Determining prevalence of osteoporosis in health-seeking population of rural central India using singh's index: A resource optimization model to fight a silent epidemic

Context: To bring the prevalence of osteoporosis in rural India to the forefront of health care, to increase awareness and encourage proactive diagnosis of osteoporosis in a cost-effective manner. Settings: A retrospective observational study was designed to analyze a cohort of adult population attending outpatient clinic at a rural mission hospital. 350 patients with low back pain were evaluated for osteoporosis using the Singh's Index (SI). Methods: Sample size was calculated with 95% confidence level, with confidence interval of five. Three hundred and eighty-four radiographs were graded as per SI. Adult patients 40 years of age and above, with low back ache were included in the study. Patient data were retrieved using Doc 99 Hospaa3 HIMS software. Radiographs for all patients were evaluated using Medsynapse PACS software. Thirty-four radiographs were excluded from the study due to poor image quality. Results: Sample included 181 females and 169 males. Two hundred and eighty-five (84%) radiographs were graded as Grade 3 or below indicating definite osteoporosis. A total of 141 males (84%) and 144 females (80%) were graded as Singh's Grade 3 or less indicating definite osteoporosis. Conclusions: The rural physician must exercise a high clinical index of suspicion of osteoporosis and should encourage routine evaluation and diagnosis of osteoporosis using cost-effective means such as SI in resource-limited areas of the rural India. Limitations: This study highlights the prevalence of osteoporosis among healthcare-seeking adult population and cannot be extrapolated to the general population.