Skip to main content
Erschienen in:

13.08.2022 | Original Article

Incidence and number of fragility fractures of the hip in South Africa: estimated projections from 2020 to 2050

verfasst von: Samuel Hawley, Sapna Dela, Anya Burton, Farhanah Paruk, Bilkish Cassim, Celia L. Gregson

Erschienen in: Osteoporosis International | Ausgabe 12/2022

Einloggen, um Zugang zu erhalten

Abstract

Summary

Sub-Saharan Africa is undergoing rapid population ageing and better understanding of the burden of musculoskeletal conditions is needed. We have estimated a large increase in the burden of hip fractures for South Africa over the coming decades. These findings should support preparation of hip fracture services to meet this demand.

Introduction

A better understanding of the burden of fragility fractures in sub-Saharan Africa is needed to inform healthcare planning. We aimed to use recent hip fracture incidence data from South Africa (SA) to estimate the future burden of hip fracture for the country over the next three decades.

Methods

Hip fracture incidence data within the Gauteng, KwaZulu-Natal and Western Cape provinces of SA were obtained from patients aged ≥ 40 years with a radiograph-confirmed hip fracture in one of 94 included hospitals. Age-, sex- and ethnicity-specific incidence rates were generated using the 2011 SA census population for the study areas. Incidence rates were standardised to United Nations (UN) population projections, for the years 2020, 2030, 2040 and 2050, and absolute numbers of hip fractures derived.

Results

The 2767 hip fracture patients studied had mean (SD) age 73.7 (12.7) years; 69% were female. Estimated age- and ethnicity-standardised incidence rates (per 100,000 person-years) for the overall SA population in 2020 were 81.2 for females and 43.1 for males. Overall projected incidence rates were discernibly higher by the year 2040 and increased further by the year 2050 (109.0 and 54.1 for females and males, respectively). Estimates of the overall annual number of hip fractures for SA increased from approximately 11,000 in 2020 to approximately 26,400 by 2050.

