Life expectancy is rising more rapidly in Africa than any other continent globally. As countries in sub-Saharan Africa (SSA) transition due to rapid urbanisation, their changing demographics are giving rise to an increasing burden of non-communicable diseases (NCDs) of ageing, this includes fractures, often as a consequence of skeletal fragility. Fractures can be devastating, causing pain, disability, loss of productivity and sometimes death. Such fractures may occur in the context of multimorbidity (e.g. obesity and osteoarthritis). At the same time in SSA, communicable diseases (e.g. HIV), with both short- and longer-term sequelae, continue to affect millions of people every year. In high-income countries fractures place significant strain on healthcare services and budgets. For countries in Africa to plan future healthcare services we need to understand the epidemiology of key fracture types, their costs both monetarily and for the patient themselves, and what healthcare resources are currently in place to provide for those who fracture, and that might be amenable to future development 1.
In South Africa, Zimbabwe, and The Gambia we will establish how frequently two key age-related fractures occur: vertebral fractures (the commonest) and hip fractures (the most life-challenging), and the associated risk factors for these fracture types. We will assess recovery, disability and death rates following hip fracture, and identify factors that improve outcomes for patients. We will calculate how much fractures cost health services now and in the future. By talking with patients and healthcare workers we will learn of their experiences and gain insights into how fracture care can be improved in the future.