Prevalence of familial hyperlipidemia in the adult population of the Colombian Caribbean

Objectives: To estimate the prevalence of Familial Hyperlipidemia (FH) in a population of the Colombian Caribbean affiliated with Colombian Public Health Insurance Company (PHIC) and project this estimate to the population of the Colombian Caribbean. Methods: Data on a history of hyperlipidemia was collected by study investigators at including adults patients affiliated with PHIC (64,667) with ICD-10 diagnosis of hyperlipidemia (E78), or with a personal history of hyperlipidemia; or with abnormal lipid profile; or patients under treatment with lipid-lowering drugs. Data on personal or family history of premature coronary artery disease (CAD), presence of xanthomas and family history of FH were included. FHHe corresponded to LDL-C .190 mg/dL (5 mmol/L) for adults and/or with 1 first-degree relative similarly affected or with CAD. FHHo corresponded to LDL-C .500 mg/dL (13 mmol/ L) or LDL-C .300 mg/dL (8 mmol/L) under treatment with statins and/or 1 or both parents having clinically diagnosed FH. For the projection of the estimated prevalence of FH to the population of the Colombian Caribbean, the data of the adult population projections for the Colombian Caribbean of 2015 (general 10,442,134, adults 6,685,734) of the Departamento Administrativo Nacional de Estadisticas (DANE) were used. Results: If we assume that 1 of 5 patients with LDL-C .190 mg/dL (5 mmol/L) may have HF. The prevalence of patients with FH was 0.13% (87/64,667). The prevalence of adults with heterozygous FH (FHHe) was 0.13% (85/64,639). The prevalence of adults with homozygous HF (FHHo) was 0.0015% (1/64,639). Applying these estimates to the general population of Colombian Caribbean in 2015, the estimated number of cases of HF, FHHe and FHHo in the Caribbean Colombian could be approximately 13,574, 8,691 and 140, respectively. Conclusions: The estimated prevalence of FH, FHHe and FHHo in Colombian Caribbean was 1 of 769, 1 of 769 and 2 of 100,000 patients, respectivel

Prevalence of four statin benefit groups in a population of the Caribbean region of Colombia

Objectives: To estimate the prevalence of four Statin Benefit Groups (SBG) according to the 2018 ACC/AHA Multisociety Guideline on the Management of Blood Cholesterol, in a population of the Caribbean region of Colombia enrolled to DTC program Mutual SER-EPS in 2015 Methods: Data on a history of hyperlipidemia was collected by study investigators at including adults patients enrolled to DTC program Mutual SER-EPS in 2015 (N = 64,667) with ICD-10 diagnosis of hyperlipidemia (E78), or with a personal history of hyperlipidemia; or with abnormal lipid profile; or patients under treatment with lipid-lowering drugs. The four SBG were comprised adult patients $21 years of age with clinical atherosclerotic cardiovascular disease (ASCVD) (SBG1); adults$21 years of age with LDL-C $190 mg/dL (not due to secondary modifiable causes) (SBG2); adults aged 40 to 75 years without ASCVD, but with diabetes and with LDL-C 70 to 189 mg/dL (SBG3); and adults ages 40 to 75 years without ASCVD or diabetes, with LDL-C 70 to 189 mg/dL, and an estimated 10-year risk for ASCVD of$ 20% as determined by the Framingham Risk Score (SBG4). The prevalence of statin use by SBG and factors associated with statin use were estimated. Results: The prevalence of SBG1, SBG2, SBG3 and SBG4 in patients enrolled to DTC program Mutual SER-EPS in 2015 were 4.6% (2,985), 0.5% (337), 2.5% (1,633) and 1.3% (891), respectively. The prevalence of statin use in SBG1, SBG2, SBG3 and SBG4 were 69.1% (2,064), 40.6% (137), 47% (768) and 59.1% (463), respectively. Arterial hypertension (OR: 2.70; 95% IC 1.70-4.28) and personal history of ASCVD (OR: 3.43; 95% IC 2.15-5.46) were very significantly associated with statin use. Conclusions: The prevalence of SBG and statin use in patients enrolled to DTC program Mutual SEREPS in 2015 were 9% (5,846) and 58.7% (3,432), respectively

