: interquartile range; BMI: body mass index; \\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e* \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eat least 30 minutes of moderate to vigorous activity a minimum of five days a week;\\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eany history of smoking; consumption of at least five servings of fruits or vegetables weekly; GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus.\\u003c/em\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"4.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/04c8101342e087d9403307cb.png\"},{\"id\":73869923,\"identity\":\"41248440-26e8-4f96-8da1-960ab61671c2\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"png\",\"order_by\":5,\"title\":\"Figure 5\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":225744,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eMultivariable logistic regression model for chronic pain. \\u003cem\\u003eaOR: adjusted odds ratio; CI: confidence interval; IQR: interquartile range; BMI: body mass index; \\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e* \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eat least 30 minutes of moderate to vigorous activity a minimum of five days a week;\\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eany history of smoking; alcohol use in the three months before study; consumption of at least five servings of fruits or vegetables weekly; GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus.\\u003c/em\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"5.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/1fae78d9128f1eebedf96e38.png\"},{\"id\":73869920,\"identity\":\"6656ea62-9f71-4e7c-a189-4bb44b7ebea4\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"png\",\"order_by\":6,\"title\":\"Figure 6\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":235371,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eMultivariable logistic regression model for high-impact chronic pain. \\u003cem\\u003eHCP: high-impact chronic pain; aOR: adjusted odds ratio; CI: confidence interval; IQR: interquartile range; BMI: body mass index; \\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e* \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eat least 30 minutes of moderate to vigorous activity a minimum of five days a week;\\u003c/em\\u003e\\u003cem\\u003e\\u003cstrong\\u003e \\u003c/strong\\u003e\\u003c/em\\u003e\\u003cem\\u003eany history of smoking; alcohol use in the three months before study; GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus.\\u003c/em\\u003e\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"6.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/2546d8737e5a92b6a34c22a2.png\"},{\"id\":73872550,\"identity\":\"ee543735-b48d-45a6-80d0-cf55b9f624d3\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:28:22\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":2643546,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/bc7d8271-b062-4603-af0c-5e1d4d3f6fc0.pdf\"},{\"id\":73869921,\"identity\":\"b8d8e4b3-cb6d-491f-a1b2-1ac9300718ed\",\"added_by\":\"auto\",\"created_at\":\"2025-01-15 12:12:22\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":728145,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"supplementarymaterialPain.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5819163/v1/b8f0dd59d241a5aa640ea5c5.docx\"}],\"financialInterests\":\"The authors declare no competing interests.\",\"formattedTitle\":\"\\u003cp\\u003eUnspecified Pain, Chronic Pain and High-Impact Chronic Pain in Lesotho, Southern Africa: a Population-based Cross-sectional study\\u003c/p\\u003e\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003ePain and its associated disorders are among the most frequent causes of disability globally\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u003c/sup\\u003e. A recent analysis of unspecified pain among adults using data across 52 countries estimated the prevalence of pain to be 27.5% on average, ranging from 9.9\\u0026ndash;50.3% between countries\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u003c/sup\\u003e. The burden of pain is reportedly greater in low- and middle-income countries due to manual labor, accidents, violence, low availability of potent analgesics, and is expected to grow as life-expectancy increases\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u003c/sup\\u003e. Chronic pain, defined as the presence of pain that lasts or recurs for more than three months\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u003c/sup\\u003e, affects 20% of individuals worldwide\\u003csup\\u003e\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u003c/sup\\u003e, with 1 in 10 adults newly affected every year\\u003csup\\u003e\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e\\u003c/sup\\u003e. It exerts substantial pressures on health systems\\u003csup\\u003e\\u003cspan additionalcitationids=\\\"CR9 CR10\\\" citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e\\u003c/sup\\u003e and is the leading cause of years lived with disability\\u003csup\\u003e\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e\\u003c/sup\\u003e, resulting in an annual loss of 149\\u0026nbsp;million workdays.\\u003csup\\u003e\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e\\u003c/sup\\u003e Chronic pain has been linked to restrictions in daily activities, dependence on opioids, anxiety and depression, and overall poor quality of life\\u003csup\\u003e\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e,\\u003cspan additionalcitationids=\\\"CR17 CR18\\\" citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eHigh-impact chronic pain is defined as the presence of chronic pain, accompanied with restrictions in activity and/or participation in daily life\\u003csup\\u003e\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e\\u003c/sup\\u003e. Estimates of high-impact chronic pain distinguish individuals with limitations in such domains as work, social, recreation, and self-care activities from individuals who continue to lead a normal life despite chronic pain.\\u003csup\\u003e\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e \\u003cp\\u003eAlthough the burden of pain-related disorders is estimated to be higher in low- and middle-income countries\\u003csup\\u003e\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e\\u003c/sup\\u003e, good prevalence data from these countries are extremely limited.\\u003csup\\u003e\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u003c/sup\\u003e In Lesotho, Southern Africa, there is limited data on chronic pain, and no data on high-impact chronic pain to inform the design, implementation and scale up of relevant population-wide interventions\\u003csup\\u003e\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e\\u003c/sup\\u003e. Here, we present the prevalence of unspecified pain, chronic pain and high-impact chronic pain, and their determinants in a population-based survey in two districts in Lesotho.\\u003c/p\\u003e\"},{\"header\":\"Method\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e\\n\\u003ch2\\u003eDesign, setting and participants selection\\u003c/h2\\u003e\\n\\u003cp\\u003eThis cross-sectional study was conducted during a large household-based survey to assess the prevalence and determinants of several chronic conditions in two districts in Northern Lesotho\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e\\u003c/sup\\u003e. The two districts have an estimated population of about 220,000 people in an area of over 6,000 km2. The major occupations are subsistence farming, mining and construction\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e\\u003c/sup\\u003e. This study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e\\n\\u003cp\\u003eA detailed description of the survey has been published elsewhere\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e\\u003c/sup\\u003e. To summarize, we used two-stage cluster sampling where population clusters were primary sampling units and household members secondary sampling units. From a list containing 785 clusters with at least 30 households each, 120 clusters were randomly selected (60 in each district), stratified by settlement type (urban vs rural), and accessibility with respect to the closest health facility (hard-to-reach vs easy-to-reach areas). All households in a sampled cluster were eligible if consent was provided by the head of household. Household members\\u0026thinsp;\\u0026ge;\\u0026thinsp;18 years old were randomly selected by an algorithm based on age, sex and settlement (rural vs urban), programmed in the Open Data Kit data collection tool\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e\\u003c/sup\\u003e. The sampled individuals were then approached to be included in the study.