Title : Osteoporosis as a silent driver of fragility fractures: A narrative review of risk factors, management, and health system gaps in Nigeria with comparative insights from the United Kingdom
Abstract:
Osteoporosis is an under-recognised contributor to fragility fractures, particularly in low- and middle-income countries. In Nigeria, limited awareness, inadequate screening, and fragmented care pathways contribute to delayed diagnosis and increased fracture risk, whereas the United Kingdom demonstrates more structured approaches to prevention and management.
This narrative review synthesised evidence from 42 studies and policy documents published between 2010 and 2025. Data were analysed thematically, focusing on risk factors, diagnostic practices, management strategies, and health system capacity.
Findings demonstrate that osteoporosis in Nigeria is driven by demographic, hormonal, nutritional, and lifestyle factors, compounded by limited access to diagnostic tools and treatment. System-level challenges, including lack of screening programmes and coordinated care pathways, further worsen outcomes. In contrast, the UK benefits from structured risk assessment, improved access to diagnostics, and integrated fracture care services.
Addressing osteoporosis in Nigeria requires improved awareness, expanded access to diagnostics and treatment, and development of coordinated care pathways. Adapting context-appropriate elements from established systems such as the UK may offer practical solutions to improve fracture prevention and management in resource-limited settings.
