Osteoporosis International

, Volume 24, Issue 4, pp 1267–1273 | Cite as

Age-adjusted incidence rates of hip fractures between 2006 and 2009 in Rabat, Morocco

  • A. El Maghraoui
  • A. R. Ngbanda
  • N. Bensaoud
  • M. Bensaoud
  • A. Rezqi
  • M. A. Tazi
Original Article



This study, characterizing the incidence of hip fracture in the province of Rabat, showed that age- and sex-specific rates remained stable between 2006 and 2009. The demographic projections estimated for Morocco indicate that between 2010 and 2030, the expected annual number of hip fractures would increase about twofold.


No data on hip fracture incidence trends exist from Africa. The aim of the study was to determine time trends in hip fracture rates for the province of Rabat and to forecast the number of hip fractures expected in Morocco up to 2030.


All hip fracture cases registered during the years 2006–2009 were collected at all the public hospitals and private clinics with a trauma unit and/or a permanent orthopedic surgeon across the province.


Over the 4-year period, 723 (54.3 %) hip fractures were recorded in women and 607 (45.6 %) in men. The age- and gender-specific incidence of hip fracture rose steeply with advancing age. Hip fractures occurred later in women 75.0 (10.7) years than in men 73.3 (11.0) years (p = 0.014), and its incidence was higher in women than in men [85.9 (95 % CI 79.7–92.2) per 100,000 person-years vs. 72.7 (95 % CI 66.9–78.5)]. The incidence remained globally stable over the period study, and the linear regression analysis showed no significant statistical difference. For the year 2010, there were 4,327 hip fractures estimated in Morocco (53.3 % in women). Assuming no change in the age- and sex-specific incidence of hip fracture from 2010 to 2030, the number of hip fractures in men is expected to increase progressively from 2,019 to 3,961 and from 2,308 to 4,259 in women.


The age-specific incidence of hip fracture between the years 2006 and 2009 remained stable in Morocco, and the number of expected hip fractures would double between 2010 and 2030.


