{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:17:50Z","timestamp":1785424670873,"version":"3.56.0"},"reference-count":35,"publisher":"AOSIS","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Low back pain (LBP) is increasingly reported among school-aged children, a population vulnerable to musculoskeletal strain as a result of growth-related changes, developing spinal structures and school demands such as heavy backpacks and prolonged sitting. Although international evidence highlights these risk factors, data from African contexts, particularly Botswana, remain limited.\nAim: This study investigated associations between school backpack loading, sitting time and the prevalence and intensity of LBP among 10\u201312-year-old schoolchildren.\nSetting: Primary schools in Gaborone, Botswana.\nMethods: A cross-sectional study was conducted among 521 children (46% boys; mean age = 11.1 \u00b1 0.7 years). Backpack and body mass were measured using calibrated scales, and sitting time was self-reported using the International Physical Activity Questionnaire \u2013 Short Form (IPAQ-SF). Low back pain frequency and intensity were assessed using the Young Spine Questionnaire (YSQ). Chi-square tests examined associations between LBP outcomes and independent variables, and Cram\u00e9r\u2019s V interpreted effect sizes.\nResults: Approximately 43% carried backpacks exceeding 10% of body mass; 34% reported frequent LBP and 14% moderate-to-severe intensity. Heavier loads were weakly but significantly associated with more frequent LBP (\u03c72 = 4.05; p = 0.044; \u03a6 = 0.09). No associations were found with sitting time, age or sex.\nConclusion: Heavier backpack loads were associated with higher LBP frequency among Gaborone schoolchildren, although the effect size was small. These findings highlight the importance of addressing modifiable ergonomic factors, particularly load management, in school health strategies.\nContribution: This study highlights modifiable ergonomic risk factors for LBP in Botswana and supports the inclusion of load management and posture education in school health programmes.<\/jats:p>","DOI":"10.4102\/hsag.v31i0.3415","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:47:59Z","timestamp":1779691679000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between school backpack loading, sitting time and low back pain among schoolchildren in Gaborone, Botswana"],"prefix":"10.4102","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4229-0520","authenticated-orcid":false,"given":"Ngonidzaishe B.","family":"Mudiwa","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/010f1sq29","id-type":"ROR","asserted-by":"publisher"}],"name":"North-West University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4038-9466","authenticated-orcid":false,"given":"Mariette","family":"Swanepoel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/010f1sq29","id-type":"ROR","asserted-by":"publisher"}],"name":"North-West University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3225-7949","authenticated-orcid":false,"given":"Terry J.","family":"Ellapen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/037mrss42","id-type":"ROR","asserted-by":"publisher"}],"name":"Tshwane University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Acar, M., Erdil, Y. & Ozcan, C., 2023, \u2018Computer-aided ergonomic analysis of primary school furniture dimensions\u2019, Ergonomics 68(1), 1\u201318. https:\/\/doi.org\/10.1080\/00140139.2023.2286909","DOI":"10.1080\/00140139.2023.2286909"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Adeyemi, A.J., Rohani, J.M. & Rani, M.R.A., 2017, \u2018Backpack-back pain complexity and the need for multifactorial safe weight recommendation\u2019, Applied Ergonomics 58, 573\u2013582. https:\/\/doi.org\/10.1016\/j.apergo.2016.04.009","DOI":"10.1016\/j.apergo.2016.04.009"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Akbar, F., AlBesharah, M., Al-Baghli, J., Bulbul, F., Mohammad, D., Qadoura, B. et al., 2019, \u2018Prevalence of low back pain among adolescents in relation to the weight of school bags\u2019, BMC Musculoskeletal Disorders 20(1), 37. https:\/\/doi.org\/10.1186\/s12891-019-2398-2","DOI":"10.1186\/s12891-019-2398-2"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Ambrosio, L., Mazzuca, G., Maguolo, A., Russo, F., Cannata, F., Vadal\u00e0, G. et al., 2023, \u2018The burden of low