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Challenges and opportunities for quality densitometry in Latin America

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Abstract

Latin America and the Caribbean region account for 8% of the world’s total population. Experts from 18 countries were invited to contribute to this article to provide the best available data on the number, types, and quality of densitometry, DXA experts, the local/national incidence and prevalence of osteoporosis and fragility fractures, and other uses and information on the challenges and opportunities for quality densitometry with examples of local initiatives. Osteoporosis is the primary reason for densitometry in our region, which is not a priority for public health in most countries. Access and quality are major challenges, and there is a clear trend to concentrate on densitometry services in the largest cities. Urgent action is needed to face the rapidly increasing burden of osteoporosis in our region, including robust and up to date epidemiology, access to health professionals, and quality densitometry. Health professionals require better access to training, courses, and other activities at a more local or regional level.

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References

  1. IOF. The Latin American regional audit: epidemiology, costs & burden of osteoporosis in 2012. International Osteoporosis Foundation. https://www.iofbonehealth.org/data-publications/regional-audits/latin-america-regional-audit. Accessed February 6, 2018

  2. Aziziyeh R, Amin M, Habib M, Garcia Perlaza J, Szafranski K, McTavish RK, Disher T, Lüdke A, Cameron C (2019) The burden of osteoporosis in four Latin American countries: Brazil, Mexico, Colombia, and Argentina. W J Med Econ. 22(7):638–644

    Article  Google Scholar 

  3. Mautalen C, Schianchi A, Sigal D, Gianetti G, Vidan V, Bagur A, González D, Mastaglia S, Oliveri B (2016) Prevalence of osteoporosis in women in Buenos Aires based on bone mineral density at the lumbar spine and femur. J Clin Densitom. 19(4):471–476

    Article  PubMed  Google Scholar 

  4. Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Pérez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int. 20(2):275–282

    Article  CAS  PubMed  Google Scholar 

  5. Kanis JA, Odén A, McCloskey EV et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 23:2239–2256

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Wittich A, Bagur A, Mautalen C, Cristofari A, Escobar O, Carrizo G, Oliveri B (2010) Epidemiology of hip fracture in Tucuman, Argentina. Osteoporos Int. 21(11):1803–1807

    Article  CAS  PubMed  Google Scholar 

  7. Camargo MB, Cendoroglo MS, Ramos LR et al (2005) Bone mineral density and osteoporosis among a predominantly Caucasian elderly population in the city of São Paulo, Brazil. Osteoporos Int 16(11):1451–1460

    Article  PubMed  Google Scholar 

  8. Pinheiro MM, Ciconelli RM, Martini LA, Ferraz MB (2009) Clinical risk factors for osteoporotic fractures in Brazilian women and men: the Brazilian Osteoporosis Study (BRAZOS). Osteoporos Int. 20(3):399–408

    Article  CAS  PubMed  Google Scholar 

  9. Domiciano DS, Machado LG, Lopes JB, Figueiredo CP, Caparbo VF, Takayama L, Oliveira RM, Menezes PR, Pereira RMR (2014) Incidence and risk factors for osteoporotic vertebral fracture in low-income community-dwelling elderly: a population-based prospective cohort study in Brazil. The São Paulo Ageing & Health (SPAH) Study. Osteoporos Int. 25(12):2805–2815

    Article  CAS  PubMed  Google Scholar 

  10. Rodríguez PJA, Valdivia CG, Trincado MP (2007) [Vertebral fractures, osteoporosis and vitamin D levels in Chilean postmenopausal women]. [Article in Spanish]. Rev Med Chil. 135(1):31–36

    Article  Google Scholar 

  11. Contreras L, Kirschbaum A, Pumarino H (1991) Epidemiology of fractures in Chile. Rev Med Chile 119(1):92–98

    CAS  PubMed  Google Scholar 

  12. García J, Guerrero E, Terront A et al (2014) Costos de fracturas en mujeres con osteoporosis en Colombia. Acta Méd Colombiana 39:46–56

    Google Scholar 

  13. Medina-Orjuela A, Rosero-Olarte O, Rueda-Plata P et al (2018) II Consenso Colombiano para el Manejo de la Osteoporosis Posmenopáusica. Rev. Colomb. Reumatol. [Internet] 25(3):184–210

