By Chidinma Ewunonu-Aluko, Ibadan
Health experts have called for greater public awareness, early prevention and stronger government-private sector collaboration to address the growing burden of osteoporosis in Nigeria, particularly among the elderly.
They made the call during the official commissioning of Centre for Osteoporosis and Bone Health on Thursday in Ibadan.
The Chief Executive Officer of the Centre for Osteoporosis and Bone Health, Prof. Temitope Alonge, emphasised the need for deepened synergy between governments at all levels and the organised private sector health operators to create more access to quality healthcare to the public.
He described osteoporosis as a condition where bone mineral content reduced to the point that even minor falls can lead to fractures, known as fragility fractures, commonly affecting the wrist, hip and spine.
Alonge, a former Chief Medical Director at the University College Hospital (UCH), Ibadan, said bone health remained poorly understood by the general public, in spite of the fact that bones were one of the most vital organs of the human body.
“People often think bone is just the skeleton that gives you height and structure, but bone is a very important organ.
“Apart from providing the framework of what you look like, it is the biggest store of key minerals in the body, particularly calcium,” he stated.
He explained that bone formation and breakdown occurred continuously through a process known as remodeling, driven by a delicate balance between bone-forming cells, called osteoblasts, and bone-resorbing cells, known as osteoclasts.
According to him, there is a synergy and hormonal interplay that determines how much bone is formed and how much is removed.
“If bones were formed alone without resorption, everybody would be monsters.”
Resorption is the biological process, where specialised cells, mostly osteoclasts, breakdown and absorb tissues like bone structure into the body. It is a normal process for remodeling bone.
He remarked that women generally had stronger bones during their reproductive years due to the protective role of estrogen, but “bone loss accelerates after menopause when estrogen levels fall.”
Citing findings from a study conducted at the University College Hospital Ibadan, Alonge said osteoporosis was rarely seen before the age of 40.
“But, its prevalence increased significantly from middle age.
“We studied about 2,040 patients and found that before the age of 40, no patient had osteoporosis.
“After 45 to 50, we started seeing osteopenia, and by the time people got to 60, we began to see full-blown osteoporosis,” he said.
Explaining further, he said: “Osteoporosis as a condition where bone mineral content reduced to the point that even minor falls can lead to fractures, known as fragility fractures, commonly affecting the wrist, hip and spine.
“That is why someone who was six feet tall when younger may appear to be shrinking at 70 or 80. The spine collapses gradually, leading to wedge fractures and sometimes a hunchback”.
Alonge stressed that exercise, good nutrition and early lifestyle habits were crucial in building adequate bone stock before old age.
“The reason people go to the gym and exercise is not because they have nothing to do. They are trying to maintain a reasonable bone stock so that when they get older, they are protected.”
He warned that Nigeria was likely to face a growing osteoporosis burden as life expectancy improved.
“In the past, life expectancy was low, so osteoporosis was not a major public health issue but now, people are living longer, and the risk of osteoporosis and fragility fractures is much higher,” he added.
He also referenced global figures showing that countries like the U.S. and the United Kingdom spent billions of dollars annually to manage osteoporosis-related complications.
“About 20 years ago, the U.S. was spending around 18 billion dollars annually on osteoporosis. By now, it is probably 20 to 30 billion dollars, that is why prevention is better than cure,” he said.
According to him, the Centre for Osteoporosis and Bone Health was established to focus on education, early diagnosis and individualized treatment.
“There is treatment for osteoporosis, and it depends on the severity and what the patient can afford, some medications are taken orally, some weekly or monthly, some by injection, and some intravenously,” he noted.
Alonge added that nutritional management is central to treatment, stressing the importance of using calcium supplements that are properly absorbed into the bones.
“There is no point taking calcium that will not be absorbed.
“The calcium must be combined with vitamin D3 for absorption and vitamin K2 to transport it into the bone. Otherwise, it may be wasted or end up as kidney stones,” he said.
On access and affordability, he called for stronger partnerships between government and the private sector, as well as wider health insurance coverage.
“Health is both a business and a social service, no amount of money released by government alone can solve Nigeria’s health problems.
“If the private sector is not integrated, the system will not work.”
He urged political leaders and institutions to invest in preventive care for the elderly rather than short-term, populist spending.
“Why can’t someone say, in my village I have 50 elderly people and I want to help 10 of them get screened?
“That is a better relationship with the people than flamboyant spending,” he said.
Alonge further advocated making bone density screening routine for older Nigerians.
“Outside this country, it is almost mandatory for anyone above 60 or 65 to have a DEXA scan every year.
“Not just because they love the people, but because the cost of fractures is enormous,” he said.
Earlier in her remarks, the Oyo State Commissioner for Health, Dr Oluwaserimi Ajetunmobi, described the centre as a major step toward improving the quality of life of elderly residents.
“This centre is actually for our health, as we grow older, there is a tendency for our bones to become softer, and when elderly people fall, their bones can break easily,” she said.
Ajetunmobi explained that the facility was equipped to assess bone mineral density and determine the level of bone loss in patients.
She said from the assessment, they could know whether a patient has bone softness or related conditions, and then offer the right support to keep the bones strong.
Ajetunmobi added that the centre would also provide counselling, lifestyle guidance and nutritional advice to help older people age more gracefully.
“We will all grow old one day.
“Aging gracefully means not breaking hips, not becoming completely dependent, and being able to stay active for as long as possible.
“The state government, through the Oyo State Government, is exploring ways to collaborate with the centre to improve access, especially for elderly residents,” she said.
The News Agency of Nigeria (NAN) reports that Health stakeholders at the event in their separate remarks, agreed that with Nigeria’s aging population, sustained investment in bone health, prevention and insurance-backed care would be critical to achieving broader universal health coverage. (NAN)
Post a Comment