back pain in children and adolescents with overweight and obesity: From pathophysiology to prevention and treatment strategies\u2019, Therapeutic Advances in Musculoskeletal Disease 15, 1\u201312. https:\/\/doi.org\/10.1177\/1759720X231188831","DOI":"10.1177\/1759720X231188831"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Arundell, L., Salmon, J., Koorts, H., Contardo Ayala, A.M. & Timperio, A., 2019, \u2018Exploring when and how adolescents sit: Cross-sectional analysis of activPAL-measured patterns of daily sitting time, bouts and breaks\u2019, BMC Public Health 19(1), 653. https:\/\/doi.org\/10.1186\/s12889-019-6960-5","DOI":"10.1186\/s12889-019-6960-5"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Brackley, H.M. & Stevenson, J.M., 2004, \u2018Are children\u2019s backpack weight limits enough? 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A systematic review with meta-analysis\u2019, British Journal of Sports Medicine 59, 409\u2013422. https:\/\/doi.org\/10.1136\/bjsports-2024-108648","DOI":"10.1136\/bjsports-2024-108648"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Mwaka, E.S., Munabi, I.G., Buwembo, W., Kukkiriza, J. & Ochieng, J., 2014, \u2018Musculoskeletal pain and school bag use: A cross-sectional study among Ugandan pupils\u2019, BMC Research Notes 7(1), 222. https:\/\/doi.org\/10.1186\/1756-0500-7-222","DOI":"10.1186\/1756-0500-7-222"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Noll, M., Candotti, C.T., Da Rosa, B.N. & Loss, J.F., 2016, \u2018Back pain prevalence and associated factors in children and adolescents: An epidemiological population study\u2019, Revista de Sa\u00fade P\u00fablica 50, 31. https:\/\/doi.org\/10.1590\/S1518-8787.2016050006175","DOI":"10.1590\/S1518-8787.2016050006175"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Puckree, T., Silal, S.P. & Lin, J., 2004, \u2018School bag carriage and pain in school children\u2019, Disability and Rehabilitation 26(1), 54\u201359. https:\/\/doi.org\/10.1080\/09638280310001616376","DOI":"10.1080\/09638280310001616376"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Ridgers, N.D., Timperio, A., Cerin, E. & Salmon, J., 2015, \u2018Within- and between-day associations between children\u2019s sitting and physical activity time\u2019, BMC Public Health 15(1), 950. https:\/\/doi.org\/10.1186\/s12889-015-2291-3","DOI":"10.1186\/s12889-015-2291-3"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Sankaran, S., John, J., Patra, S.S., Das, R.R. & Satapathy, A.K., 2021, \u2018Prevalence of musculoskeletal pain and its relation with weight of backpacks in school-going children in eastern India\u2019, Frontiers in Pain Research 2, 684133. https:\/\/doi.org\/10.3389\/fpain.2021.684133","DOI":"10.3389\/fpain.2021.684133"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Spiteri, K., Busuttil, M.-L., Aquilina, S., Gauci, D., Camilleri, E. & Grech, V., 2017, \u2018Schoolbags and back pain in children between 8 and 13 years: A national study\u2019, British Journal of Pain 11(2), 81\u201386. https:\/\/doi.org\/10.1177\/2049463717695144","DOI":"10.1177\/2049463717695144"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Tomal, P., Fryzowicz, A., Skorupska, E. & Dworak, L., 2022, \u2018Influence of school backpack load as a variable affecting gait kinematics among seven-year-old children\u2019, International Journal of Environmental Research and Public Health 19(7), 3843. https:\/\/doi.org\/10.3390\/ijerph19073843","DOI":"10.3390\/ijerph19073843"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Wirth, B., Knecht, C. & Humphreys, K., 2013, \u2018Spinal pain in Swiss school children: Epidemiology and risk factors\u2019, BMC Pediatrics 13, 159. https:\/\/doi.org\/10.1186\/1471-2431-13-159","DOI":"10.1186\/1471-2431-13-159"}],"container-title":["Health SA Gesondheid"],"original-title":[],"link":[{"URL":"https:\/\/hsag.co.za\/index.php\/hsag\/article\/view\/3415\/6965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:48:07Z","timestamp":1779691687000},"score":1,"resource":{"primary":{"URL":"https:\/\/hsag.co.za\/index.php\/hsag\/article\/view\/3415"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":35,"URL":"https:\/\/doi.org\/10.4102\/hsag.v31i0.3415","relation":{},"ISSN":["1025-9848","2071-9736"],"issn-type":[{"value":"1025-9848","type":"print"},{"value":"2071-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"article-number":"a3415"}}