    Google Scholar 

  14. Jaller-Raad JJ, Jaller-Char JJ, Lechuga-Ortiz JA, Navarro-Lechuga E, Johansson H, Kanis JA (2013) Incidence of hip fracture in Barranquilla, Colombia, and the development of a Colombian FRAX model. Calcif Tissue Int. 93(1):15–22

    Article  CAS  PubMed  Google Scholar 

  15. Lopez G, Chacon K, Rivero A (2007) Incidencia de fractura de cadera en Costa Rica. Revista Medica de Costa Rica Y Centroamerica 580:125–132

    Google Scholar 

  16. López Gavilánez E, Chedraui P, Guerrero Franco K, Marriott Blum D, Palacio Riofrío J, Segale BA (2018) Fracturas osteoporóticas de cadera en adultos mayores en Ecuador 2016. Rev Osteoporos Metab Miner 10(2):63–70

    Google Scholar 

  17. Clark P, Tamayo JA, Cisneros F, Rivera FC, Valdés M (2013) Epidemiology of osteoporosis in Mexico. Present and future directions. Rev Invest Clin. 65(2):183–191

    PubMed  Google Scholar 

  18. Johansson H, Clark P, Carlos F, Oden A, McCloskey EV, Kanis JA (2011) Increasing age-and sex-specific rates of hip fracture in Mexico: a survey of the Mexican institute of social security. Osteoporos Int. 22(8):2359–2364

    Article  CAS  PubMed  Google Scholar 

  19. Chue de Coto E (1997) The incidence of hip fractures in pre- and postmenopausal women in Panama. Rev Med Panama 22:30–38

    CAS  PubMed  Google Scholar 

  20. Becarra-Rojas F, Jupari M (2001) Epidemiology of osteoporosis in Peru. Bone 29:294–313

    Article  Google Scholar 

  21. Morales-Torres J, Gutiérrez-Ureña S, Osteoporosis committee of PANLAR (2004) The burden of osteoporosis in Latin America. Osteoporos Int 15(625-632):6

    Google Scholar 

  22. Capunay MP, Vincentelo R, Dorregaray J, Angulo J (2002) Incidencia de fractura de femur proximal atribuible a osteoporosis en una población de Lima. J Clin Rheumatol 8:S49(abstract)

    Google Scholar 

  23. Riera-Espinoza G, Lopez D, Kanis JA (2008) Life-Time risk of hip fracture and incidence rates in Carabobo, Venezuela. Osteoporos Int 19(Suppl 2):S356

    Google Scholar 

  24. Cosman F (2017) Spine fracture prevalence in a nationally representative sample of US women and men aged ≥40 years: results from the National Health and Nutrition Examination Survey (NHANES) 2013-2014---supplementary Presentation. Osteoporos Int. 28(8):2319–2320

    Article  CAS  PubMed  Google Scholar 

  25. Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, Lorentzon M, McCloskey EV, Harvey NC, Javaid MK, Kanis JA, International Osteoporosis Foundation (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15(1):59

    Article  PubMed  PubMed Central  Google Scholar 

  26. Leslie WD, Crandall CJ (2019) Population-based osteoporosis primary prevention and screening for quality of care in osteoporosis. Current Osteoporosis Reports Curr Osteoporos Rep. 17(6):483–490

    Article  PubMed  Google Scholar 

  27. Rubin KH, Friis-Holmberg T, Pernille Hermann AP, Abrahamsen B, Brixen K (2013) Risk assessment tools to identify women with increased risk of osteoporotic fracture: complexity or simplicity? A systematic review. J Bone Miner Res. 28(8):1701–1717

    Article  PubMed  Google Scholar 

  28. Saraví FD (2013) Osteoporosis self-assessment tool performance in a large sample of postmenopausal women of mendoza, Argentina. J Osteoporos 2013:150154

    PubMed  PubMed Central  Google Scholar 

  29. Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int. 16(3):229–238

    Article  CAS  PubMed  Google Scholar 

  30. Lewiecke EM, Binkley N, Morgan SL, Shuhart CR, Camargos BM, Carey JJ, Gordon CM, Jankowski LG, Lee JK, Leslie WD, International Society for Clinical Densitometry (2016) Best practices for dual-energy X-ray absorptiometry measurement and reporting: International Society for Clinical Densitometry Guidance. J Clin Densitom. 19(2):127–140

    Article  Google Scholar 

  31. Radominski SC, Bernardo W, Paula AP et al (2017) Brazilian guidelines for the diagnosis and treatment of postmenopausal osteoporosis. Rev Bras Reumatol Engl Ed. 57(Suppl 2):452–466