Hip fracture Hip fracture incidence Morocco Osteoporosis 


  1. 1.
    Jarvinen TL, Sievanen H, Khan KM, Heinonen A, Kannus P (2008) Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 336:124–126PubMedCrossRefGoogle Scholar
  2. 2.
    Sterling RS (2011) Gender and race/ethnicity differences in hip fracture incidence, morbidity, mortality, and function. Clin Orthop Relat Res 469:1913–1918PubMedCrossRefGoogle Scholar
  3. 3.
    Cals JW, Scheppers NA, Hopstaken RM et al (2007) Evidence based management of acute bronchitis; sustained competence of enhanced communication skills acquisition in general practice. Patient Educ Couns 68:270–278PubMedCrossRefGoogle Scholar
  4. 4.
    Diamantopoulos AP, Rohde G, Johnsrud I et al (2011) Incidence rates of fragility hip fracture in middle-aged and elderly men and women in southern Norway. Age Ageing 41(1):86–92PubMedCrossRefGoogle Scholar
  5. 5.
    Smith MZ, Goettsch BM, Van Ramshorst RD, O’Brien JA, Jaque SV, Sumida KD (2008) Resistance training and bone mineral density during growth. Int J Sports Med 29:316–321PubMedCrossRefGoogle Scholar
  6. 6.
    Dhanwal DK, Cooper C, Dennison EM (2010) Geographic variation in osteoporotic hip fracture incidence: the growing importance of Asian influences in coming decades. J Osteoporos 2010:757102PubMedGoogle Scholar
  7. 7.
    Melton LJ 3rd, Kearns AE, Atkinson EJ et al (2009) Secular trends in hip fracture incidence and recurrence. Osteoporos Int 20:687–694PubMedCrossRefGoogle Scholar
  8. 8.
  9. 9.
  10. 10.
    Ahlborg HG, Rosengren BE, Jarvinen TL et al (2010) Prevalence of osteoporosis and incidence of hip fracture in women—secular trends over 30 years. BMC Musculoskelet Disord 11:48PubMedCrossRefGoogle Scholar
  11. 11.
    El Maghraoui A, Koumba BA, Jroundi I, Achemlal L, Bezza A, Tazi MA (2005) Epidemiology of hip fractures in 2002 in Rabat, Morocco. Osteoporos Int 16:597–602PubMedCrossRefGoogle Scholar
  12. 12.
    Zebaze RM, Seeman E (2003) Epidemiology of hip and wrist fractures in Cameroon, Africa. Osteoporos Int 14:301–305PubMedCrossRefGoogle Scholar
  13. 13.
    Castro da Rocha FA, Ribeiro AR (2003) Low incidence of hip fractures in an equatorial area. Osteoporos Int 14:496–499PubMedCrossRefGoogle Scholar
  14. 14.
    Liu AM, Xu L, Zhao XH (1996) Rates of hip fractures in Beijing China. Zhonghua Liu Xing Bing Xue Za Zhi 17:6–9PubMedGoogle Scholar
  15. 15.
    Rowe SM, Yoon TR, Ryang DH (1993) An epidemiological study of hip fracture in Honam, Korea. Int Orthop 17:139–143PubMedGoogle Scholar
  16. 16.
    Orces CH (2009) Epidemiology of hip fractures in Ecuador. Rev Panam Salud Publica 25:438–442PubMedCrossRefGoogle Scholar
  17. 17.
    Sibai AM, Nasser W, Ammar W, Khalife MJ, Harb H, Fuleihan Gel H (2010) Hip fracture incidence in Lebanon: a national registry-based study with reference to standardized rates worldwide. Osteoporos Int 22:2499–2506PubMedCrossRefGoogle Scholar
  18. 18.
    Memon A, Pospula WM, Tantawy AY, Abdul-Ghafar S, Suresh A, Al-Rowaih A (1998) Incidence of hip fracture in Kuwait. Int J Epidemiol 27:860–865PubMedCrossRefGoogle Scholar
  19. 19.
    Valizadeh M, Mazloomzadeh S, Azizi R (2008) Epidemiology of hip fractures in Zanjan, Iran. Arch Osteoporos 3:1–5CrossRefGoogle Scholar
  20. 20.
    Lau EM (1993) Admission rates for hip fracture in Australia in the last decade. The New South Wales scene in a world perspective. Med J Aust 158:604–606PubMedGoogle Scholar
  21. 21.
    Lonnroos E, Kautiainen H, Karppi P et al (2006) Increased incidence of hip fractures. A population based-study in Finland. Bone 39:623–627PubMedCrossRefGoogle Scholar
  22. 22.
    de Pina MF, Alves SM, Barbosa M, Barros H (2008) Hip fractures cluster in space: an epidemiological analysis in Portugal. Osteoporos Int 19:1797–1804PubMedCrossRefGoogle Scholar
  23. 23.
    Hernandez JL, Olmos JM, Alonso MA et al (2006) Trend in hip fracture epidemiology over a 14-year period in a Spanish population. Osteoporos Int 17:464–470PubMedCrossRefGoogle Scholar
  24. 24.
    Ho SC, Bacon WE, Harris T, Looker A, Maggi S (1993) Hip fracture rates in Hong Kong and the United States, 1988 through 1989. Am J Public Health 83:694–697PubMedCrossRefGoogle Scholar
  25. 25.
    Clark P, Lavielle P, Franco-Marina F et al (2005) Incidence rates and life-time risk of hip fractures in Mexicans over 50 years of age: a population-based study. Osteoporos Int 16:2025–2030PubMedCrossRefGoogle Scholar
  26. 26.
    Morosano M, Masoni A, Sanchez A (2005) Incidence of hip fractures in the city of Rosario, Argentina. Osteoporos Int 16:1339–1344PubMedCrossRefGoogle Scholar
  27. 27.
    Couris CM, Duclos A, Rabilloud M et al (2007) A seventy percent overestimation of the burden of hip fractures in women aged 85 and over. Bone 41:896–900PubMedCrossRefGoogle Scholar
  28. 28.
    Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237–1244PubMedCrossRefGoogle Scholar
  29. 29.
    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 22:2359–2364PubMedCrossRefGoogle Scholar
  30. 30.
    Cooper C, Cole ZA, Holroyd CR et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288PubMedCrossRefGoogle Scholar
  31. 31.
    Holt G, Smith R, Duncan K, Hutchison JD, Reid D (2009) Changes in population demographics and the future incidence of hip fracture. Injury 40:722–726PubMedCrossRefGoogle Scholar
  32. 32.
    Bergstrom U, Jonsson H, Gustafson Y, Pettersson U, Stenlund H, Svensson O (2009) The hip fracture incidence curve is shifting to the right. Acta Orthop 80:520–524PubMedCrossRefGoogle Scholar
  33. 33.
    Fujiwara S, Sone T, Yamazaki K et al (2005) Heel bone ultrasound predicts non-spine fracture in Japanese men and women. Osteoporos Int 16:2107–2112PubMedCrossRefGoogle Scholar
  34. 34.
    Chevalley T, Guilley E, Herrmann FR, Hoffmeyer P, Rapin CH, Rizzoli R (2007) Incidence of hip fracture over a 10-year period (1991–2000): reversal of a secular trend. Bone 40:1284–1289PubMedCrossRefGoogle Scholar
  35. 35.
    Goettsch WG, de Jong RB, Kramarz P, Herings RM (2007) Developments of the incidence of osteoporosis in The Netherlands: a PHARMO study. Pharmacoepidemiol Drug Saf 16:166–172PubMedCrossRefGoogle Scholar
  36. 36.
    Maravic M, Taupin P, Landais P, Roux C (2011) Change in hip fracture incidence over the last 6 years in France. Osteoporos Int 22:797–801PubMedCrossRefGoogle Scholar
  37. 37.
    Kannus P, Niemi S, Parkkari J, Palvanen M, Vuori I, Jarvinen M (2006) Nationwide decline in incidence of hip fracture. J Bone Miner Res 21:1836–1838PubMedCrossRefGoogle Scholar
  38. 38.
    Kaastad TS, Meyer HE, Falch JA (1998) Incidence of hip fracture in Oslo, Norway: differences within the city. Bone 22:175–178PubMedCrossRefGoogle Scholar
  39. 39.
    Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427PubMedCrossRefGoogle Scholar
  40. 40.
    Armstrong ME, Spencer EA, Cairns BJ et al (2011) Body mass index and physical activity in relation to the incidence of hip fracture in postmenopausal women. J Bone Miner Res 26:1330–1338PubMedCrossRefGoogle Scholar
  41. 41.
    Guilley E, Herrmann F, Rapin CH, Hoffmeyer P, Rizzoli R, Chevalley T (2011) Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly. Osteoporos Int 22:647–653PubMedCrossRefGoogle Scholar
  42. 42.
    Kanis JA, Oden A, McCloskey EV, et al. (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. doi:10.1007/s00198-012-1964-3

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • A. El Maghraoui
    • 1
  • A. R. Ngbanda
    • 1
  • N. Bensaoud
    • 1
  • M. Bensaoud
    • 1
  • A. Rezqi
    • 1
  • M. A. Tazi
    • 2
  1. 1.Rheumatology DepartmentMilitary Hospital Mohammed VRabatMorocco
  2. 2.Epidemiology DepartmentMinistry of HealthRabatMorocco

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