Department of Rheumatology, Inkosi Albert Luthuli Central Hospital, School of Clinical Medicine, College of Health Science, University of KwaZulu-Natal, 719 Umbilo Road, eThekwini, Congella, Durban, 4001, South Africa.
Department of Surgery-Orthopaedics and Traumatology, Harare Central Hospital, Harare, Zimbabwe.
Clin Rheumatol. 2021 Sep;40(9):3419-3428. doi: 10.1007/s10067-020-05335-6. Epub 2020 Aug 14.
Africa is experiencing an exponential increase in the number of older persons. The number of persons surviving with human immunodeficiency virus is simultaneously increasing due to improved availability of anti-retroviral therapy. The burden of non-communicable diseases, in particular, osteoporosis and its consequent fragility fractures, is also predicted to increase. Osteoporosis, however, remains a neglected disease and there are no age-standardized reference data available to accurately screen and diagnose individuals with osteoporosis. Epidemiological studies reporting the incidence of hip fracture or vertebral fractures are limited from Africa, especially Sub-Saharan Africa. The studies are usually limited as they are based on a retrospective data and small study numbers and often from a single study site. However, compared with early initial studies, the more recent studies show that osteoporosis and fractures are increasing across the continent. The overall incidence rates for osteoporosis and fractures still vary greatly between different regions in Africa and ethnic groups. Predisposing factors are similar with those in developed countries, but awareness of osteoporosis is sorely lacking. There is a lack of awareness among the population as well as health authorities, making it extremely difficult to quantify the burden of disease. There is great potential for research into the need and availability of preventive strategies. The FRAX® tool needs to be developed for African populations and may circumvent the shortage of bone densitometry.
非洲的老年人口数量正在呈指数级增长。由于抗逆转录病毒疗法的普及，艾滋病毒感染者的数量也在同时增加。预计骨质疏松症及其导致的脆性骨折等非传染性疾病的负担也将增加。然而，骨质疏松症仍然是一种被忽视的疾病，没有可用的年龄标准化参考数据来准确筛查和诊断骨质疏松症患者。来自非洲，特别是撒哈拉以南非洲的报告髋部骨折或椎体骨折发生率的流行病学研究非常有限。这些研究通常受到限制，因为它们基于回顾性数据和少量研究，而且通常来自单一的研究地点。然而，与早期的初步研究相比，最近的研究表明，骨质疏松症和骨折在整个非洲大陆都在增加。骨质疏松症和骨折的总体发病率在非洲不同地区和不同种族之间仍有很大差异。易患因素与发达国家相似，但对骨质疏松症的认识严重缺乏。民众和卫生当局都缺乏认识，这使得疾病负担的量化变得极其困难。对于研究预防策略的需求和可行性有很大的潜力。需要为非洲人群开发 FRAX®工具，该工具可能会规避骨密度仪短缺的问题。