\\u003c/p\\u003e\\n\\u003c/div\\u003e\\n\\u003ch3\\u003eProcedure and measurements\\u003c/h3\\u003e\\n\\u003cp\\u003eThe study was conducted from November 2, 2021 to August 31, 2022. The study staff interviewed consenting household members using a detailed questionnaire, collecting sociodemographic and medical history data. Variables included age, sex, settlement (rural or urban), district (Butha Buthe or Mokhotlong), educational level, marital status, employment status. Additionally, we collected lifestyle variables such as level of physical activity, smoking and alcohol consumption in the three months before survey, as well as daily consumption of fruit and vegetables. Furthermore, the patient health questionnaire (PHQ-9)\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e\\u003c/sup\\u003e and the general anxiety disorder-7 questionnaire (GAD-7)\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e\\u003c/sup\\u003e were used to screen for risk of depression and generalized anxiety disorders, respectively. We used the Demographic and Health Survey program questionnaire for Lesotho to assess household wealth. This wealth index questionnaire assesses housing construction characteristics, household assets and utility services, as well as country-specific assets. Using principal component analysis, the questionnaire responses are analyzed to indicate the household\\u0026rsquo;s economic status in Lesotho which is subsequently categorized into five quintiles ranging from poorest to wealthiest \\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e,\\u003cspan class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e\\n\\u003ch3\\u003eAssessment of unspecified pain, chronic pain, high-impact chronic pain\\u003c/h3\\u003e\\n\\u003cp\\u003eUnspecified pain and chronic pain were assessed using a semi-structured questionnaire\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u003c/sup\\u003e. Participants were asked: 1. Are you currently affected by pain either all the time or on and off? (Yes/No); 2. Have you had this pain for more than 3 months? (Yes/No); 3. Where do you feel this pain? (options included back pain; neck and shoulder pain; chest pain; headache, facial, or dental pain; stomachache or abdominal pain; pain in the limbs; and other). A positive response to question 1 indicated the presence of unspecified pain. Affirmative responses to both questions 1 and 2 indicated the presence of chronic pain.\\u003c/p\\u003e\\n\\u003cp\\u003eTo assess high-impact chronic pain, participants were questioned about the level of incapacity to carry out routine activities on account of pain. They were asked to state if there was no interference with any routine activity; mild interference where most routine activities could still be undertaken; moderate interference where only routine activities judged to be of importance could be undertaken; and severe interference where participants could not undertake any activities except assisted. To assess severity of pain, participants were asked to determine how intense their pain was on a scale of 1 to 10, 1 being the lowest and 10 being the most severe pain. Severity of pain was classified according to a 10-point Numerical Rating Scale (NRS) where mild pain corresponded to NRS 1\\u0026ndash;3; moderate pain NRS 4\\u0026ndash;6; and severe pain NRS 7\\u0026ndash;10. Participants with chronic pain and moderate to severe restriction of activities or severe pain intensity were considered to have high-impact chronic pain.\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n\\u003ch3\\u003eData collection and statistical analysis\\u003c/h3\\u003e\\n\\u003cp\\u003eData was collected using KoboCollect (\\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.kobotoolbox.org/\\u003c/span\\u003e\\u003c/span\\u003e). Statistical analyses were conducted in Stata (16,1, StataCorp LLC, College Station, TX). Descriptive statistics, such as mean and standard deviation; median and interquartile range were used for continuous variables, while frequency and percentage were used for categorical variables.\\u003c/p\\u003e\\n\\u003cp\\u003eThe prevalence of unspecified pain, chronic pain, and high-impact chronic pain are presented graphically using a nested area chart. We used a multivariable logistic regression model to assess the factors associated with each of unspecified pain, chronic pain, and high-impact chronic pain. Variables with a p-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.25 in univariate logistic regression were included in the final multivariable model. Participants with missing data were excluded from the regression analyses.\\u003c/p\\u003e\\n\\u003ch3\\u003eEthics statement\\u003c/h3\\u003e\\n\\u003cp\\u003eAll procedures were carried out in line with the ethical standards laid out in the Declaration of Helsinki\\u003csup\\u003e\\u003cspan class=\\\"CitationRef\\\"\\u003e37\\u003c/span\\u003e\\u003c/sup\\u003e. Participants received information on all research procedures in Sesotho and provided written informed consent. Illiterate participants gave consent by thumbprint and a witness who was not involved in the study co-signed the form. Once the informed consent process was completed, a signed copy of the form was retained by study staff and a copy was given to the participant. This study was reviewed by the Ethics Committee Northwest and Central Switzerland (ID AO_2021-00056) and approved by the National Health Research Ethics Committee in Lesotho (ID 139\\u0026ndash;2021).\\u003c/p\\u003e\\n\\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e\\n\\u003ch2\\u003ePatient and public involvement\\u003c/h2\\u003e\\n\\u003cp\\u003eThis survey is part of the Community-Based chronic Care project Lesotho (ComBaCaL; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ewww.combacal.org\\u003c/span\\u003e\\u003c/span\\u003e\\u003cspan class=\\\"Underline\\\"\\u003e).\\u003c/span\\u003e It was designed together with the ComBaCaL steering committee that includes a community representative, as well as representatives from the Ministry of Health of Lesotho. The survey was discussed with local authorities (village chiefs, local Ministry of Health leaders), who were engaged throughout the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eFigure \\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e displays the study flow. Out of 7412 participants surveyed, 6039 were \\u0026ge;\\u0026thinsp;18 years old, eligible and included in this analysis. Participants\\u0026rsquo; sociodemographic characteristics and prevalence of unspecified pain, chronic pain and high-impact chronic pain for each characteristic are shown in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e (and S1 table in the supplementary material). The overall median age of participants was 39 years (interquartile range [IQR]: 27\\u0026ndash;58), 3153/6039 (52.2%) were female. As depicted in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e (and displayed for each pain category in the supplementary material, S2 table), 1302/6039 (21.5%) of the study population had arterial hypertension, 257/6039 (4.3%) had diabetes mellitus, 98/6039 (1.6%) were at moderate to high risk of depression, 43/6039 (0.7%) were at moderate to high risk of generalized anxiety disorder, and 923/6039 (15.3%) reported to live with HIV. Overall, 1194/6039 (19.8%) had unspecified pain (95% confidence interval [CI]: 18.8\\u0026ndash;20.8); 909/6039 (15.1%) had chronic pain (95% CI: 14.2\\u0026ndash;16.0); and 428/6039 (7.1%) had high-impact chronic pain (95% CI: 6.5\\u0026ndash;7.8) corresponding to 47.1% (428/909) among the participants who had chronic pain.\\u003c/p\\u003e\\n\\u003cp\\u003eFor participants with unspecified pain, chronic pain and high-impact chronic pain, the median age ranged from 58 years to 61 years. All pain categories increased with rising age and were higher among females than males (Fig.\\u0026nbsp;2). The prevalence of unspecified pain, chronic pain and high-impact chronic pain were higher among participants with hypertension, diabetes mellitus, risk of depression or risk of anxiety disorder (Table \\u003cspan class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e\\n\\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003cdiv class=\\\"colspec\\\" align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/div\\u003e\\n \\u003ctable id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003ePrevalence of unspecified pain, chronic pain and high-impact chronic pain, by sociodemographic characteristics.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eVariables\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEnrolled\\u003c/p\\u003e\\n \\u003cp\\u003eN\\u0026thinsp;=\\u0026thinsp;6039\\u003c/p\\u003e\\n \\u003cp\\u003en(%)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUnspecified pain\\u003c/p\\u003e\\n \\u003cp\\u003e%(95%CI)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eChronic pain\\u003c/p\\u003e\\n \\u003cp\\u003e%(95%CI)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHigh-impact chronic pain\\u003c/p\\u003e\\n \\u003cp\\u003e%(95%CI)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eAge, years\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18\\u0026ndash;24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1162(19.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.5 (5.1-8.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.9(2.8-5.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.5(1.0-2.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25\\u0026ndash;34\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1362(22.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10.6 (9.0-12.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.1(5.8\\u0026ndash;8.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.0(2.1\\u0026ndash;3.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35\\u0026ndash;44\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e996(16.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.2 (12.9\\u0026ndash;17.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10.4(8.5\\u0026ndash;12.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.1(3.8\\u0026ndash;6.