Osteoporotic fractures prevalence in Latin American countries: A systematic review of literature and meta-analysis.

Abstract

Osteoporotic fractures (OF), or fragility fractures, are a major cause of morbidity, mortality, and healthcare utilization worldwide. While their burden is well described in high-income countries, data in Latin America remain fragmented and poorly synthesized. To systematically review and synthesize available evidence on the prevalence of OF among adults in Latin America. We conducted a systematic review and meta-analysis of observational studies, following JBI methodology and PRISMA 2020 guidelines. MEDLINE, Scopus, Virtual Health Library, and Google Scholar were searched up to January 8, 2025. Random-effects meta-analysis with restricted maximum likelihood estimation and Hartung-Knapp adjustment was used. Subgroup and sensitivity analyses were conducted according to population type, fracture ascertainment method, age group, sex, country, setting, and fracture type. Univariable meta-regression was used to explore sources of heterogeneity. Risk of bias was assessed using the JBI checklist. Twenty-two studies were included in the systematic review, and 16 contributed to the meta-analysis, comprising 1,182,219 participants and 47,954 osteoporotic fractures. The pooled prevalence of OF was 10.2% (95% CI 5.0-16.9%), with substantial heterogeneity (I² = 100%). Prevalence varied significantly according to population type (p < 0.001), with higher estimates in clinical samples than in population-based studies, and by fracture type (p = 0.002), with vertebral fractures being the most frequent (19.1%). No overall sex differences were identified, although women had higher prevalence of vertebral and non-vertebral fractures after stratification. Meta-regression identified country and fracture type as significant contributors to heterogeneity. OF represent a substantial but highly heterogeneous health burden, and pooled prevalence estimates should be interpreted as indicative rather than precise estimates. Strengthening epidemiological surveillance and implementing early diagnosis and prevention strategies should be prioritized to address the growing impact of OF in the region.