Prevalence and Severity of Self‐Assessed Hallux Valgus in Community‐Dwelling Older South African and Flemish Individuals

INTRODUCTION: Hallux valgus (HV) is a common foot deformity in older adults, frequently associated with pain and functional impairment. Global prevalence is estimated at 19%, although it varies by continent; consequently, there is a notable knowledge gap concerning its prevalence and severity in older populations of South Africa and Belgium. This study aimed to compare HV prevalence and severity, report on footwear habits within these cohorts, and examine associations with sex, age, and body mass index (BMI). METHODS: This observational cross-sectional study recruited 300 community-dwelling adults aged ≥ 60 years from Flanders, Belgium (n = 145) and the Western Cape, South Africa (n = 155). Demographic data, footwear habits, and HV self-assessment scores (using the Manchester scale) were collected via an online questionnaire. Associations between HV and other variables were examined using chi-square tests. RESULTS: HV prevalence was 27.6% in the Flemish cohort and 31.6% in the South African cohort. Although South Africans reported more frequent barefootedness, HV prevalence rates remained similar. HV prevalence was significantly higher in females (35.4%) compared to males (17.0%). Furthermore, prevalence and severity increased with age but were inversely associated with BMI. CONCLUSION: HV prevalence is similar in older South African and Flemish individuals, despite differing footwear habits, supporting the multifactorial nature of HV formation. These findings emphasize the need for region-specific data and clinical strategies to address HV in older populations.