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e45\\u0026ndash;54\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e778(12.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e22.2(19.3\\u0026ndash;25.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.3(13.7\\u0026ndash;18.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.7(4.9\\u0026ndash;8.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e55\\u0026ndash;64\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e726(12.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e30.3(27.0-33.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e24.4(21.3\\u0026ndash;27.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11.8(9.5\\u0026ndash;14.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;\\u0026thinsp;65\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1015(16.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e42.3(39.2\\u0026ndash;45.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35.4(32.4\\u0026ndash;38.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.7(15.4\\u0026ndash;20.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMedian age, (IQR)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e39 (27\\u0026ndash;58)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e58(41\\u0026ndash;69)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e60(43\\u0026ndash;71)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e61(44\\u0026ndash;73)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eSex\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFemale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3153(52.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e22.4(20.9\\u0026ndash;23.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.3(15.0-17.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.8(6.9\\u0026ndash;8.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2886(47.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.9(15.5\\u0026ndash;18.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.7(12.5\\u0026ndash;15.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.3(5.4\\u0026ndash;7.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eBMI, Kg/m\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e2\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;18\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e533(8.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20.1(16.7\\u0026ndash;23.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.9(13.7\\u0026ndash;20.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.6(6.2\\u0026ndash;11.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18\\u0026ndash;24.9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3057(50.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.6(16.3\\u0026ndash;19.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.3(12.1\\u0026ndash;14.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.4(5.6\\u0026ndash;7.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25\\u0026ndash;29.9\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1300(21.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.8(17.7\\u0026ndash;22.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.5(13.6\\u0026ndash;17.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.5(5.1\\u0026ndash;7.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;\\u0026thinsp;30\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1092(18.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e23.9(21.4\\u0026ndash;26.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.1(14.9\\u0026ndash;19.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.9(6.3\\u0026ndash;9.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e57(0.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMedian BMI, (IQR)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e23.4(20.5\\u0026ndash;27.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e24.2(21.0-29.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e24.0(20.8\\u0026ndash;28.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e23.8(20.7\\u0026ndash;29.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eSettlement\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRural\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2888(47.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20.4(19.0-21.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.3(14.0-16.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.4(6.5\\u0026ndash;8.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eUrban\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3151(52.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.2(17.8\\u0026ndash;20.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.8(13.5\\u0026ndash;16.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.8(5.9\\u0026ndash;7.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDistrict\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eButha Buthe\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3162(52.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.3(13.0-15.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e9.8(8.8\\u0026ndash;10.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.7(4.9\\u0026ndash;6.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMokhotlong\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2877(47.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25.8(24.2\\u0026ndash;27.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20.8(19.3\\u0026ndash;22.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.6(7.6\\u0026ndash;9.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eEducation\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNone\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e607(10.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e30.6(27.0-34.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25.5(22.1\\u0026ndash;29.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.2(10.5\\u0026ndash;15.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePrimary\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2817(46.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e23.4(21.8\\u0026ndash;24.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18.1(16.6\\u0026ndash;19.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.7(7.7\\u0026ndash;9.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSecondary\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2172(36.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e12.6(11.2\\u0026ndash;14.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.7(7.5\\u0026ndash;9.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.8(3.0-4.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eTertiary\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e442(7.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.2(13.7\\u0026ndash;20.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e12.7(9.6\\u0026ndash;15.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.5(2.6\\u0026ndash;6.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRefused to say\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1(0.02)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eMarital status\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSingle\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1325(21.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.6(7.1\\u0026ndash;10.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.5(5.2\\u0026ndash;7.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.6(1.7\\u0026ndash;3.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIn a committed relationship\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3529(58.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.1(17.8\\u0026ndash;20.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.8(12.7\\u0026ndash;14.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.7(5.9\\u0026ndash;7.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDivorced/separated/widowed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1181(19.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e34.2(31.5\\u0026ndash;36.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e28.4(25.8\\u0026ndash;30.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.2(11.3\\u0026ndash;15.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRefused to say\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eEmployment\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEmployed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3063(50.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.7(16.3\\u0026ndash;19.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.6 (12.4\\u0026ndash;14.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.1(5.3-7.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNot employed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2952(48.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e21.8(20.3\\u0026ndash;23.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.5(15.1\\u0026ndash;17.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.1(7.1\\u0026ndash;9.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e24(0.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eWealth index\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFirst quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1230(20.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18.1(16.0-20.