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

Sam Hawley; Sapna Dela; Anya J Burton; Farhanah Paruk; Bilkish Cassim; Celia L Gregson

doi:10.1007/s00198-022-06525-5

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

Sam Hawley^*, Sapna Dela, Anya J Burton, Farhanah Paruk, Bilkish Cassim, Celia L Gregson

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

16 Citations (Scopus)

133 Downloads (Pure)

Abstract

Purpose
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.

Original language	English
Pages (from-to)	2575-2583
Number of pages	9
Journal	Osteoporosis International
Volume	33
Issue number	12
Early online date	13 Aug 2022
DOIs	https://doi.org/10.1007/s00198-022-06525-5
Publication status	Published - 1 Dec 2022

Bibliographical note

Funding Information:
This work was supported by the National Institute for Health Research (NIHR) (using the UK’s Official Development Assistance (ODA) Funding) and Wellcome (217135/Z/19/Z) under the NIHR-Wellcome Partnership for Global Health Research. The work was also supported by the University of Kwazulu-Natal and the South African Medical Research Council (MRC). All authors declare that they have no conflict of interest.

Publisher Copyright:
© 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.

Keywords

Hip fracture
Incidence
South Africa
Sub-Saharan Africa
Osteoporosis
Epidemiology

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The healthcare system costs of hip fracture care in South Africa
Mafirakureva, N., Paruk, F., Cassim, B., Lukhele, M., Gregson, C. L. & Noble, S. M., 27 Jan 2023, (E-pub ahead of print) In: Osteoporosis International. 34, 4, p. 803–813 11 p.
Research output: Contribution to journal › Article (Academic Journal) › peer-review

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11 Citations (Scopus)

144 Downloads (Pure)

Cite this

@article{bf2a8686a9024f72bea527beda495190,

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

abstract = "Purpose 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. ",

keywords = "Hip fracture, Incidence, South Africa, Sub-Saharan Africa, Osteoporosis, Epidemiology",

author = "Sam Hawley and Sapna Dela and Burton, \{Anya J\} and Farhanah Paruk and Bilkish Cassim and Gregson, \{Celia L\}",

note = "Funding Information: This work was supported by the National Institute for Health Research (NIHR) (using the UK{\textquoteright}s Official Development Assistance (ODA) Funding) and Wellcome (217135/Z/19/Z) under the NIHR-Wellcome Partnership for Global Health Research. The work was also supported by the University of Kwazulu-Natal and the South African Medical Research Council (MRC). All authors declare that they have no conflict of interest. Publisher Copyright: {\textcopyright} 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.",

year = "2022",

month = dec,

day = "1",

doi = "10.1007/s00198-022-06525-5",

language = "English",

volume = "33",

pages = "2575--2583",

journal = "Osteoporosis International",

issn = "0937-941X",

publisher = "Springer Science and Business Media Deutschland GmbH",

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}

TY - JOUR

T1 - Incidence and number of fragility fractures of the hip in South Africa

T2 - estimated projections from 2020 to 2050

AU - Hawley, Sam

AU - Dela, Sapna

AU - Burton, Anya J

AU - Paruk, Farhanah

AU - Cassim, Bilkish

AU - Gregson, Celia L

N1 - Funding Information: This work was supported by the National Institute for Health Research (NIHR) (using the UK’s Official Development Assistance (ODA) Funding) and Wellcome (217135/Z/19/Z) under the NIHR-Wellcome Partnership for Global Health Research. The work was also supported by the University of Kwazulu-Natal and the South African Medical Research Council (MRC). All authors declare that they have no conflict of interest. Publisher Copyright: © 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.

PY - 2022/12/1

Y1 - 2022/12/1

N2 - Purpose 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.

AB - Purpose 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.

KW - Hip fracture

KW - Incidence

KW - South Africa

KW - Sub-Saharan Africa

KW - Osteoporosis

KW - Epidemiology

U2 - 10.1007/s00198-022-06525-5

DO - 10.1007/s00198-022-06525-5

M3 - Article (Academic Journal)

C2 - 35962821

SN - 0937-941X

VL - 33

SP - 2575

EP - 2583

JO - Osteoporosis International

JF - Osteoporosis International

IS - 12

ER -