Prevalence of juvenile idiophatic arthritis in Colombia

To estimate the prevalence of Juvenile Idiophatic Arthritis (JIA) in Colombia. This cross-sectional study identified patients with a diagnosis code for AIJ (ICD-10 M08-M09) using a nationally-representative database of health care resource utilization provided by the “Sistema Integral de Información de la Protección Social (SISPRO)” in 2017. In addition, estimated prevalence was contrasted using data of personal history of JIA using a database of patients with ≤ 16 years affiliated to a subsidized-regime insurance company (N = 397,160) of the Caribbean region of Colombia. The estimated prevalences were extrapolated to the overall Colombian population using the demographic projections of individuals with ≤ 16 years of age (14,588,845) provided by the Departamento Administrativo Nacional de Estadisticas (DANE). In 2017, the prevalence of JIA in the subsidized-regime company was 13 per 100,000 (52/397.160). According to the data of SISPRO the prevalence of JIA in Colombia was 10.9 per 100,000 (1,602/14,588,845). Extrapolating these estimations to the general population of Colombia, the estimated number of prevalent cases of JIA in Colombia could be approximately 1.602 and 1.896 cases, respectively. These estimations are lower in Colombia compared to previously reported prevalence globally (between 60 and 400 cases per 100,000)

Associated factors to the control Of cardiovascular risk in a low-income population from the caribbean region of Colombia

To identify associated factors to the control of blood pressure (BP), low-density lipoprotein cholesterol (LDL) and glycated hemoglobin (hba1c) in a low-income population from the Caribbean region of Colombia, enrolled in “De todo corazón -DTC” program between 2013-201

Burden of disease in young population of a colombian health insurance company

To estimate the burden of disease of population between 10-24 years old enrolled in the SER JOVEN program of a Colombian insurance company using disability-adjusted life-years (DALYs). Incidences were estimated from the administrative claims data of Mutual SER EPS. The ICD-10 codes of the main diagnosis were identified and regrouped according to the categories of diseases reported in the global burden of disease (GBD) study. To estimate the years of life lost (YLL), the difference between the age of death and the life expectancy at that age was obtained in a reference mortality population. The years lived with disability (YLD) were obtained by multiplying the estimated morbidity and the disability weights of the GBD 2017. DALYs were calculated by adding YLD and YLLs. We used the information of 512 patients insured to Mutual SER-EPS between 10-24 years, who died during January 2015 to December 2017 from all causes, and the healthcare registers of young people aged 10-24 years residing in 21 municipalities where Mutual SER EPS has presence. In the studied population, premature deaths and disability produced 5,355 DALYs, for 2017. Of these, 67.1% (3,591) of the burden of disease was due to non-communicable causes; followed by communicable, maternal, neonatal, and nutritional diseases (15.9%). The remaining 17% were due to unintentional and vital injuries and unclassified causes. The specific causes with the highest reported burden were substance use disorders and mental disorders, and this relationship remained constant between 2015-2017. In both sexes the first cause was non-communicable diseases; in men, injuries; and in women, communicable, maternal, neonatal diseases. In the analyzed population there was a considerable burden of disease associated with mental disorders and substance use. It is recommended to implement effective strategies that allow prioritizing the diseases that generate the greatest burden

Adherence to long-acting reversible contraceptive methods in low- income young women from the caribbean region of Colombia

Adolescent pregnancies are more likely to occur in poor communities, commonly driven by lack of education and employment opportunities. We aimed to estimate the subdermal implant discontinuation rate and to establish the factors associated with the discontinuation of long-acting reversible contraceptive (LARC) methods in a cohort of poor women in the Caribbean region of Colombia. A retrospective cohort study of LARC method use through review of administrative record data was conducted. A population of 2,192 adolescents and young women between 10-24 years old enrolled in the “SER JOVEN” program and who received subdermal implants between 2015-2018 was considered for eligibility. This program is for young people affiliated to a health care company in the Caribbean region of Colombia. We realized a follow-up time-person of the retrospective cohort, and we estimated the incidence of discontinuation of the subdermal implant at six months, one year, two years, and three years. Kaplan-Meier estimator for survival curves, and Cox proportional hazard model were used to ascertain factors associated with method discontinuation risk. A p-value <0.050 was considered significant. A total of 2,192 women were selected with a mean (standard deviation -SD) age of 19.4 (2.8) years and a mean duration of use of subdermal implant of 2.6 (0.8) years. We estimated the subdermal implant discontinuation rate at six months in 0.7% [CI95% 0.3-1.1], a year later in 1.5% [CI95% 1-2], two years later in 2.1% [CI95% 1.5-2.7] and finally at three years in 2.2% [CI95% 1.6-2.8]. Women who stated they have children at baseline were about 70% less risk to discontinue subdermal implants (HR: 0.3 [CI95% 0.1 – 0.8]). Adolescent pregnancy is a public health problem, and it is an important cause of poverty and illness. Then, the use of subdermal implants is an effective alternative to prevent unintended pregnancies