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.3(12.4\\u0026ndash;16.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.8(5.4\\u0026ndash;8.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSecond quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1211(20.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e21.6(19.2\\u0026ndash;23.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.4(14.3\\u0026ndash;18.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.8(6.3\\u0026ndash;9.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eThird quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1220(20.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e21.4(19.1\\u0026ndash;23.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.1(14.1\\u0026ndash;18.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.8(6.3\\u0026ndash;9.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFourth quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1197(19.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.5(17.3\\u0026ndash;21.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.0(13.0-17.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.0(6.5\\u0026ndash;9.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFifth quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1164(19.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18.5(16.2\\u0026ndash;20.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.4(11.6\\u0026ndash;15.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.0(3.7\\u0026ndash;6.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17(0.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003ePhysically active*\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4180(69.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.9(15.7\\u0026ndash;18.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.3(12.2\\u0026ndash;14.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.2(5.4\\u0026ndash;6.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1851(30.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e26.4(24.4\\u0026ndash;28.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.1(17.3\\u0026ndash;20.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e9.2(7.9\\u0026ndash;10.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eSmoker\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e#\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1509(25.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e24.8(22.6\\u0026ndash;27.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.7(17.7\\u0026ndash;21.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e9.3(7.8\\u0026ndash;10.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4525(74.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18.1(17.0-19.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.5(12.5\\u0026ndash;14.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.4(5.7\\u0026ndash;7.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAlcohol\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e$\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1575(26.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20.4(18.5\\u0026ndash;22.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.5(14.7\\u0026ndash;18.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.8(6.5\\u0026ndash;9.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4464(73.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.5(18.4\\u0026ndash;20.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.5(13.5\\u0026ndash;15.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.8(6.1\\u0026ndash;7.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eFruits and vegetables consumption\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e\\u0026beta;\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e468(7.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.8(12.5\\u0026ndash;19.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10.9(8.1\\u0026ndash;13.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.7(5.3\\u0026ndash;10.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5563(92.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e20.1(19.1\\u0026ndash;21.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.4(14.5\\u0026ndash;16.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.0(6.4\\u0026ndash;7.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003c/table\\u003e\\n\\u003c/div\\u003e\\n\\u003cp\\u003eCI: confidence interval\\u003c/p\\u003e\\n\\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e\\n \\u003cp\\u003eIQR: interquartile range\\u003c/p\\u003e\\n \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section3\\\"\\u003e\\n \\u003cp\\u003eBMI: body mass index\\u003c/p\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e*\\u003c/strong\\u003e \\u003cem\\u003eat least 30 minutes of moderate to vigorous activity a minimum of five days a week\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e#\\u003c/strong\\u003e \\u003cem\\u003eany history of smoking\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e$\\u003c/strong\\u003e \\u003cem\\u003euse in the three months before study\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003e\\u0026beta;\\u003c/strong\\u003e \\u003cem\\u003eat least five servings weekly.\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003cdiv class=\\\"colspec\\\" align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/div\\u003e\\n \\u003cdiv class=\\\"colspec\\\" align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/div\\u003e\\n \\u003ctable id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003ePrevalence of unspecified pain, chronic pain and high-impact chronic pain, by clinical characteristics.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eVariable\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEnrolled\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eChronic pain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHigh-impact chronic pain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eN\\u0026thinsp;=\\u0026thinsp;6039\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e% (95% CI)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e% (95% CI)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e% (95% CI)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eArterial hypertension\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1302(21.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35.3(32.8\\u0026ndash;38.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e29.0(26.6\\u0026ndash;31.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.4(12.6\\u0026ndash;16.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4726(78.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e15.5(14.5\\u0026ndash;16.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11.2(10.3\\u0026ndash;12.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.1(4.5\\u0026ndash;5.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11(0.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDiabetes mellitus\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDiabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e257(4.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35.8(30.2\\u0026ndash;41.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e28.8(23.6\\u0026ndash;34.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e17.9(13.7\\u0026ndash;23.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePrediabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e36(0.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e36.1(22.3\\u0026ndash;52.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e30.6(17.8\\u0026ndash;47.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.7(7.5\\u0026ndash;33.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5210(86.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.1(18.9\\u0026ndash;20.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.3(13.4\\u0026ndash;15.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.6(6.0-7.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e536(8.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDepression (PHQ-9)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eModerate/high risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e98(1.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e48.0(38.3\\u0026ndash;57.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e39.8(30.6\\u0026ndash;49.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e32.7(24.0-42.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMinimal to low risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5930(98.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.3(18.3\\u0026ndash;20.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.6(13.7\\u0026ndash;15.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.7(6.1\\u0026ndash;7.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e11(0.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAnxiety (GAD-7)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eModerate/high risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e43(0.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e48.8(34.4\\u0026ndash;63.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e41.9(28.2\\u0026ndash;56.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e34.9(21.9\\u0026ndash;50.