Status of osteoporosis in postmenopausal women in rural communities of Southeast Nigeria: a cross-sectional study

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BACKGROUND/OBJECTIVES: Osteoporosis is a critical yet under-recognized public health issue among aging populations, particularly in resource-limited rural settings. This study assessed the prevalence, knowledge, attitudes, and practices (KAP) regarding osteoporosis among postmenopausal women in rural communities of Southeast Nigeria. METHODS: A community-based cross-sectional survey was conducted over a period of 10 months, from August 2024 to May 2025 across ten purposely selected rural communities in the five southeastern Nigerian states. A multistage sampling strategy recruited 587 eligible postmenopausal women aged ≥ 51 years. Data were collected using the Osteoporosis Prevalence, Knowledge, Attitude and Practice Questionnaire (OPKAPQ), a validated tool with high internal consistency (Cronbach's α = 0.84). Descriptive statistics and chi-square tests were performed using IBM SPSS v22. A p-value ≤ 0.05 was considered statistically significant. RESULTS: Of the 587 participants (mean age 59.8 years), 68.0% were diagnosed with osteoporosis. Knowledge about osteoporosis was low, with 28.1% demonstrating accurate understanding. Despite this, 63.4% had positive attitudes toward prevention and management. Preventive practices were poor, with only 20.1% engaging in appropriate behaviors. Significant associations were observed between osteoporosis prevalence and age ≥ 60 years (p = 0.011), parity ≤ 5 (p = 0.033), unmarried status (p = 0.020), alcohol use (p = 0.020), tobacco use (p = 0.013), and fracture history (p = 0.022). No significant associations were found with education, occupation, religion, or living arrangement. CONCLUSION: Osteoporosis prevalence among postmenopausal women in Southeast Nigeria is alarmingly high and accompanied by poor knowledge and preventive behaviors. While attitudes toward osteoporosis prevention were positive, these have not translated into effective practices. Community-based health interventions, including education and behavioral change strategies, are urgently needed to address this silent epidemic in rural Nigeria.