PREVALENCE OF OSTEOPOROSIS IN LOW ECONOMIC COUNTRIES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Main Article Content

Ahmed Abdelaziz Abdelkader Elgohary
Ahmed Gad Ragheb Abdelbaky
Mahantesh Magadum
Moataz Ibrahim Mohammed Abdelfattah
Nasrullah Aamer
Niaz Hussain Keerio

Keywords

Prevalence, meta-analysis, osteoporosis, bone disorders, systematic review

Abstract

Background: Osteoporosis, a prevalent metabolic condition, is defined by reduced bone strength and represents a significant contributor to bone fractures, especially in the older demographic. Despite its prevalence, there is currently insufficient synthesized evidence regarding its distribution and occurrence in the population under study, necessitating comprehensive research in this area.


Objective: The primary objective of this systematic review and subsequent meta-analysis was to determine and synthesize the prevalence of osteoporosis within the studied adult population. The study sought to fill the knowledge gap surrounding osteoporosis and provide valuable insights for healthcare policy decision-making.


Study design: A systematic review and meta-analysis


Methodology: A thorough systematic search, adhering to predefined standardized criteria, was conducted across several electronic databases, including authentic articles and journals. A systematic review followed the Joanna Briggs Institute methodology, focusing on osteoporosis prevalence in adults aged 18 and above via Bone Mineral Density (BMD) measurements (DEXA and heel ultrasound). It included general population, school, and hospital surveys but excluded inaccessible texts, duplicates, modeling studies, and more. Data was extracted by two independent reviewers using a standardized tool. Findings were synthesized narratively, with meta-analysis when possible, using R software. Subgroup analyses and heterogeneity assessment were conducted, along with publication bias evaluation.


Results: This review examined 7 selected articles from an initial pool of 520 papers. The region's osteoporosis data scarcity is due to a lack of registries and diagnostic resources, with few DXA machines in urban areas. Recent hospital-based studies mainly used heel ultrasound, lacking DXA data. There was a different prevalence of osteoporosis in different time frames. It was 12.9% in 2007, 6.7% in 2009, it was between 24-48% in 2010. Furthermore, it was 27% in 2011, 17.8% in 2012 and in 2015 it was 28.6%


Conclusion: This comprehensive study provides a vital estimate of osteoporosis prevalence and highlights the pressing need for healthcare policy adjustments and the provision of necessary resources to address this public health concern. Enhanced accessibility to healthcare services and increased focus on health systems and policy research are essential for promoting osteoporosis screening and treatment.

Abstract 157 | PDF Downloads 93

References

1. Reginster JY, Burlet N. Osteoporosis: a still increasing prevalence. Bone. 2006 Feb 1;38(2):4-9.
2. Wade SW, Strader C, Fitzpatrick LA, Anthony MS, O’Malley CD. Estimating prevalence of osteoporosis: examples from industrialized countries. Archives of osteoporosis. 2014 Dec;9:1-0.
3. Melton LJ. The prevalence of osteoporosis: gender and racial comparison. Calcified tissue international. 2001 Oct 1;69(4):179.
4. Askari M, Lotfi MH, Owlia MB, Fallahzadeh H, Mohammadi M. Survey of osteoporosis risk factors. Journal of Sabzevar University of Medical Sciences. 2019 Jan 21;25(6):854-63.
5. Chen P, Li Z, Hu Y. Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC public health. 2016 Dec;16:1-1.
6. Silambanan S, Menon PG, Arunalatha P. Comparison of bone mineral density with biochemical parameters and prevalence of osteopenia and osteoporosis in South Indian population. Biomedical and Pharmacology Journal. 2018 Dec 25;11(4):2209-14.
7. Wang L, Yu W, Yin X, Cui L, Tang S, Jiang N, Cui L, Zhao N, Lin Q, Chen L, Lin H. Prevalence of osteoporosis and fracture in China: the China osteoporosis prevalence study. JAMA network Open. 2021 Aug 2;4(8):e2121106-.
8. Wang Y, Tao Y, Hyman ME, Li J, Chen Y. Osteoporosis in china. Osteoporosis international. 2009 Oct;20:1651-62.
9. Salari N, Ghasemi H, Mohammadi L, Rabieenia E, Shohaimi S, Mohammadi M. The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. Journal of orthopaedic surgery and research. 2021 Dec;16(1):1-20.
10. Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z. Prevalence of osteoporosis in Iran: A meta-analysis. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2013 Sep;18(9):759.
11. Fatima M, Nawaz H, Kassi M, Rehman R, Kasi PM, Kassi M, Afghan AK, Baloch SN. Determining the risk factors and prevalence of osteoporosis using quantitative ultrasonography in Pakistani adult women. Singapore medical journal. 2009 Jan 1;50(1):20.
12. Baig L, Mansuri FA, Karim SA. Association of menopause with osteopenia and osteoporosis: results from population based study done in Karachi. J Coll Physicians Surg Pak. 2009 Apr 1;19(4):240-4.
13. Jaleel RI, Nasrullah FD, Khan AY. Osteopenia in the younger females. J Surg Pakistan. 2010 Jan;15:29-33.
14. Zahoor S, Ayub U. PREVALENCE OF OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN VISITING POLICE & SERVICES HOSPITAL, PESHAWAR, NWFP. JPMI: Journal of postgraduate medical institute. 2010 Jan 1;24(1).
15. Lowe NM, Ellahi B, Bano Q, Bangash SA, Mitra SR, Zaman M. Dietary calcium intake, vitamin D status, and bone health in postmenopausal women in rural Pakistan. Journal of health, population, and nutrition. 2011 Oct;29(5):465.
16. Ejaz S, Mahmood A, Qureshi MA, Ali M. Prevalence of osteoporosis and osteopenia among Pakistani pre and post menopausal women. J Dent Med Sci. 2012;2(6):12-7.
17. Naeem ST, Hussain R, Raheem A, Siddiqui I, Ghani F, Khan AH. Bone turnover markers for osteoporosis status assessment at baseline in postmenopausal Pakistani females. J Coll Physicians Surg Pak. 2016 May 1;26(5):408-12.
18. Riaz M, Abid N, Patel MJ, Tariq M, Khan MS, Zuberi L. Knowledge about osteoporosis among healthy women attending a tertiary care hospital. Journal of the Pakistan Medical Association. 2008;58(4):190.
19. Mamji MF, Hasan JA, Sabri MS. Risk factors for osteoporosis in post-menopausal women with hip fractures. J Surg Pak. 2010 Apr;15(2):82-6.
20. Khan AH, Iqbal R, Naureen G, Dar FJ, Ahmed FN. Prevalence of vitamin D deficiency and its correlates: results of a community-based study conducted in Karachi, Pakistan. Archives of osteoporosis. 2012 Dec;7:275-82.

Most read articles by the same author(s)