Effectiveness of a cardiovascular risk management program in the reduction of premature mortality associated to cardiovascular events in the Caribbean region of Colombia

Objectives: To establish the effectiveness of a cardiovascular risk management program [“De Todo Corazon (DTC)” program in Mutual SER-EPS] in the reduction of premature mortality associated to cardiovascular events (CVE) (male , 55 years, female , 60 years). Methods: The population eligible for the study were patients over 18 years of age affiliated to Mutual SER insurance company between June 2015 and June 2018 and residents of the Caribbean region of Colombia, enrolled or not to DTC program in which a cardiovascular event (CVE) occurred. The main outcomes considered were age of occurrence of cardiovascular events (AOCVE), age at death due to CVE (ADCVE) and years life lost (YLL). For the evaluation of the effectiveness, differences in AOCVO, ADCVO and the YPLL between the patients enrolled and nonenrolled in the DTC program were estimated using a Simple Linear Regression model. Results: A total of 3.902 CVE occurred in the study period among both groups. The enrolled patients had an average of AOCVE of 4.96 years (95% CI 3.85-6.06) higher than in non-enrolled patients. The ADCVE average was 4.64 years (95% CI 1.47 - 7.81) higher in the enrolled patients compared with the non-enrolled patients. Patients enrolled in the DTC program had on average -3.54 (95% CI -5.62 - -1.46) YLL compared to the non-enrolled patients. Conclusions: The DTC program in Mutual SER-EPS was effective to delay the AOCVE, ADCVE and YPLL. DTC program is an effective strategy to reduce the incidence and premature mortality due to CVE in the Caribbean region of Colombia

Effectiveness of a cardiovascular disease prevention program in the control of cardiovascular risk factors in a low-income population from the caribbean region of Colombia

To evaluate the effectiveness of a cardiovascular disease prevention program in the control of cardiovascular risk factors in a low-income population from the Caribbean region of Colombi

Effectiveness of a cardiovascular risk management program in reducing the probability of premature death due to cardiovascular events in the Colombian caribbean region

Effectiveness of a cardiovascular risk management program in reducing the probability of premature death due to cardiovascular events in the Colombian Caribbean regio

Association between exposure/adherence to a cardiovascular risk management program and the incidence and mortality of cardiovascular events in the Caribbean region of Colombia

Objectives: To establish the association between the exposure to a cardiovascular risk management program [“De Todo Corazon (DTC)” program in Mutual SER-EPS] and the reduction of incidence and mortality by cardiovascular events (CVE: AMI, Stroke, congestive heart failure). Methods: Cohort study that compared the occurrence of CVE among patients over 18 years of age exposed and non-exposed to the DTC program (N = 113,277). Enrolled patients in the DTC program between June 2015 and June 2017 were considered as the exposed population and patients enrolled in the DTC program between July 2017 and July 2018 were considered as the unexposed population. Patients who achieved clinical goals (blood pressure, 140/90 mmHg, HbA1c, 7.5% and LDL cholesterol, 100 mg/dl) were considered adherent to the DTC program. Incidence and mortality rates were compared and Incidence rate ratio (IRR) was used to evaluate the effect of the program. A Poisson regression model was used to assess the association between exposure to the program and CVE adjusting by socio-demographic characteristics and clinical goals. Results: The incidence of CVE in exposed and unexposed patients was 6.8 and 9.5 per 1.000 persons per year, respectively [IRR of 0.72 (95% CI 0.60-0.87)]. Mortality associated to CVE in exposed and unexposed patients was 0.46 and 0.56 per 1.000 persons per year, respectively [IRR 0.82 (95% CI 0.40-1.95)]. When adjusting the estimation by age, sex and achievement of clinical goals, a lower incidence rate of CVE among patients who were adherent to the program was observed [IRR = 0.62 (CI 95% 0.46 - 0.86)]. Conclusions: Exposure to the DTC program significantly decreased the incidence and mortality CVE by 28% and 18%, respectively. Adherence to the DTC program significantly decreased the incidence of CVE by 38%