Fracture rates in urban South African children of different ethnic origins: The Birth to Twenty Cohort

• Published in: Osteoporosis international 2009-01, Vol.20 (1), p.47-52
• Main Authors: Thandrayen, K, Norris, S. A, Pettifor, J. M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Continental Ancestry Group; Biological and medical sciences; Black; Child; Child, Preschool; children; Children & youth; Cohort Studies; Comparative studies; Diseases of the osteoarticular system; Endocrinology; Ethnic Groups; Ethnicity; European Continental Ancestry Group; Female; Fractures; Fractures, Bone - epidemiology; Fractures, Bone - ethnology; Humans; Incidence; Infant; Infant, Newborn; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Medicine; Medicine & Public Health; Multiple Trauma - epidemiology; nationalities and ethnic groups; Original; Original Article; Orthopedics; Osteoporosis. Osteomalacia. Paget disease; Rheumatology; South Africa - epidemiology; Traumas. Diseases due to physical agents; Urban Population; White; Young Adult
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-008-0627-x

Summary Fracture rates were compared in children of different ethnic backgrounds from Johannesburg, South Africa. More white children fracture than black and mixed ancestry children. Reasons for this may be due to greater sports participation by whites and genetic protective factors in blacks. This has to be further investigated. Introduction Fracture rates in childhood are as high as those in the elderly. Recent research has been undertaken to understand the reasons for this, but there is little information available on ethnic differences in childhood fracture rates. Methods Using the birth to twenty longitudinal cohort of children, we retrospectively obtained information on fractures and their sites from birth to 14.9 years of age on 2031 participants. The ethnic breakdown of the children was black (B) 78%, white (W) 9%, mixed ancestry (MA) 10.5% and Indian (I) 1.5%. Results Four hundred and forty-one (22%) children had sustained a fracture one or more times during their lifetime (males 27.5% and females 16.3%; p < 0.001). The percentage of children fracturing differed between the ethnic groups (W 41.5%, B 19%, MA 21%, I 30%; p < 0.001). Of the 441 children reporting fractures, 89(20%) sustained multiple fractures. The most common site of fracture was the upper limb (57%). Conclusion More white children fracture than black and mixed ancestry children. This is the first study to show ethnic differences in fracture rates among children. The reasons for these differences have to be further elucidated. Greater sports participation by whites and genetic protective factors in blacks may be contributing factors.