Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved]
Background: The population of older adults is growing in sub-Saharan Africa. Ageing exponentially increases fragility fracture risk. Of all global regions, Africa is projected to observe the greatest increase in fragility fractures. Fractures cause pain, disability and sometimes death, and managemen...
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Wellcome
2023-06-01
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| Online Access: | https://wellcomeopenresearch.org/articles/8-261/v1 |
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| author | Christopher Grundy Simon Matthew Graham Hannah Wilson Samuel Hawley Kebba Marenah Tadios Manyanga James Masters Bintou Trawally Munyardardzi Ndekwere Prudance Mushayavanhu Mkhululi Lukhele Rachael Gooberman-Hill Farhanah Paruk Kate A. Ward Matthew Costa Celia L. Gregson Rashida A. Ferrand Sarah Drew Anya Burton Landing M. Jarjou Bilkish Cassim Nyashadzaishe Mafirakureva Sian Noble |
| author_facet | Christopher Grundy Simon Matthew Graham Hannah Wilson Samuel Hawley Kebba Marenah Tadios Manyanga James Masters Bintou Trawally Munyardardzi Ndekwere Prudance Mushayavanhu Mkhululi Lukhele Rachael Gooberman-Hill Farhanah Paruk Kate A. Ward Matthew Costa Celia L. Gregson Rashida A. Ferrand Sarah Drew Anya Burton Landing M. Jarjou Bilkish Cassim Nyashadzaishe Mafirakureva Sian Noble |
| author_sort | Christopher Grundy |
| collection | DOAJ |
| description | Background: The population of older adults is growing in sub-Saharan Africa. Ageing exponentially increases fragility fracture risk. Of all global regions, Africa is projected to observe the greatest increase in fragility fractures. Fractures cause pain, disability and sometimes death, and management is expensive, often requiring complex healthcare delivery. For countries to plan future healthcare services, understanding is needed of fracture epidemiology, associated health service costs and the currently available healthcare resources. Methods: The Fractures-E3 5-year mixed-methods research programme will investigate the epidemiology, economic impact, and treatment provision for fracture and wider musculoskeletal health in The Gambia, South Africa and Zimbabwe. These three countries are diverse in their geography, degree of urbanisation, maturity of health service infrastructure, and health profiles. The programme comprises five study types: (i) population-based cross-sectional studies to determine vertebral fracture prevalence. Secondary outcomes will include osteoarthritis and sarcopenia. Age- and sex-stratified household sampling will recruit 5030 adults aged 40 years and older; (ii) prospective cohort studies in adults aged 40 years and older will determine hip fracture incidence, associated risk factors, and outcomes over one year (e.g. mortality, disability, health-related quality of life); (iii) economic studies of direct health costs of hip fracture with projection modelling of future national health costs and cost-effectiveness analyses of different hip fracture care pathways; (iv) national surveys of hip fracture services (including traditional bonesetters in The Gambia); and (v) ethnographic studies of hip fracture care provision and experiences will understand fracture service pathways. Conclusions: Greater understanding of current and expected fracture burdens, fracture risk factors, and existing fracture care provision, is intended to inform national clinical guidelines, health service policy and planning and future health service development in sub-Saharan Africa. |
| format | Article |
| id | doaj-art-19d011705b664641873d84514aebdec6 |
| institution | Kabale University |
| issn | 2398-502X |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Wellcome |
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| series | Wellcome Open Research |
| spelling | doaj-art-19d011705b664641873d84514aebdec62025-01-16T01:00:01ZengWellcomeWellcome Open Research2398-502X2023-06-01821479Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved]Christopher Grundy0https://orcid.org/0000-0002-7042-2394Simon Matthew Graham1Hannah Wilson2https://orcid.org/0000-0003-0297-8259Samuel Hawley3Kebba Marenah4Tadios Manyanga5https://orcid.org/0000-0001-5036-9314James Masters6https://orcid.org/0000-0001-9663-8858Bintou Trawally7Munyardardzi Ndekwere8Prudance Mushayavanhu9https://orcid.org/0000-0003-2950-1856Mkhululi Lukhele10Rachael Gooberman-Hill11https://orcid.org/0000-0003-3353-2882Farhanah Paruk12Kate A. Ward13https://orcid.org/0000-0001-7034-6750Matthew Costa14Celia L. Gregson15Rashida A. Ferrand16https://orcid.org/0000-0002-7660-9176Sarah Drew17Anya Burton18https://orcid.org/0000-0002-4416-0538Landing M. Jarjou19Bilkish Cassim20https://orcid.org/0000-0002-0859-868XNyashadzaishe Mafirakureva21https://orcid.org/0000-0001-9775-6581Sian Noble22MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UKOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, England, OX3 7LD, UKMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKDepartment of orthopaedics, Edward Francis Small Teaching Hospital, Banjul, The GambiaThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Harare Province, ZimbabweOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, England, OX3 7LD, UKDepartment of orthopaedics, Edward Francis Small Teaching Hospital, Banjul, The GambiaDepartment of surgery, Sally Mugabe Central Hospital, Harare, ST14, ZimbabweDepartment of surgery, Sally Mugabe Central Hospital, Harare, ST14, ZimbabweSchool of Clinical Medicine, University of the Witwatersrand Johannesburg, Johannesburg, Gauteng, South AfricaElizabeth Blackwell Institute for Health, University of Bristol, Bristol, England, BS8 1UH, UKDepartment of Rheumatology, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South AfricaMRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Banjul, The GambiaOxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, England, OX3 7LD, UKMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKThe Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Harare Province, ZimbabweMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKMRC Unit The Gambia, London School of Hygiene and Tropical Medicine, Banjul, The GambiaDepartment of Geriatrics, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South AfricaMusculoskeletal Research Unit, University of Bristol, Bristol, England, BS10 5NB, UKPopulation Health Sciences, University of Bristol, Bristol, England, BS8 1UH, UKBackground: The population of older adults is growing in sub-Saharan Africa. Ageing exponentially increases fragility fracture risk. Of all global regions, Africa is projected to observe the greatest increase in fragility fractures. Fractures cause pain, disability and sometimes death, and management is expensive, often requiring complex healthcare delivery. For countries to plan future healthcare services, understanding is needed of fracture epidemiology, associated health service costs and the currently available healthcare resources. Methods: The Fractures-E3 5-year mixed-methods research programme will investigate the epidemiology, economic impact, and treatment provision for fracture and wider musculoskeletal health in The Gambia, South Africa and Zimbabwe. These three countries are diverse in their geography, degree of urbanisation, maturity of health service infrastructure, and health profiles. The programme comprises five study types: (i) population-based cross-sectional studies to determine vertebral fracture prevalence. Secondary outcomes will include osteoarthritis and sarcopenia. Age- and sex-stratified household sampling will recruit 5030 adults aged 40 years and older; (ii) prospective cohort studies in adults aged 40 years and older will determine hip fracture incidence, associated risk factors, and outcomes over one year (e.g. mortality, disability, health-related quality of life); (iii) economic studies of direct health costs of hip fracture with projection modelling of future national health costs and cost-effectiveness analyses of different hip fracture care pathways; (iv) national surveys of hip fracture services (including traditional bonesetters in The Gambia); and (v) ethnographic studies of hip fracture care provision and experiences will understand fracture service pathways. Conclusions: Greater understanding of current and expected fracture burdens, fracture risk factors, and existing fracture care provision, is intended to inform national clinical guidelines, health service policy and planning and future health service development in sub-Saharan Africa.https://wellcomeopenresearch.org/articles/8-261/v1Fracture Fragility sub-Saharan Africa Epidemiology Health economics Ethnographyeng |
| spellingShingle | Christopher Grundy Simon Matthew Graham Hannah Wilson Samuel Hawley Kebba Marenah Tadios Manyanga James Masters Bintou Trawally Munyardardzi Ndekwere Prudance Mushayavanhu Mkhululi Lukhele Rachael Gooberman-Hill Farhanah Paruk Kate A. Ward Matthew Costa Celia L. Gregson Rashida A. Ferrand Sarah Drew Anya Burton Landing M. Jarjou Bilkish Cassim Nyashadzaishe Mafirakureva Sian Noble Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] Wellcome Open Research Fracture Fragility sub-Saharan Africa Epidemiology Health economics Ethnography eng |
| title | Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] |
| title_full | Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] |
| title_fullStr | Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] |
| title_full_unstemmed | Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] |
| title_short | Fractures in sub-Saharan Africa: epidemiology, economic impact and ethnography (Fractures-E3): study protocol [version 1; peer review: 2 approved] |
| title_sort | fractures in sub saharan africa epidemiology economic impact and ethnography fractures e3 study protocol version 1 peer review 2 approved |
| topic | Fracture Fragility sub-Saharan Africa Epidemiology Health economics Ethnography eng |
| url | https://wellcomeopenresearch.org/articles/8-261/v1 |
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