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMinimal to low risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5990(99.2)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.5(18.6\\u0026ndash;20.6)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.9(14.0-15.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.9(6.3\\u0026ndash;7.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eLiving with HIV\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e923(15.3)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e22.6(20.1\\u0026ndash;25.5)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e16.5(14.2\\u0026ndash;19.0)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.9(5.5\\u0026ndash;8.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eno\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5113(84.7)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e19.3(18.2\\u0026ndash;20.4)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e14.8(13.9\\u0026ndash;15.8)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.1(6.4\\u0026ndash;7.9)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMissing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3(0.1)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003c/table\\u003e\\n \\u003c/div\\u003e\\n \\u003cp\\u003eGAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus.\\u003c/p\\u003e\\n \\u003cp\\u003eFor all pain categories, the most common locations were the limbs, followed by the back (see Fig.\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e and S1 figure in the supplementary material).\\u003c/p\\u003e\\n \\u003cp\\u003eResults of univariate and multivariable logistic regression models for the pain categories are given in Table \\u003cspan class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e and Figs.\\u0026nbsp;\\u003cspan class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e to \\u003cspan class=\\\"InternalRef\\\"\\u003e6\\u003c/span\\u003e. Compared to participants 18\\u0026ndash;24 years old, older participants had higher odds of unspecified pain. Similarly, participants living in Mokhotlong district (adjusted odds ratio [aOR], 2.41; 95% CI: 2.07\\u0026ndash;2.81; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), who smoked (aOR, 1.41; 95% CI: 1.18\\u0026ndash;1.69; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), had hypertension (aOR, 1.41; 95% CI: 1.18\\u0026ndash;1.68; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), or were at high/moderate risk of depression (aOR, 2.98; 95% CI: 1.76\\u0026ndash;5.04; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), had higher odds of having unspecified pain. Conversely, participants who were male (aOR, 0.68; 95% CI: 0.56\\u0026ndash;0.82; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), or who were physically active (aOR, 0.64; 95% CI: 0.55\\u0026ndash;0.75; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001) were less likely to have unspecified pain.\\u003c/p\\u003e\\n \\u003cp\\u003eAs seen with unspecified pain, higher age groups were associated with higher odds of chronic pain. Living in Mokhotlong district (aOR, 2.78; 95% CI: 2.34\\u0026ndash;3.30; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), smoking (aOR, 1.33; 95% CI: 1.07\\u0026ndash;1.64; p\\u0026thinsp;=\\u0026thinsp;0.008), hypertension (aOR, 1.53; 95% CI: 1.26\\u0026ndash;1.85; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), and moderate to high risk of depression (aOR, 2.74; 95% CI: 1.52\\u0026ndash;4.79; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), were associated with higher odds of chronic pain. Physically active participants (aOR, 0.82; 95% CI: 0.69\\u0026ndash;0.98; p\\u0026thinsp;=\\u0026thinsp;0.0252), were less likely to have chronic pain.\\u003c/p\\u003e\\n \\u003cp\\u003eLike unspecified pain and chronic pain, older participants were more likely to experience high-impact chronic pain. Also, participants living in Mokhotlong district had higher odds of high-impact chronic pain (aOR, 1.53; 95% CI: 1.22\\u0026ndash;1,91; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). Compared to the fifth (highest) wealth quintile, other wealth quintiles had higher odds of high-impact chronic pain. Hypertension (aOR, 1.47; 95% CI: 1.14\\u0026ndash;1.90; p\\u0026thinsp;=\\u0026thinsp;0.003), diabetes mellitus (aOR, 1.86; 95% CI: 1.27\\u0026ndash;2.74; p\\u0026thinsp;=\\u0026thinsp;0.002), moderate to high risk of depression (aOR, 4.93; 95% CI: 2.75\\u0026ndash;8.86; p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001), and moderate to high risk of generalized anxiety disorder (aOR, 2.85; 95% CI: 1.18\\u0026ndash;6.92; p\\u0026thinsp;=\\u0026thinsp;0.023), were associated with higher odds of high-impact chronic pain.\\u003c/p\\u003e\\n \\u003cp\\u003e\\u0026nbsp;\\u003c/p\\u003e\\n \\u003cdiv class=\\\"gridtable\\\"\\u003e\\n \\u003ctable id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e\\n \\u003ccaption\\u003e\\n \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\n \\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\n \\u003cp\\u003eUnivariate logistic regression models for unspecified pain, chronic pain, and high-impact chronic pain.\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth rowspan=\\\"2\\\" align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eVariable\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth colspan=\\\"2\\\" align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth colspan=\\\"2\\\" align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eChronic pain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth colspan=\\\"2\\\" align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eHigh-impact chronic pain\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOR (CI)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOR (CI)\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eOR (CI\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eP\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAge, years, n(%)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e18\\u0026ndash;24\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e25\\u0026ndash;34\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.70\\u003c/p\\u003e\\n \\u003cp\\u003e(1.27\\u0026ndash;2.27)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.90(1.32\\u0026ndash;2.74)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.97(1.13\\u0026ndash;3.45)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.017\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e35\\u0026ndash;44\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.55(1.91\\u0026ndash;3.41)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.89(2.02\\u0026ndash;4.15)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.43(1.99\\u0026ndash;5.91)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e45\\u0026ndash;54\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.09(3.07\\u0026ndash;5.45)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.84(3.40\\u0026ndash;6.90)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.55(2.64\\u0026ndash;7.84)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e55\\u0026ndash;64\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.21(4.69\\u0026ndash;8.23)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.00(5.68\\u0026ndash;11.27)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e8.54(5.09\\u0026ndash;14.32)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026ge;\\u0026thinsp;65\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e10.46(8.04\\u0026ndash;13.62)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.58(9.82\\u0026ndash;18.79)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e13.70(8.37\\u0026ndash;22.42)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eSex\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFemale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMale\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.71(0.62\\u0026ndash;0.80)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n 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\\u003cp\\u003e\\u003cstrong\\u003eMarital status\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSingle\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eIn a committed relationship\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.5(2.04\\u0026ndash;3.10)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.31(1.82\\u0026ndash;2.93)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.73(1.90\\u0026ndash;3.94)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDivorced/separated/widowed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.52(4.40\\u0026ndash;6.93)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.70(4.43\\u0026ndash;7.34)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e5.78(3.40\\u0026ndash;8.45)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eEmployment\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eEmployed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNot employed\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.30(1.15\\u0026ndash;1.48)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.25(1.09\\u0026ndash;1.44)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.002\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.36(1.12\\u0026ndash;1.66)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.002\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eWealth index\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFirst quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.98(0.79\\u0026ndash;1.20)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.829\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.06(0.84\\u0026ndash;1.34)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.604\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.40(0.99\\u0026ndash;1.97)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.057\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eSecond quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.21(0.99\\u0026ndash;1.48)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.061\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.24(0.99\\u0026ndash;1.56)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.058\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.62(1.16\\u0026ndash;2.27)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.005\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eThird quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.20(0.98\\u0026ndash;1.47)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.075\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.23(0.98\\u0026ndash;1.54)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.078\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.61(1.15\\u0026ndash;2.26)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.006\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFourth quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.07(0.87\\u0026ndash;1.32)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.505\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.13(0.89\\u0026ndash;1.42)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.310\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.66(1.19\\u0026ndash;2.33)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.003\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eFifth quintile\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003ePhysically active*\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.57(0.50\\u0026ndash;0.64)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.65(0.56\\u0026ndash;0.75)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.65(0.53\\u0026ndash;0.80)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eSmoker\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e#\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.49(1.30\\u0026ndash;1.71)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.58(1.35\\u0026ndash;1.84)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.50(1.22\\u0026ndash;1.86)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAlcohol\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e$\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.06(0.92\\u0026ndash;1.22)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.435\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.16(0.99\\u0026ndash;1.36)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.060\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.16(0.93\\u0026ndash;1.44)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.194\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eFruits and vegetables\\u003c/strong\\u003e\\u003csup\\u003e\\u003cstrong\\u003e\\u0026beta;\\u003c/strong\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.75(0.58\\u0026ndash;0.96)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.025\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.67(0.50\\u0026ndash;0.91)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.009\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.10(0.77\\u0026ndash;1.57)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.601\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eArterial hypertension\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.99(2.60\\u0026ndash;3.43)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.23(2.78\\u0026ndash;3.75)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.15(2.57\\u0026ndash;3.85)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDiabetes mellitus\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eDiabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.36(1.82\\u0026ndash;3.08)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.43(1.83\\u0026ndash;3.21)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.07(2.19\\u0026ndash;4.31)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003ePrediabetes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.40(1.21\\u0026ndash;4.75)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.012\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.64(1.29\\u0026ndash;5.39)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.008\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e2.82(1.17\\u0026ndash;6.82)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.021\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eDepression (PHQ-9)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMinimal to low risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eModerate/high risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.86(2.58\\u0026ndash;5.76)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.86(2.56\\u0026ndash;5.82)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e6.79(4.40-10.49)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eAnxiety (GAD-7)\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eMinimal to low risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eModerate/high risk\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e3.93(2.15\\u0026ndash;7.17)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e4.13(2.24\\u0026ndash;7.59)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e7.25(3.84\\u0026ndash;13.69)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e\\u003cstrong\\u003eLiving with HIV\\u003c/strong\\u003e\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eNo\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eRef\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e-\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003eYes\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.23(1.04\\u0026ndash;1.45)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.018\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e1.13(0.94\\u0026ndash;1.37)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.194\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.97(0.74\\u0026ndash;1.28)\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\"\\u003e\\n \\u003cp\\u003e0.840\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n \\u003c/table\\u003e\\n \\u003c/div\\u003e\\n \\u003cp\\u003e\\u003cem\\u003eCI: confidence interval; IQR: interquartile range; BMI: body mass index; Ref: reference group;\\u003c/em\\u003e \\u003cstrong\\u003e*\\u003c/strong\\u003e \\u003cem\\u003eat least 30 minutes of moderate to vigorous activity a minimum of five days a week;\\u003c/em\\u003e \\u003cstrong\\u003e#\\u003c/strong\\u003e \\u003cem\\u003eany history of smoking;\\u003c/em\\u003e \\u003cstrong\\u003e$\\u003c/strong\\u003e \\u003cem\\u003euse in the three months before study;\\u003c/em\\u003e \\u003cstrong\\u003e\\u0026beta;\\u003c/strong\\u003e \\u003cem\\u003eat least five servings weekly. GAD-7: generalized anxiety disorder questionnaire; PHQ-9: patient health questionnaire; HIV: human immune deficiency virus.\\u003c/em\\u003e\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n\\u003c/div\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis population-based survey assessed the prevalence of unspecified pain, chronic pain and high-impact chronic pain in the general population in Lesotho. It is the first to evaluate high-impact chronic pain in Africa. The prevalence of unspecified pain, chronic pain and high-impact chronic pain were 19.8%, 15.1%, and 7.1% respectively. Unspecified pain and chronic pain were associated with increasing age, living in the more mountainous Mokhotlong district, smoking, hypertension and moderate to high risk of depression. In addition to its association with increasing age, high-impact chronic pain was also associated with hypertension, diabetes mellitus, moderate to high risk of depression, and moderate to high risk of generalized anxiety disorder. Furthermore, participants from lower wealth quintiles were more likely to have high-impact chronic pain compared to those in the highest wealth quintile. Our findings indicate that a fifth of adults in the study area experience pain disorder. Almost half of those with chronic pain have high-impact chronic pain.\\u003c/p\\u003e \\u003cp\\u003eRecent data on unspecified pain within Africa are scant. However, a global prevalence of pain study across 52 countries using data from the World Health Survey 2002 to 2004 presents prevalence figures in 14 countries from Africa including South Africa, Zambia, Namibia, Zimbabwe and Malawi.\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u003c/sup\\u003e This study found an average unspecified pain prevalence of 28% among included African countries, with a range of 25\\u0026ndash;37%.\\u003csup\\u003e3\\u003c/sup\\u003e Reasons that explain the lower prevalence of unspecified pain in our study compared to that in the global prevalence of pain study include that the latter study consisted of an older population, who were mostly female and who predominantly lived in rural areas- factors associated with higher prevalence of pain.