Epidemiology of hip and wrist fractures in Cameroon, Africa

Abstract

Osteoporosis and fragility fractures are believed to be uncommon in Africa. To reevaluate this notion, we documented all patients aged 35 years and older admitted to the two main urban hospitals in Cameroon following a diagnosis of fracture during 2 years. Among 513 patients sustaining fractures (192 women, 321 men), 13.5% of all fractures in women occurred at the hip (n=26), 4.7% at the forearm (n=9), and 81.8% (n=157) at other sites (mainly tibia and femoral shaft). In men, the corresponding figures were 9% (n=29), 1.9% (n=6), and 89.1% (n=286). Of the hip and wrist fractures occurring in women, 80.0% were low energy trauma fractures due to falls, 8.6% were high-energy trauma fractures (road accidents), and 11.4% were undefined. In men, the corresponding figures were 42.9%, 34.3%, and 22.9%. Using the 1997 estimates of the population, the annual incidence rates of low-energy trauma fractures (per 100,000 persons over 35 years and above) were 4.1 in women, 2.2 in men for hip fractures, 1.2 in women, and 0.2 in men for wrist fractures. The pattern of most of the hip and wrist fractures in women is consistent with underlying bone fragility. The low incidence of fragility fractures is confirmed and is likely to be, in part, the result of reduced longevity as only 1.1% of women and 0.7% of men survive beyond 65 years of age.

Epidemiology of osteoporotic hip fractures in Spain

“…This higher proportion of women has been explained by the higher incidence of osteoporosis among women and by aging. The incidence rates of hip fractures increase exponentially with age [1,4,18,19,22,25]. In our study, almost 50% of hip fractures appeared in people aged 80-90 years.…”

“…However, the values are greater than those reported in the multinational study by Schwartz et al [22] and to those from other parts of the world, such as the Mediterranean countries [1] or the African countries [25]. In the USA, the rates may differ within the same county between urban and rural populations, with the incidence of hip fracture being lower in rural areas [19].…”

Geographic trends in incidence of hip fractures: a comprehensive literature review

“…Only two publications of hip fractures emanated from Africa, from Rabat, Morocco [42] and Cameroon [43].…”

“…The life expectancy at birth varied greatly for the regions considered in our review-for men and women, respectively: 50 and 52 in Cameroon, 69 and 73 in Morocco, 69 and 76 in Brazil, 70 and 73 in Iran, 78 and 83 in Canada, and 79 and 83 in Sweden [81]. Among the countries in our review, Morocco and Cameroon have a relatively low life expectancy and a very young population [42,43], but also had among the lowest hip fracture incidence rates in our review. It is uncertain, however, how much of the low incidence is an artifact of incomplete case ascertainment in developing countries-countries in which a national database of health service usage may not be available.…”

Major osteoporotic fragility fractures: Risk factor updates and societal impact

“…The incidence rate of hip fractures depends also on the country's development. Where life expectancy at birth is low and the population is very young, as well as in African countries, the hip fracture incidence rates are the lowest [67,68] . However, the low incidence might be an artifact due to incomplete case ascertainment or national health database unavailability in developing countries.…”