Report shows growing burden of osteoporotic fractures in the Middle East, Africa

A recently issued audit report by the International Osteoporosis Foundation indicates that osteoporosis is a growing problem in the Middle East and areas of Africa, and calls for more research to aid in the development of comprehensive health care policies in these regions.

Findings of the audit, which included data from Turkey and 17 countries in the Middle East and Africa, were introduced at the First Middle East and Africa Osteoporosis Meeting, according to an International Osteoporosis Foundation press release.

“This report reveals that a great research gap needs to be filled,” Professor Ghada El-Hajj Fuleihan, a lead author of the report and director of the Calcium Metabolism and Osteoporosis Program and the World Health Organization’s Collaborating Center for Metabolic Bone Disorders at the American University of Beirut, stated in the release. “Published data on incidence rates for hip fractures are only available for Iran, Kuwait, Saudi Arabia, Lebanon, Morocco and Turkey. Furthermore, access to densitometry and care was limited in many countries, and reimbursement for diagnostics and therapeutics varied widely.”

The role of vitamin D

According to the release, it is estimated that 25% of the population in the Middle East will be older than 50 years by 2020 and this figure will increase to 40% by 2050. Based on these figures, the rate of hip fractures in Lebanon, Jordan and Syria could quadruple by 2050.

Of the countries included in the audit, three have identified osteoporosis as a national health priority and five have national treatment guidelines for the condition.

Vitamin D deficiency and low calcium intake may also play a role in the increased rates of osteoporosis in the region. The incidence of hypovitaminosis D is one of the highest in the world and has been estimated to be between 50% to 90% in many countries, according to the release.

“Vitamin D is an essential component of bone health and a relatively inexpensive way to decrease fracture risk,” Gemma Adib, MD, first author of the report and general secretary of the Pan Arab Osteoporosis Society, stated in the release. “It is essential that the region develops vitamin D supplementation strategies based on local data for at-risk groups.”

Mortality rates

In addition, mortality rates following hip fracture may be higher in the Middle East and Africa than in the West. While Western populations show post-fracture mortality rates ranging between 25% and 35%, early research has shown two to 2.5 times higher rates among certain populations in the Middle East and Africa.

“Despite the severity of the problem, osteoporosis is being dangerously ignored as it competes with other diseases for scarce health care resources and recognition,” International Osteoporosis Foundation President Professor John A. Kanis, stated in the release. “Notwithstanding the burden of fragility fractures, osteoporosis remains greatly under diagnosed and under treated, and both health professional training and public awareness is suboptimal in most countries in the region. The result is premature death for many hip fracture sufferers, immense personal suffering, lost productivity and long-term dependence on family members.”

Reference:

www.iofbonehealth.org

Disclosure: The audit was supported by an unrestricted grant from Servier and Fonterra.

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