\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e39\\u003c/span\\u003e\\u003c/sup\\u003e Nonetheless, the chronic pain prevalence of 15.1% in our study is similar to the 18% pooled prevalence of chronic pain from several low- and middle-income countries\\u003csup\\u003e\\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e40\\u003c/span\\u003e\\u003c/sup\\u003e. A study conducted in neighboring South Africa reports a chronic pain prevalence of 18%\\u003csup\\u003e28\\u003c/sup\\u003e. Interestingly, the South African study also displays prevalence figures for the country\\u0026rsquo;s regions, and Free State and KwaZulu-Natal, the proximal provinces to our study area had 12% and 13% chronic pain prevalence respectively\\u003csup\\u003e\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u003c/sup\\u003e. In our study, we found the prevalence of high-impact chronic pain to be 7.1%. There are no studies in Africa on high impact chronic pain with which to compare this finding. However, our results are consistent with the 6.9\\u0026ndash;8% of adults with high-impact chronic pain in the United States\\u003csup\\u003e\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR41\\\" class=\\\"CitationRef\\\"\\u003e41\\u003c/span\\u003e\\u003c/sup\\u003e, and 7.8% in the United Kingdom\\u003csup\\u003e\\u003cspan citationid=\\\"CR42\\\" class=\\\"CitationRef\\\"\\u003e42\\u003c/span\\u003e\\u003c/sup\\u003e. In Saudi Arabia, high-impact chronic pain was found to affect 4% of the adult population.\\u003csup\\u003e\\u003cspan citationid=\\\"CR43\\\" class=\\\"CitationRef\\\"\\u003e43\\u003c/span\\u003e\\u003c/sup\\u003e This low figure may be due to differences in the operationalized definition of high-impact chronic pain applied in the Saudi Arabian study.\\u003c/p\\u003e \\u003cp\\u003eThe most common pain locations for all pain categories were the limbs and the back. This is consistent with other studies.\\u003csup\\u003e\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e\\u003c/sup\\u003e We found that the odds of experiencing unspecified pain and chronic pain were higher with increasing age, among females, and among those living in the mountainous Mokhotlong region, similar to results from other studies.\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e,\\u003cspan additionalcitationids=\\\"CR46\\\" citationid=\\\"CR45\\\" class=\\\"CitationRef\\\"\\u003e45\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR47\\\" class=\\\"CitationRef\\\"\\u003e47\\u003c/span\\u003e\\u003c/sup\\u003e In the current study, physically active participants were less likely to have unspecified pain and chronic pain, whereas smoking was associated with higher odds of pain. Regular physical activity prevents pain\\u003csup\\u003e\\u003cspan citationid=\\\"CR48\\\" class=\\\"CitationRef\\\"\\u003e48\\u003c/span\\u003e\\u003c/sup\\u003e, and a systematic review has shown evidence of an exercise program reducing the risk of pain.\\u003csup\\u003e\\u003cspan citationid=\\\"CR49\\\" class=\\\"CitationRef\\\"\\u003e49\\u003c/span\\u003e\\u003c/sup\\u003e Indeed, several guidelines advocate physical activity as an effective intervention to reduce pain\\u003csup\\u003e\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e\\u003c/sup\\u003e. Conversely, the relationship between pain and smoking is thought to be bidirectional with smoking increasing the risk of pain, and sufferers in turn relying on smoking as a coping mechanism\\u003csup\\u003e\\u003cspan citationid=\\\"CR50\\\" class=\\\"CitationRef\\\"\\u003e50\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR51\\\" class=\\\"CitationRef\\\"\\u003e51\\u003c/span\\u003e\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eHigh-impact chronic pain was higher among those in lower wealth index quintiles compared to the highest wealth index quintile. In their recent study, Weissman et. al. report similar findings in the United States of America where poorer participants, unable to afford the cost of medical care, had higher odds of high-impact chronic pain\\u003csup\\u003e\\u003cspan citationid=\\\"CR52\\\" class=\\\"CitationRef\\\"\\u003e52\\u003c/span\\u003e\\u003c/sup\\u003e. Several other studies have shown identical findings suggesting that higher odds of pain in low wealth groups could be due to poor access to health care.\\u003csup\\u003e\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e\\u003c/sup\\u003e\\u003c/p\\u003e \\u003cp\\u003eA further interesting finding in our study is the number of comorbidities among participants with high-impact chronic pain where sufferers had higher likelihood of hypertension, diabetes mellitus, and higher risks of depression and anxiety disorder. Although mechanisms underlying this are not yet fully understood, other studies similarly reported multimorbidity among people experiencing high-impact chronic pain.\\u003csup\\u003e\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR53\\\" class=\\\"CitationRef\\\"\\u003e53\\u003c/span\\u003e,\\u003cspan citationid=\\\"CR54\\\" class=\\\"CitationRef\\\"\\u003e54\\u003c/span\\u003e\\u003c/sup\\u003e Multidisciplinary and multimodal approaches are required within pain medicine\\u003csup\\u003e\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e\\u003c/sup\\u003e, and appropriate pain classifications ensure that available resources are efficiently deployed for diagnosis, workup and treatment\\u003csup\\u003e\\u003cspan citationid=\\\"CR55\\\" class=\\\"CitationRef\\\"\\u003e55\\u003c/span\\u003e\\u003c/sup\\u003e. The effort to separate high-impact chronic pain from chronic pain without activity limitation/participation restriction represents such a classification attempt aimed at improving efficiency in pain management. Our study helps solve the need for more data within the African region to adequately characterize the pain burden within the general population and will be useful to stakeholders within pain medicine in the region.\\u003c/p\\u003e \\u003cp\\u003eImportant strengths in our study are the large sample size, a systematic sampling of the study population, and a high response rate of participants. Additionally, it is the first study in Africa to produce estimates on high-impact chronic pain. This study has several limitations. First, due to the cross-sectional nature of the survey, causality could not be established. As the presence of pain was self-reported, there is a potential for recall bias especially regarding unspecified pain. Furthermore, in grading the level of pain interference, mild interference and moderate interference were sometimes difficult to define, and participants occasionally could not distinguish routine activities from crucial activities.\\u003c/p\\u003e \\u003cp\\u003eTo conclude, we conducted a study to determine the prevalence of unspecified pain, chronic pain and high-impact chronic pain in a general population in Lesotho, and to assess their determinants. We found associations with increasing age, location, smoking, elevated blood pressure, moderate to high risk of depression, diabetes mellitus, and moderate to high risk of generalized anxiety disorder. Participants with high-impact chronic pain had the highest prevalence of co-morbidities. Furthermore, participants from less wealthier households had higher chances of having high-impact chronic pain compared to participants in the highest wealth quintile. These findings may encourage health systems in Lesotho and similar settings to integrate pain management into chronic care provision.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\" \\u003cp\\u003e \\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e \\u003cp\\u003eNot applicable, included in consent to participate in survey.\\u003c/p\\u003e \\u003c/p\\u003e\\u003cp\\u003e \\u003ch2\\u003eCompeting interests\\u003c/h2\\u003e \\u003cp\\u003eThe authors declare no conflicts of interest.\\u003c/p\\u003e \\u003c/p\\u003e\\u003ch2\\u003eFunding\\u003c/h2\\u003e \\u003cp\\u003eThis study is part of the ComBaCaL project. The project is funded by the TRANSFORM grant of the Swiss Agency for Development and Cooperation (project number 7F-10345.01.01) and a grant by the World Diabetes Foundation (WDF-1778). NDL and AA are the Co-Principal investigators of ComBaCaL. EF received his salary from the European Union\\u0026rsquo;s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement (No 801076), through the SSPH\\u0026thinsp;+\\u0026thinsp;Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS). Druing conduction of the study, NDL received his salary from the Swiss National Science Foundation (SNSF Eccellenza PCEFP3_181355); AA receives his salary from the postdoc mobility grant of the Swiss National Science Foundation (#P500PM_221961).\\u003c/p\\u003e\\u003ch2\\u003eAuthors\\u0026rsquo; Contributions\\u003c/h2\\u003e \\u003cp\\u003eEF, LG, RG, AA and NDL conceptualized the study. EF, MM, MPS, MB, MK conducted the field work.TL oversaw routine data quality checks. EF performed the statistical analysis with support from TL and FC. SMC and MW provided important clinical, technical, and intellectual input. EF drafted the first version of the manuscript with input from NDL. NDL and AA acquired the funding. All authors reviewed the manuscript and approved the final version.\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgments\\u003c/h2\\u003e \\u003cp\\u003e The authors would like to thank all the involved staff at the Ministry of Health in Lesotho, the SolidarMed team in Lesotho, the extended ComBaCaL survey team, and all the participants in this study.\\u003c/p\\u003e\\u003ch2\\u003eAvailability of data and materials\\u003c/h2\\u003e \\u003cp\\u003eThe key datasets used and analysed in this study will be made available in a public repository (Zenodo).