Wilson Hannah, Manyanga Tadios, Burton Anya, Mushayavanhu Prudance, Chipanga Joseph, Hawley Samuel, Ward Kate A, Graham Simon, Masters James, Bandason Tsitsi, Costa Matthew L, Ndekwere Munyaradzi, Ferrand Rashida A, Gregson Celia L
University of Bristol Musculoskeletal Research Unit, Bristol, Bristol, UK
The Health Research Unit Zimbabwe at the Biomedical Research and Training Institute, Harare, Zimbabwe.
BMJ Glob Health. 2025 Jan 27;10(1):e017365. doi: 10.1136/bmjgh-2024-017365.
Population ageing in Africa is increasing healthcare demands. Hip fractures require multidisciplinary care and are considered an indicator condition for age-related health services. We aimed to estimate current hip fracture incidence in Zimbabwe, compare rates against other regional estimates and estimate future fracture numbers.
All hip fracture cases in adults aged ≥40 years, presenting to any hospital in Harare over 2 years, were identified. From this, age- and sex-specific hip fracture incidence rates per 100 000 person-years were estimated using 2022 Zimbabwean Census data and compared with South African and Botswanan estimates. Furthermore, using the United Nations population projections, future hip fracture numbers were estimated to 2052 for Zimbabwe.
In 2022, 1 83 312 women and 1 79 212 men aged ≥40 years were living in Harare (14.9% of the city's population). Over 2 years 243 hip fracture cases, 133 (54.7%) female, mean (SD) age 71.2 (15.9) years, were identified. Most presented to public hospitals (202 [83.1%]) and were fragility hip fractures (211 [86.8%]); high-impact trauma (eg, traffic accidents) was more common in younger men. Presentation delays of >2 weeks were common (37.4%). Incidence rates for adults aged ≥40 years in Harare (observed) and Zimbabwe (estimated) were 33.5 and 53.8/100 000 person-years, respectively. Over age 50, rates increased with age, with the highest rates seen in women aged ≥85 years (704/100 000 person-years). Age-standardised hip fracture incidence rates are broadly comparable between Zimbabwe, Botswana and Black South Africans in those aged 40-69 years; thereafter, rates in Zimbabwean women and men exceed those in Botswana and South Africa. Across Zimbabwe, the number of hip fractures occurring annually is expected to increase more than 2.5-fold from 1709 in 2022 to 4414 by 2052.
In Zimbabwe, most hip fractures in adults ≥50 years are fragility fractures, consistent with age-associated osteoporosis; incidence rates exceed those previously reported regionally. Demands on already challenged healthcare systems will increase.
非洲的人口老龄化正在增加医疗保健需求。髋部骨折需要多学科护理，被视为与年龄相关的健康服务的一个指标性病症。我们旨在估计津巴布韦目前的髋部骨折发病率，将发病率与其他地区的估计值进行比较，并估计未来的骨折数量。
确定了在两年内前往哈拉雷任何一家医院就诊的所有40岁及以上成年人的髋部骨折病例。据此，利用2022年津巴布韦人口普查数据估计了每10万人年的年龄和性别特异性髋部骨折发病率，并与南非和博茨瓦纳的估计值进行了比较。此外，利用联合国的人口预测，估计了到2052年津巴布韦未来的髋部骨折数量。
2022年，哈拉雷有183312名40岁及以上的女性和179212名40岁及以上的男性（占该市人口的14.9%）。在两年内，共确定了243例髋部骨折病例，其中133例（54.7%）为女性，平均（标准差）年龄为71.2（15.9）岁。大多数病例前往公立医院就诊（202例[83.1%]），且为脆性髋部骨折（211例[86.8%]）；高能量创伤（如交通事故）在年轻男性中更为常见。超过2周的就诊延迟很常见（37.4%）。哈拉雷40岁及以上成年人（观察到的）和津巴布韦（估计的）的发病率分别为每10万人年33.5例和53.8例。50岁以上，发病率随年龄增长而增加，85岁及以上女性的发病率最高（每10万人年704例）。在40-69岁年龄段，津巴布韦、博茨瓦纳和南非黑人的年龄标准化髋部骨折发病率大致相当；此后，津巴布韦女性和男性的发病率超过了博茨瓦纳和南非。在整个津巴布韦，每年发生的髋部骨折数量预计将增加2.5倍以上，从2022年的1709例增至2052年的4414例。
在津巴布韦，50岁及以上成年人的大多数髋部骨折为脆性骨折，与年龄相关的骨质疏松症一致；发病率超过了该地区此前报告的水平。对本就面临挑战的医疗系统的需求将会增加。
