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Disparities in the prevalence of osteoporosis and osteopenia in men and women living in sub-Saharan Africa, the UK, and the USA

Disparities in the prevalence of osteoporosis and osteopenia in men and women living in sub-Saharan Africa, the UK, and the USA
Disparities in the prevalence of osteoporosis and osteopenia in men and women living in sub-Saharan Africa, the UK, and the USA

Purpose: To review the rising prevalence of osteopenia and osteoporosis in sub-Saharan Africa and the challenges this poses to governments and healthcare services. Using existing studies, we compare the prevalence of osteopenia and osteoporosis in men and women from sub-Saharan Africa to US and UK cohorts. Context-specific disparities in healthcare are discussed particularly the challenges in diagnosis and treatment of osteoporosis. Recent Findings: There are few epidemiological data describing the burden of osteoporosis in sub-Saharan Africa. In the studies and cohorts presented here, osteoporosis prevalence varies by sex, country and area of residence, but is generally higher in African populations, than has previously been appreciated. Risk factors contributing to poorer bone health include HIV, malnutrition and “inflammaging.” Summary: Reprioritization towards care of ageing populations is urgently required. Equitable access to implementable preventative strategies, diagnostic services, treatments and pathways of care for bone health (for example embedded within HIV services) need now to be recognized and addressed by policy makers.

Africa, Ageing, Bone density, DXA, Osteoporosis, Treatment
360-371
Ward, Kate A.
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Pearse, Camille M.
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Madanhire, Tafadzwa
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Wade, Alisha N.
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Fabian, June
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Micklesfield, Lisa K.
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Gregson, Celia L.
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Ward, Kate A.
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Pearse, Camille M.
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Madanhire, Tafadzwa
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Wade, Alisha N.
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Fabian, June
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Micklesfield, Lisa K.
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Gregson, Celia L.
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Ward, Kate A., Pearse, Camille M., Madanhire, Tafadzwa, Wade, Alisha N., Fabian, June, Micklesfield, Lisa K. and Gregson, Celia L. (2023) Disparities in the prevalence of osteoporosis and osteopenia in men and women living in sub-Saharan Africa, the UK, and the USA. Current Osteoporosis Reports, 21 (4), 360-371. (doi:10.1007/s11914-023-00801-x).

Record type: Review

Abstract

Purpose: To review the rising prevalence of osteopenia and osteoporosis in sub-Saharan Africa and the challenges this poses to governments and healthcare services. Using existing studies, we compare the prevalence of osteopenia and osteoporosis in men and women from sub-Saharan Africa to US and UK cohorts. Context-specific disparities in healthcare are discussed particularly the challenges in diagnosis and treatment of osteoporosis. Recent Findings: There are few epidemiological data describing the burden of osteoporosis in sub-Saharan Africa. In the studies and cohorts presented here, osteoporosis prevalence varies by sex, country and area of residence, but is generally higher in African populations, than has previously been appreciated. Risk factors contributing to poorer bone health include HIV, malnutrition and “inflammaging.” Summary: Reprioritization towards care of ageing populations is urgently required. Equitable access to implementable preventative strategies, diagnostic services, treatments and pathways of care for bone health (for example embedded within HIV services) need now to be recognized and addressed by policy makers.

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Accepted/In Press date: 4 June 2023
e-pub ahead of print date: 23 June 2023
Published date: August 2023
Additional Information: Funding Information: GamBAS: This research was jointly funded by the MRC (programme codes U105960371, U123261351, MCA760-5QX00) and the Department for International Development (DFID) under the MRC/DFID Concordat agreement. Funding Information: Agincourt: The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). Research was jointly supported by (i) the South African Medical Research Council, with funds from the South African National Department of Health, MRC UK (via the Newton Fund) and GSK R&D; (ii) Faculty Research Committee Individual Research Grant, University of Witwatersrand; (iii) The International Society of Nephrology Clinical Research Program. ANW is supported by the Fogarty International Center, National Institutes of Health (NIH) under award number K43TW010698. This article describes the views of the authors and does not necessarily represent the official views of the NIH (USA). Analysis was funded by University of Bristol QR Global Challenges Research Funding (GCRF) (ref: H100004-135). Funding Information: Ayse Zengin Ph.D., Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia MRC Nutrition and Bone Health Group, Cambridge, UK Sam Hawley Ph.D., Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK Jane A Cauley Ph.D., University of Pittsburgh, Pittsburgh, PA, USA Roger Fielding Ph.D., Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Boston, MA, USA Anne Newman Ph.D., University of Pittsburgh, Pittsburgh, PA, USA Elaine Dennison Ph.D., MRC Lifecourse Epidemiology Centre, University of Southampton, UK Cyrus Cooper Ph.D., MRC Lifecourse Epidemiology Centre, University of Southampton, UK National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK Julia Goedecke Ph.D., Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town; SAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Rashida Ferrand Ph.D., The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK Funding Information: Middle Aged Soweto Cohort (MASC): The study was funded by the South African Medical Research Council (SAMRC) with funds received from the South African National Department of Health, the UKMRC (via the Newton Fund), and GSK Africa NonCommunicable Disease Open Lab (via a supporting Grant project no: ES/N013891/1). Supplementary funds were also received from the South African National Research Foundation (Grant no: UID:98,561). Opinions expressed and conclusions arrived at are those of the authors and are not necessarily attributed to the research funders. 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 (217,135/Z/19/Z) under the NIHR-Wellcome Partnership for Global Health Research. Funding Information: Hertfordshire Cohort Study: The Hertfordshire Cohort Study was supported by the following organisations: Medical Research Council; British Heart Foundation; Versus Arthritis UK; International Osteoporosis Foundation; NIHR Southampton Biomedical Research Centre; NIHR Oxford Biomedical Research Centre; University of Southampton. Funding Information: Menopause: This work was funded by University of Bristol QR Global Challenges Research Funding (GCRF) (ref: H100004-135). Funding Information: Health ABC Study: The Health, Aging and Body Composition Study was supported by the National Institute on Aging (NIA) grants (R01AG027017, P30AG024827, T32AG021885 and K07AG033174); the Intramural Research Program of the National Institutes of Health (N01AG62101, N01AG62103, N01AG62106 and R01AG028050); and a National Institute of Nursing Research grant (R01NR012459). Publisher Copyright: © 2023, The Author(s).
Keywords: Africa, Ageing, Bone density, DXA, Osteoporosis, Treatment

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Local EPrints ID: 479016
URI: http://eprints.soton.ac.uk/id/eprint/479016
PURE UUID: 4d9a255d-e855-43ab-9821-cdf11487b92c
ORCID for Kate A. Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 18 Jul 2023 16:36
Last modified: 17 Mar 2024 03:40

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Contributors

Author: Kate A. Ward ORCID iD
Author: Camille M. Pearse
Author: Tafadzwa Madanhire
Author: Alisha N. Wade
Author: June Fabian
Author: Lisa K. Micklesfield
Author: Celia L. Gregson

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