    Article  PubMed  Google Scholar 

  32. Population ages above 65 and above (% of total population) – Latin America & Caribbean. https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS?locations=zj&name_des=null Acessed June 22, 2020

  33. Schurman L, Galich AM, González C, González D, Messina OD, Sedlinsky C, Uñas CR, Sánchez A (2017) Argentine guidelines for the diagnosis, prevention and treatment of osteoporosis, 2015. Medicina (B Aires). 77(1):46–60

    PubMed  Google Scholar 

  34. Messina OD, Somma LF, Tamborenea MI et al (2016) Guías para el diagnóstico, la prevención y el tratamiento de la osteoporosis inducida por glucocorticoides en el adulto. Actual. Osteol. 12(2):107–125

    Google Scholar 

  35. Pereira RM, Carvalho JF, Paula AP et al (2012) Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis. Rev Bras Reumatol. 52(4):580–593

    Article  PubMed  Google Scholar 

  36. Loures MAR, Zerbini CAF, Danowski JS, Pereira RMR, Moreira C, Paula AP, Castro CHM, Szejnfeld VL, Mendonça LMC, Radominiski SC, Bezerra MC, Simões R, Bernardo WM (2017) Guidelines of the Brazilian Society of Rheumatology for the diagnosis and treatment of osteoporosis in men. Rev Bras Reumatol Engl Ed. 57(Suppl 2):497–514

    Article  PubMed  Google Scholar 

  37. Guías de diagnóstico, prevención y tratamento de la Osteoporosis 2018 http://schomm.cl/SCHOMM_Guias2018_Final.pdf Acessed January 22, 2020.

  38. Barberán M, Campusano C, Trincado P et al (2018) Recomendaciones para el uso correcto de densitometría ósea en la práctica clínica. Consenso de la Sociedad Chilena de Endocrinología y Diabetes. Revista médica de Chile 146(12):1471–1480

    Article  Google Scholar 

  39. Orjuela AM, Olarte OR, Plata PN, Escobar FS, Choueka MC et al (2018) II Consenso Colombiano para el Manejo de la Osteoporosis Posmenopáusica. Revista Colombiana de reumatologia 25(3):184–210. https://doi.org/10.1016/j.rcreu.2018.02.006

    Article  Google Scholar 

  40. Guía de práctica clínica sobre el diagnótico y el tratamento de la osteoporosis em la mujer posmenopáusica mexicana. https://www.ammom.mx/files/Osteoporosis%20GPC.pdf. Acessed January 22, 2020.

  41. Guía de prática clínica osteoporosis EsSalud (Seguro Social del Perú) http://www.essalud.gob.pe/transparencia/pdf/informacion/guia_osteoporosis2011.pdf. Acessed January 22, 2020.

  42. (2018) Consenso Venezolano de Menopausia. Rev Obstet Ginecol Venez;78(Supl 1):S81-S99.

  43. Salica D, Paley AM, Palacios S, Sánchez A, Eis SR et al (2010) Iberoamerican consensus on osteoporosis SIBOMM 2009. Rev Argentina Osteología 9(1):04–47 https://www.iofbonehealth.org/sites/default/files/PDFs/National%20Guidelines/SIBOMMConsensus-2009-english.pdf. Acessed January 22, 2020

    Google Scholar 

  44. Clynes MA, Westbury LD, Dennison EM, Kanis JA, Javaid MK, Harvey NC, Fujita M, Cooper C, Leslie WD, Shuhart CR, International Society for Clinical Densitometry (ISCD) and the International Osteoporosis Foundation (IOF) (2020) Bone densitometry worldwide: a global survey by the ISCD and IOF. Osteoporos Int. 31(9):1779–1786

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Albergaria BH, Chalem M, Clark P, Messina OD, Pereira RMR, Vidal LF (2018) Consensus statement: osteoporosis prevention and treatment in Latin America-current structure and future directions. Arch Osteoporos. 13(1):90

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank ABRASSO and SIBOMM for supporting this paper.

The authors thank Greta O. Solis (Nicaragua), Ricardo Alberto Farias Balatestra (Paraguay), Ana Marcela Jiménez Portillo (Honduras), and Rene Alfredo Benitez Campos (El Salvador) for providing data from your countries.

