Burden of disease in Colombian Orinoquia, 2017

Abstract

Background: Population health diagnoses are a fundamental tool to guide health policies and programs, and consequently, public health requirements. In this perspective, the burden of disease in inhabitants of Colombian Orinoquia is quantified for the first time. Methods: A descriptive population-based study that was based on secondary sources was carried out, which aimed at measuring the burden of the disease in the Colombian region of Orinoquia, using the simplified synthetic indicator of disability-adjusted life years (DALYs) of the global health estimation methodology. We used mortality records from the National Administrative Department of Statistics (DANE) and service provision records from the Ministry of Health and Social Protection of Colombia, both records from the year 2017, available on the Integrated Social Protection Information System. Results: 288,740.2 DALYs occurred (95% UI 210,714.6-382,948.8), with higher reports for men (59%); group of non-communicable diseases accounted for 62.3% of DALY (179,993.6, 95% UI, 115,030.2-268,405.0), followed by external cause injuries group which contributed 24.6% (71,000.0, 95% UI, 25,638.1-134,013.1), and group of communicable, maternal, neonatal, and nutritional disorders which contributed 13.1% (37,746.0, 95% UI, 28,048.0-50,239.7). Interpersonal violence was the primary cause specific of DALYs with 9.8% of the burden, (28,290.0, 95% UI, 7,365.1-64,208.1). Conclusions: Most DALYs in Orinoquia are produced by non-communicable diseases (NCD), largely caused by neoplasms and cardiovascular disease, which increased with age. However, when considered by specific cause of illness or injury, interpersonal violence is indicated as the main cause of DALYs, affecting mainly young men, possibly as an expression of social inequality, substance use, criminality, and insecurity. It is important to highlight that this region has been recognized as an area of armed conflict, drug trafficking, and poverty.

The burden of tuberculosis disease in women, Colombia 2010-2018

“…In the case of Vichada, the underreporting of mortality in women, estimated for its vital statistics system, was 64%, while in men it was 49%, evidencing the possibility of underreporting of mortality from TB 30 in this entity. In addition to the above, in the BD study conducted for the Colombian Orinoquia, the rate of YLL in women from Vichada was 124.1 (II95% 9.9-366.9) for 2017, which may be due to the adjustment for completeness that was made in that study 6 that did not differentiate events, however, in our study Vichada did not report deaths.…”

“…Finally, the research described here is important to fill the knowledge gap on the use of DALYs as a composite indicator, which in addition to resolving the antagonisms for decisionmaking generated by simple indicators, unifies the quantification in the same unit of measurement of morbidity as a suboptimal health status and mortality as the time lost when dying before reaching life expectancy 6 . Additionally, to fill the knowledge gap on finding the causes of subnational gaps in TB disease burden in women.…”

“…The use of composite indicators such as Disability Adjusted Life Years (DALYs) to measure burden disease BD with the up-dated methodology of the World Health Organization WHO is recent in the country. It has been used for the global burden in the Colombian Orinoquía 6 and for the regionalized national order for TB 7,8 , however, although these include the variable sex, the specific behavior in women is not analyzed.…”