Cordero Daniella M, Miclau Theodore A, Paul Alexandra V, Morshed Saam, Miclau Theodore, Martin Claude, Shearer David W
School of Medicine, University of California San Francisco, San Francisco.
Stanford University, Palo Alto.
OTA Int. 2020 Apr 23;3(2):e062. doi: 10.1097/OI9.0000000000000062. eCollection 2020 Jun.
While the global burden of musculoskeletal injury is increasingly recognized, few epidemiologic studies have specifically recorded its incidence or prevalence, particularly in low- and middle-income countries. Understanding the burden of musculoskeletal injury relative to other health conditions is critical to effective allocation of resources to mitigate the disability that results from trauma. The current study aims to systematically review the existing primary literature on the incidence and prevalence of pelvic and appendicular fractures, a major component of musculoskeletal injury, in low- and lower-middle income countries (LMICs).
This study conforms to the systematic review and traditional meta-analysis guidelines outlined in the PRISMA-P statement. Incidence rates were calculated as the occurrence of new fracture cases per 100,000 person-years, and prevalence as total fracture cases per population sample, reported as percentages.
The literature search yielded 3497 total citations. There were 21 full-text articles, representing 14 different countries, selected for data extraction. Included studies reported a wide range of incidence and prevalence rates, with an overall mean fracture incidence ranging from 779 (95% CI: 483.0-1188.7) to 1574 (95% CI: 1285.1-1915.1) per 100,000 person-years.
Better understanding the unmet burden of musculoskeletal injury in LMICs is critical to effectively allocating resources and advocating for underserved populations. To address existing gaps and heterogeneity within the literature, future research should incorporate population-based sampling with broader geographic representation in LMICs to more accurately capture the burden of disease.
虽然肌肉骨骼损伤的全球负担日益受到认可，但很少有流行病学研究专门记录其发病率或患病率，特别是在低收入和中等收入国家。了解肌肉骨骼损伤相对于其他健康状况的负担对于有效分配资源以减轻创伤导致的残疾至关重要。本研究旨在系统回顾低收入和中低收入国家（LMICs）中作为肌肉骨骼损伤主要组成部分的骨盆和四肢骨折的发病率和患病率的现有原始文献。
本研究符合PRISMA-P声明中概述的系统评价和传统荟萃分析指南。发病率计算为每10万人年新骨折病例的发生数，患病率为每人口样本中的骨折病例总数，以百分比报告。
文献检索共获得3497条引用。有21篇全文文章，代表14个不同国家，被选用于数据提取。纳入研究报告的发病率和患病率范围广泛，总体平均骨折发病率为每10万人年779例（95%可信区间：483.0 - 1188.7）至1574例（95%可信区间：1,285.1 - 1,915.1）。
更好地了解低收入和中低收入国家未满足的肌肉骨骼损伤负担对于有效分配资源和为服务不足的人群争取权益至关重要。为了解决文献中现有的差距和异质性，未来的研究应在低收入和中低收入国家采用具有更广泛地理代表性的基于人群的抽样方法，以更准确地捕捉疾病负担。