Author information

Authors and Affiliations

  1. Universidade Federal de São Paulo (UNIFESP), Rua Ministro Gastão Mesquita, 250 - apto 307, São Paulo, SP, São Paulo, SP, 05012-010, Brazil

    Sergio Setsuo Maeda

  2. Associação Brasileira de Avaliação e Osteometabolismo (ABRASSO), São Paulo, SP, Brazil

    Sergio Setsuo Maeda, Henrique Pierotti Arantes, Guilherme Cardenaz de Souza & João Lindolfo Cunha Borges

  3. Hospital Santo Tomas, Ciudad del Panama, Panama

    Ramiro Da Silva LLibre

  4. Sociedad Iberoamericana de Osteologia y Metabolismo Mineral (SIBOMM), Lisbon, Portugal

    Ramiro Da Silva LLibre, Francisco Fidencio Cons Molina, Diana Wiluzanski, Jorge Antonio Cedeño Taborda, Claudia Campusano Montaño, Tatiana Maida Vargas, Guillermo Luis Feldmann Lopez, Luis Vidal Neira, Gustavo Adolfo Molina Uribe, Daniel Salica, Ascanio Rafael Bencosme, Sonia Cerdas Perez & Carlos Ramón Rios Acosta

  5. Instituto Master de Ensino Presidente Antônio Carlos (IMEPAC), Araguari, MG, Brazil

    Henrique Pierotti Arantes

  6. Bone D Consultoria e Treinamento, São Paulo, SP, Brazil

    Guilherme Cardenaz de Souza

  7. Centro de Investigación en Artritis y Osteoporosis SC, Mexicali, BC, México

    Francisco Fidencio Cons Molina

  8. Centroseo, Montevideo, Uruguay

    Diana Wiluzanski

  9. Instituto Venezolano de Infertilidad, Valencia, Venezuela

    Jorge Antonio Cedeño Taborda

  10. Universidad de los Andes, Santiago, Chile

    Claudia Campusano Montaño

  11. Universidad Gabriel Rene Moreno, Santa Cruz, Bolívia

    Tatiana Maida Vargas

  12. Hospital Centro Médico, Guatemala, Guatemala

    Guillermo Luis Feldmann Lopez

  13. Hospital María Auxiliadora, Lima, Peru

    Luis Vidal Neira

  14. Grupo SOM, Clínica Las Américas, Medellín, Colombia

    Gustavo Adolfo Molina Uribe

  15. Universidad Nacional de Córdoba, Cordoba, Argentina

    Daniel Salica

  16. Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic

    Ascanio Rafael Bencosme

  17. Universidad de Costa Rica, San José, Costa Rica

    Sonia Cerdas Perez

  18. Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador

    Carlos Ramón Rios Acosta

  19. National University of Ireland, Galway & Galway University Hospitals, Galway, Ireland

    John J. Carey

  20. International Society for Clinical Densitometry (ISCD), Middletown, CT, USA

    John J. Carey

  21. Centro de Pesquisa Clínica do Brasil, Brasília, DF, Brazil

    João Lindolfo Cunha Borges

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  1. Sergio Setsuo Maeda
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  2. Ramiro Da Silva LLibre
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  8. Claudia Campusano Montaño
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  12. Gustavo Adolfo Molina Uribe
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  13. Daniel Salica
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  14. Ascanio Rafael Bencosme
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  15. Sonia Cerdas Perez
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  16. Carlos Ramón Rios Acosta
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  17. John J. Carey
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  18. João Lindolfo Cunha Borges
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Corresponding author

Correspondence to Sergio Setsuo Maeda.

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Conflicts of interest

Guilherme Cardenaz de Souza is a technical consultant of GE. Sergio Setsuo Maeda, Ramiro Da Silva LLibre, Henrique Pierotti Arantes, Francisco Fidencio Cons Molina, Diana Wiluzanski, Jorge Antonio Cedeño Taborda, Claudia Campusano Montaño, Tatiana Maida Vargas, Guillermo Luis Feldmann Lopez, Luis Vidal Neira, Gustavo Adolfo Molina Uribe, Daniel Salica, Ascanio Rafael Bencosme, Sonia Cerdas Perez, Carlos Ramón Rios Acosta, John J. Carey, and João Lindolfo Cunha Borges declare that they have no conflict of interest.

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Maeda, S.S., LLibre, R.D.S., Arantes, H.P. et al. Challenges and opportunities for quality densitometry in Latin America. Arch Osteoporos 16, 23 (2021). https://doi.org/10.1007/s11657-021-00892-y

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