\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eMohanty SK, Ambade M, Upadhyay AK et al (2023) Prevalence of pain and its treatment among older adults in India: a nationally representative population-based study. Pain 164(2):336\\u0026ndash;348\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBlyth FM, Huckel Schneider C (2018) Global burden of pain and global pain policy-creating a purposeful body of evidence. Pain 159(Suppl 1):S43\\u0026ndash;s8\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZimmer Z, Fraser K, Grol-Prokopczyk H, Zajacova A (2022) A global study of pain prevalence across 52 countries: examining the role of country-level contextual factors. Pain 163(9):1740\\u0026ndash;1750\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHaagsma JA, Graetz N, Bolliger I et al (2016) The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev 22(1):3\\u0026ndash;18\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTreede RD, Rief W, Barke A et al (2019) Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 160(1):19\\u0026ndash;27\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBreivik H, Collett B, Ventafridda V, Cohen R, Gallacher D (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10(4):287\\u0026ndash;333\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAndrew R, Derry S, Taylor RS, Straube S, Phillips CJ (2014) The costs and consequences of adequately managed chronic non-cancer pain and chronic neuropathic pain. Pain Pract 14(1):79\\u0026ndash;94\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGoldberg DS, McGee SJ (2011) Pain as a global public health priority. BMC Public Health 11(1):1\\u0026ndash;5\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMills S, Torrance N, Smith BH (2016) Identification and Management of Chronic Pain in Primary Care: a Review. Curr Psychiatry Rep 18(2):22\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eM\\u0026auml;ntyselk\\u0026auml; P, Kumpusalo E, Ahonen R et al (2001) Pain as a reason to visit the doctor: a study in Finnish primary health care. \\u003cem\\u003ePain\\u003c/em\\u003e ; 89(2\\u0026ndash;3): 175\\u0026thinsp;\\u0026ndash;\\u0026thinsp;80\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSchappert SM, Burt CW (2006) Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. 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BMJ open 6(6):e010364\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAlmalki MT, BinBaz SS, Alamri SS et al (2019) Prevalence of chronic pain and high-impact chronic pain in Saudi Arabia. Saudi Med J 40(12):1256\\u0026ndash;1266\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYong RJ, Mullins PM, Bhattacharyya N (2022) Prevalence of chronic pain among adults in the United States. Pain 163(2):e328\\u0026ndash;e32\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCoggon D, Ntani G, Palmer KT et al (2013) Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture? \\u003cem\\u003ePain\\u003c/em\\u003e ; 154(6): 856\\u0026thinsp;\\u0026ndash;\\u0026thinsp;63\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJackson T, Thomas S, Stabile V, Shotwell M, Han X, McQueen K (2016) A Systematic Review and Meta-Analysis of the Global Burden of Chronic Pain Without Clear Etiology in Low- and Middle-Income Countries: Trends in Heterogeneous Data and a Proposal for New Assessment Methods. Anesth Analg 123(3):739\\u0026ndash;748\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMansfield KE, Sim J, Jordan JL, Jordan KP (2016) A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain 157(1):55\\u0026ndash;64\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT (2012) Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 380(9838):219\\u0026ndash;229\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ede Campos TF, Maher CG, Steffens D, Fuller JT, Hancock MJ (2018) Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother 64(3):159\\u0026ndash;165\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBakhshaie J, Ditre JW, Langdon KJ, Asmundson GJ, Paulus DJ, Zvolensky MJ (2016) Pain intensity and smoking behavior among treatment seeking smokers. Psychiatry Res 237:67\\u0026ndash;71\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCroghan IT, Hurt RT, Ganesh R et al (2021) The Association of Current Tobacco Status With Pain and Symptom Severity in Fibromyalgia Patients. Mayo Clin Proc Innov Qual Outcomes 5(3):614\\u0026ndash;624\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWeissman JD, Russell D, Taylor J (2023) The Relationship Between Financial Stressors, Chronic Pain, and High-Impact Chronic Pain: Findings From the 2019 National Health Interview Survey. Public Health Rep 138(3):438\\u0026ndash;446\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCook CE, George SZ, Lentz T et al (2022) High-Impact Chronic Pain Transition in Lumbar Surgery Recipients. Pain Med 24(3):258\\u0026ndash;268\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGeorge SZ, Bolognesi MP, Bhavsar NA, Penrose CT, Horn ME (2022) Chronic Pain Prevalence and Factors Associated With High Impact Chronic Pain following Total Joint Arthroplasty: An Observational Study. J Pain 23(3):450\\u0026ndash;458\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBonezzi C, Fornasari D, Cricelli C, Magni A, Ventriglia G (2020) Not All Pain is Created Equal: Basic Definitions and Diagnostic Work-Up. Pain Ther 9(Suppl 1):1\\u0026ndash;15\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":true,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"University Hospital Basel/University of Basel\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Chronic pain, High-impact chronic pain, Lesotho\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-5819163/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-5819163/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cstrong\\u003eBackground\\u003c/strong\\u003e. Pain and its associated disorders are among the most common causes of disability and contributors to healthcare costs globally. Pain is understudied in Africa and there are no data on high-impact chronic pain from this region. In a population-based survey in Lesotho, Southern Africa, we assessed the prevalence of unspecified pain, chronic pain and high-impact chronic pain, and their determinants.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMethod\\u003c/strong\\u003e. We conducted a household-based, cross-sectional survey among adults ≥18 years old in 120 randomly sampled villages across Butha Buthe and Mokhotlong districts in Lesotho. Unspecified pain, chronic pain, and high-impact chronic pain were defined as current or recurrent pain regardless of duration; pain on most days of the week lasting for 3 or more months; and chronic pain with restriction of routine activities, respectively.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eResult\\u003c/strong\\u003e. Among the 6039 adults included, the median age was 39 years (interquartile range: 27-58), 3153/6039 (52.2%) were female. Overall, 1194 (19.8%) had unspecified pain (95% confidence interval [CI]: 18.8 – 20.8); 909 (15.1%) had chronic pain (95% CI: 14.2 – 16.0); and 428 (7.1%) had high-impact chronic pain (95% CI: 6.5 – 7.8) corresponding to 47.1% among the participants with chronic pain. Higher age groups were associated with increasing odds of unspecified pain, chronic pain and high-impact chronic pain. Male participants were less likely to have unspecified pain (adjusted odds ratio [aOR], 0.68; 95% CI: 0.56 – 0.82; p \\u0026lt; 0.001). There was no association between sex and chronic pain or high-impact chronic pain. Participants living in less wealthy households had higher odds of high-impact chronic pain. Furthermore, high-impact chronic pain was associated with hypertension (aOR, 1.47; 95% CI: 1.14 – 1.90; p = 0.003), diabetes mellitus (aOR, 1.86; 95% CI: 1.27 – 2.74; p = 0.002), moderate to high risk of depression (aOR, 4.93; 95% CI: 2.75 – 8.86; p \\u0026lt; 0.001), and moderate to high risk of generalized anxiety disorder (aOR, 2.85; 95% CI: 1.18 – 6.92; p = 0.023).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConclusion\\u003c/strong\\u003e. Prevalence of chronic pain, including high impact chronic pain was high in this population-based survey in Lesotho. Its association with further non-communicable chronic conditions, such as hypertension and diabetes, supports the need for health systems to provide integrated chronic care, including the management of chronic pain.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Unspecified Pain, Chronic Pain and High-Impact Chronic Pain in Lesotho, Southern Africa: a Population-based Cross-sectional study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-01-15 12:12:17\",\"doi\":\"10.21203/rs.3.rs-5819163/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"98661b7d-f4cc-4ca4-93e1-cf7980777633\",\"owner\":[],\"postedDate\":\"January 15th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":42783839,\"name\":\"Epidemiology\"},{\"id\":42783840,\"name\":\"Anesthesiology \\u0026 Pain Medicine\"}],\"tags\":[],\"updatedAt\":\"2025-01-15T12:12:17+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-01-15 12:12:17\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-5819163\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-5819163\",\"identity\":\"rs-5819163\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}