Estimating the Economic Impact of Musculoskeletal Disorders in Tanzania: Results from a Community-Based Survey

Background Musculoskeletal (MSK) disorders are a leading cause of disability globally, causing significant clinical and quality of life impacts, absence from work, reduced productivity and substantial personal medical costs. The aim of this study was to identify, measure and value the economic burden of MSK disorders in the Kilimanjaro region, Tanzania. Methods A community-based cross-sectional survey was undertaken between January and September 2021 using two-stage cluster sampling to select a representative sample of all Hai district residents. Clinical screening tools were used to identify and measure MSK disorders through a tiered approach. An economic questionnaire measuring healthcare costs, out-of-pocket costs, absenteeism, presenteeism and work productivity loss was administered to those with likely MSK disorders, and selected controls (individuals without MSK disorders, matched on age and gender). Resource use was valued using country-specific costs. Two-part model regressions were fitted. A descriptive analysis of catastrophic expenditure was also conducted. Results Annual average productivity and healthcare costs were, respectively, 3·5 and 2·5 times higher for those with likely MSK disorders than controls (productivity costs: Int$ 509 vs. Int$, 151 p-value<0.01; healthcare costs: Int$437 vs. Int $ 177, p-value<0.05). The difference in terms of out-of-pocket expenses was economically substantial in magnitude (Int$483 vs. 343), although not statistically significant. Conclusion The evidence will be used to inform policies addressing MSK disorders, by promoting the design of interventions, service provision, health promotion and awareness activities at local, regional and national level