Conclusion

The hip fracture burden for SA is expected to more than double over the next 30 years. Significant investment in fracture prevention services and inpatient fracture care is likely to be needed to meet this demand.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Aboderin IAG, Beard JR (2015) Older people’s health in sub-Saharan Africa. Lancet 385(9968):e9–e11CrossRefPubMed Aboderin IAG, Beard JR (2015) Older people’s health in sub-Saharan Africa. Lancet 385(9968):e9–e11CrossRefPubMed
2.
Zurück zum Zitat Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R et al (2015) The burden of disease in older people and implications for health policy and practice. Lancet 385(9967):549–562CrossRefPubMed Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R et al (2015) The burden of disease in older people and implications for health policy and practice. Lancet 385(9967):549–562CrossRefPubMed
3.
Zurück zum Zitat Gouda HN, Charlson F, Sorsdahl K, Ahmadzada S, Ferrari AJ, Erskine H et al (2019) Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. Lancet Glob Health 7(10):e1375–e1387CrossRefPubMed Gouda HN, Charlson F, Sorsdahl K, Ahmadzada S, Ferrari AJ, Erskine H et al (2019) Burden of non-communicable diseases in sub-Saharan Africa, 1990–2017: results from the Global Burden of Disease Study 2017. Lancet Glob Health 7(10):e1375–e1387CrossRefPubMed
4.
Zurück zum Zitat Salari N, Ghasemi H, Mohammadi L, Behzadi MH, Rabieenia E, Shohaimi S et al (2021) The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 16(1):609CrossRefPubMedPubMedCentral Salari N, Ghasemi H, Mohammadi L, Behzadi MH, Rabieenia E, Shohaimi S et al (2021) The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 16(1):609CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Gregson CL, Madanhire T, Rehman A, Ferrand RA, Cappola AR, Tollman S et al (2022) Osteoporosis, rather than sarcopenia, is the predominant musculoskeletal disease in a rural South African community where human immunodeficiency virus prevalence is high: a cross-sectional study. J Bone Miner Res 37(2):244–255CrossRefPubMed Gregson CL, Madanhire T, Rehman A, Ferrand RA, Cappola AR, Tollman S et al (2022) Osteoporosis, rather than sarcopenia, is the predominant musculoskeletal disease in a rural South African community where human immunodeficiency virus prevalence is high: a cross-sectional study. J Bone Miner Res 37(2):244–255CrossRefPubMed
6.
Zurück zum Zitat Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRefPubMed Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRefPubMed
7.
Zurück zum Zitat Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M et al (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos 16(1):82CrossRefPubMedPubMedCentral Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M et al (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos 16(1):82CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Paruk F, Matthews G, Gregson CL, Cassim B (2020) Hip fractures in South Africa: mortality outcomes over 12 months post-fracture. Arch Osteoporos 15(1):76CrossRefPubMed Paruk F, Matthews G, Gregson CL, Cassim B (2020) Hip fractures in South Africa: mortality outcomes over 12 months post-fracture. Arch Osteoporos 15(1):76CrossRefPubMed
10.
Zurück zum Zitat Dela SS, Paruk F, Brown SL, Lukhele M, Kalla AA, Jordaan JD et al (2020) Ethnic and gender-specific incidence rates for hip fractures in South Africa: a multi-centre study. Bone 133:115253CrossRefPubMed Dela SS, Paruk F, Brown SL, Lukhele M, Kalla AA, Jordaan JD et al (2020) Ethnic and gender-specific incidence rates for hip fractures in South Africa: a multi-centre study. Bone 133:115253CrossRefPubMed
11.
Zurück zum Zitat Conradie M, Conradie MM, Scher AT, Kidd M, Hough S (2015) Vertebral fracture prevalence in black and white South African women. Arch Osteoporos 10:203CrossRefPubMed Conradie M, Conradie MM, Scher AT, Kidd M, Hough S (2015) Vertebral fracture prevalence in black and white South African women. Arch Osteoporos 10:203CrossRefPubMed
12.
Zurück zum Zitat Gregson CL, Cassim B, Micklesfield LK, Lukhele M, Ferrand RA, Ward KA et al (2019) Fragility fractures in sub-Saharan Africa: time to break the myth. Lancet Glob Health 7(1):e26–e27CrossRefPubMed Gregson CL, Cassim B, Micklesfield LK, Lukhele M, Ferrand RA, Ward KA et al (2019) Fragility fractures in sub-Saharan Africa: time to break the myth. Lancet Glob Health 7(1):e26–e27CrossRefPubMed
13.
Zurück zum Zitat Micklesfield LK, Norris SA, Pettifor JM (2011) Ethnicity and bone: a South African perspective. J Bone Miner Metab 29(3):257–267CrossRefPubMed Micklesfield LK, Norris SA, Pettifor JM (2011) Ethnicity and bone: a South African perspective. J Bone Miner Metab 29(3):257–267CrossRefPubMed
18.
Zurück zum Zitat Grundill ML, Burger MC (2021) The incidence of fragility hip fractures in a subpopulation of South Africa. S Afr Med J 111(9):896–902PubMed Grundill ML, Burger MC (2021) The incidence of fragility hip fractures in a subpopulation of South Africa. S Afr Med J 111(9):896–902PubMed
19.
Zurück zum Zitat Paruk F, Matthews G, Cassim B (2017) Osteoporotic hip fractures in Black South Africans: a regional study. Arch Osteoporos 12(1):107CrossRefPubMed Paruk F, Matthews G, Cassim B (2017) Osteoporotic hip fractures in Black South Africans: a regional study. Arch Osteoporos 12(1):107CrossRefPubMed
20.
Zurück zum Zitat Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23(9):2239–2256CrossRefPubMedPubMedCentral Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23(9):2239–2256CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136 Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136
22.
23.
Zurück zum Zitat Johansson H, Dela SS, Cassim B, Paruk F, Brown SL, Conradie M et al (2021) FRAX-based fracture probabilities in South Africa. Arch Osteoporos 16(1):51CrossRefPubMedPubMedCentral Johansson H, Dela SS, Cassim B, Paruk F, Brown SL, Conradie M et al (2021) FRAX-based fracture probabilities in South Africa. Arch Osteoporos 16(1):51CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Curtis EM, van der Velde R, Moon RJ, van den Bergh JP, Geusens P, de Vries F et al (2016) Epidemiology of fractures in the United Kingdom 1988–2012: variation with age, sex, geography, ethnicity and socioeconomic status. Bone 87:19–26CrossRefPubMedPubMedCentral Curtis EM, van der Velde R, Moon RJ, van den Bergh JP, Geusens P, de Vries F et al (2016) Epidemiology of fractures in the United Kingdom 1988–2012: variation with age, sex, geography, ethnicity and socioeconomic status. Bone 87:19–26CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Silverman SL, Madison RE (1988) Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California Hospital Discharge Data. Am J Public Health 78(11):1482–1483CrossRefPubMedPubMedCentral Silverman SL, Madison RE (1988) Decreased incidence of hip fracture in Hispanics, Asians, and blacks: California Hospital Discharge Data. Am J Public Health 78(11):1482–1483CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Nelson DA, Pettifor JM, Barondess DA, Cody DD, Uusi-Rasi K, Beck TJ (2004) Comparison of cross-sectional geometry of the proximal femur in white and black women from Detroit and Johannesburg. J Bone Miner Res 19(4):560–565CrossRefPubMed Nelson DA, Pettifor JM, Barondess DA, Cody DD, Uusi-Rasi K, Beck TJ (2004) Comparison of cross-sectional geometry of the proximal femur in white and black women from Detroit and Johannesburg. J Bone Miner Res 19(4):560–565CrossRefPubMed
27.
Zurück zum Zitat Mukwasi C, Stranix Chibanda L, Banhwa J, Shepherd JA (2015) US White and black women do not represent the bone mineral density of sub-Saharan Black women. J Clin Densitom 18(4):525–532CrossRefPubMed Mukwasi C, Stranix Chibanda L, Banhwa J, Shepherd JA (2015) US White and black women do not represent the bone mineral density of sub-Saharan Black women. J Clin Densitom 18(4):525–532CrossRefPubMed
28.
Zurück zum Zitat Downey C, Kelly M, Quinlan JF (2019) Changing trends in the mortality rate at 1-year post hip fracture - a systematic review. World J Orthop 10(3):166–175CrossRefPubMedPubMedCentral Downey C, Kelly M, Quinlan JF (2019) Changing trends in the mortality rate at 1-year post hip fracture - a systematic review. World J Orthop 10(3):166–175CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Noel SE, Santos MP, Wright NC (2021) Racial and ethnic disparities in bone health and outcomes in the United States. J Bone Miner Res 36(10):1881–1905CrossRefPubMed Noel SE, Santos MP, Wright NC (2021) Racial and ethnic disparities in bone health and outcomes in the United States. J Bone Miner Res 36(10):1881–1905CrossRefPubMed
30.
Zurück zum Zitat Lewiecki EM, Erb SF (2022) Racial disparities and inequalities in the management of patients with osteoporosis. Orthop Nurs 41(2):125–134CrossRefPubMed Lewiecki EM, Erb SF (2022) Racial disparities and inequalities in the management of patients with osteoporosis. Orthop Nurs 41(2):125–134CrossRefPubMed
31.
Zurück zum Zitat Weil YA, Bernstein BP, Maqungo S, Khoury A, Liebergall M, Laubscher M (2020) Hip fracture care and national systems in Israel and South Africa. OTA Int 3(1):e065CrossRefPubMedPubMedCentral Weil YA, Bernstein BP, Maqungo S, Khoury A, Liebergall M, Laubscher M (2020) Hip fracture care and national systems in Israel and South Africa. OTA Int 3(1):e065CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Kauta NHM, Dlamini S, Kalula S, Ross I, Kalla G, Maqungo S (2017) The management of fragility fractures of the hip: a quality assessment project. South Africa Orthpopedic J 16(3):42–5 Kauta NHM, Dlamini S, Kalula S, Ross I, Kalla G, Maqungo S (2017) The management of fragility fractures of the hip: a quality assessment project. South Africa Orthpopedic J 16(3):42–5
38.
Zurück zum Zitat Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288CrossRefPubMedPubMedCentral Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22(5):1277–1288CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA (2002) Fracture rates lower in rural than urban communities: the Geelong Osteoporosis Study. J Epidemiol Community Health 56(6):466–470CrossRefPubMedPubMedCentral Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA (2002) Fracture rates lower in rural than urban communities: the Geelong Osteoporosis Study. J Epidemiol Community Health 56(6):466–470CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Tang X, Liu G, Kang J, Hou Y, Jiang F, Yuan W et al (2013) Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS ONE 8(4):e55077CrossRefPubMedPubMedCentral Tang X, Liu G, Kang J, Hou Y, Jiang F, Yuan W et al (2013) Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS ONE 8(4):e55077CrossRefPubMedPubMedCentral
Metadaten
Titel
Incidence and number of fragility fractures of the hip in South Africa: estimated projections from 2020 to 2050
verfasst von
Samuel Hawley
Sapna Dela
Anya Burton
Farhanah Paruk
Bilkish Cassim
Celia L. Gregson
Publikationsdatum
13.08.2022
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 12/2022
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-022-06525-5

