Health surveillance for South African Para athletes: an 88-week prospective study in a resource-limited setting

Longitudinal health monitoring studies including Para athletes are lacking in low- and middle-income countries (LMICs). This study aimed to introduce a surveillance programme developed for Swedish Para athletes to high-level South African Para athletes and describe their self-reported health outcomes. Using a prospective cohort design, we distributed weekly electronic surveys to Para athletes for 88 weeks. These included questions relating to training (e.g., volume, intensity), health (e.g., pain, injury, illness, symptoms of anxiety or depression) and lifestyle (e.g., diet, sleep). Of 28 recruited athletes, 21 responded to ≥1 survey (13 males and 8 females; 42.6% response rate). During an average week, 48% of athletes experienced mild-to-severe pain, 25% reported a new or ongoing injury or illness, 67% slept less than eight hours per night, and 20% reported symptoms of anxiety or depression. The overall injury incidence was 3.1 per 1000 hours. Longitudinal health monitoring is challenging in LMICs and each setting's unique barriers and facilitators must be explored and acknowledged if such programmes are to be sustained. Our data suggest that pain, injuries, illnesses and symptoms of anxiety or depression are common among high-level South African Para athletes and efforts should be made to manage these.