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).


Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Positive Langzeitdaten zu Inlays aus hochvernetztem Polyethylen

10-Jahres-Daten einer randomisierten Studie sprechen dafür, dass Knie-TEP-Inlays aus hochvernetztem (HXLPE) und konventionellem Polyethylen selten Revisionen erfordern – und HXLPE in puncto Abnutzung vielleicht sogar die Nase vorn hat.

Was bringt die Spritze ins Gelenk bei Arthrose?

Ein hochkarätiges Studienteam hat untersucht, wie gut intraartikulär verabreichte Substanzen zur Behandlung von Knie- und Hüftarthrose wirken. Für die meisten ist die Wirksamkeit alles andere als klar, einige werden offenbar überschätzt, für eine Substanz wird deutlich, dass sie vor allem schadet.

Leitlinienkonformes Management thermischer Verletzungen

Thermische Verletzungen gehören zu den schwerwiegendsten Traumen und hinterlassen oft langfristige körperliche und psychische Spuren. Die aktuelle S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter (Verbrennung, Verbrühung)“ bietet eine strukturierte Übersicht über das empfohlene Vorgehen.

Positive Daten für supraskapulären Nervenblock bei Schultersteife

Daten einer aktuellen Metaanalyse sprechen dafür, dass eine Blockade des Nervus suprascapularis bei Schultersteife mit Blick auf Funktion und Schmerzlinderung mindestens so effektiv ist wie eine Physiotherapie oder intraartikulär injizierte Steroide.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.