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)

Willingness to receive the COVID-19 vaccine in the population aged 80 years and older in Colombia 2021

Colombia diseñó y adoptó un plan de vacunación contra la COVID-19. El objetivo de esta investigación fue conocer la disposición para aceptar la vacunación contra esa enfermedad de personas de 80 y más anos. ˜ Métodos: Se realizó una encuesta telefónica a 11.721 personas de 80 y más anos, ˜ afiliadas a una aseguradora de salud, en la que se indagó sobre la intención a recibir la vacuna. Los respondientes fueron los afiliados o sus familiares o cuidadores. Resultados: El promedio de edad fue 85,0 anos ˜ (DE: 4,5), sin diferencias entre sexos; 3.344 participantes (28,5%) refirieron el antecedente de haberse realizado una prueba diagnóstica previa de COVID-19 y 73 resultaron positivos. La incidencia acumulada de infección por SARS-CoV-2 desde marzo de 2020 fue de 622,8 por 100.000 personas (IC95%: 491-778 por 100.000). Respecto a la actitud hacia la vacunación contra la COVID-19, uno de cada 4 respondientes se abstuvo de opinar o se manifestó neutro. Cuando el respondiente era un familiar, la aceptación de la vacuna era del 60,4% (IC95%: 59,5-61,3) con diferencias por sexo: entre los hombres era del 62,2% (IC95%: 60,8-63,6) y en mujeres del 59,2 (IC95%: 58,0-60,3), con p < 0,05. Cuando el respondiente fue el potencial receptor de la vacuna, la aceptación de la vacuna fue del 61,7% (IC95%: 59,4-64,0) y también difería por sexos: 70,2% en hombres (IC95%: 66,9-73,5) y 55,1% en mujeres (IC95%: 52,0-58,3), con p < 0,05

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

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%

Disposición a recibir la vacuna contra COVID-19 en población de 80 y más años en Colombia 2021

Objetivo Colombia diseñó y adoptó un plan de vacunación contra la COVID-19. El objetivo de esta investigación fue conocer la disposición para aceptar la vacunación contra esa enfermedad de personas de 80 y más años. Métodos Se realizó una encuesta telefónica a 11.721 personas de 80 y más años, afiliadas a una aseguradora de salud, en la que se indagó sobre la intención a recibir la vacuna. Los respondientes fueron los afiliados o sus familiares o cuidadores. Resultados El promedio de edad fue 85,0 años (SD: 4,5), sin diferencias entre sexos; 3.344 participantes (28,5%) refirieron el antecedente de haberse realizado una prueba diagnóstica previa de COVID-19 y 73 resultaron positivos. La incidencia acumulada de infección por SARS-CoV-2 desde marzo de 2020 fue de 622,8 por 100.000 personas (IC95%: 491-778 por 100.000). Respecto a la actitud hacia la vacunación contra la COVID-19, uno de cada 4 respondientes se abstuvo de opinar o se manifestó neutro. Cuando el respondiente era un familiar, la aceptación de la vacuna era del 60,4% (IC95%: 59,5-61,3) con diferencias por sexo: entre los hombres era del 62,2% (IC95%: 60,8-63,6) y en mujeres del 59,2 (IC95%: 58,0-60,3), con p < 0,05. Cuando el respondiente fue el potencial receptor de la vacuna, la aceptación de la vacuna fue del 61,7% (IC95%: 59,4-64,0) y también difería por sexos: 70,2% en hombres (IC95%: 66,9-73,5) y 55,1% en mujeres (IC95%: 52,0-58,3), con p < 0,05. Conclusión La relativamente baja aceptación de la vacunación contra la COVID-19 en Colombia plantea retos importantes para lograr el control de la pandemia.Objective Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The study aim was to detect the level of willingness to accept vaccination against COVID-19. Methods A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried out. The respondents were the affiliates or their relatives or caregivers. Results The average age was 85.0 years (SD: 4.5), with no differences between sexes; 3,344 (28.5%) referred to a previous diagnostic test for COVID-19 and 73 were positive, giving an incidence of 622.8 per 100,000 people (95% CI: 491-778). Regarding attitude to vaccination against SARS-CoV-2, 1/4 respondents refrained from giving an opinion or were neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI: 59.5-61.3) with differences by gender: men 62.2% (95% CI: 60.8-63.6) and women 59.2 (95% CI: 58.0-60.3), P < .05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI: 59.4-64.0) and this also differed by gender: 70.2% in men (95% CI: 66, 9-73.5) and 55.1% in women (95% CI: 52.0-58.3), P < .05. Conclusion The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that would allow control of the pandemic

Effectiveness of CoronaVac and BNT162b2 covid-19 mass vaccination in Colombia: a population-based cohort study

BACKGROUND: In February 2021, Colombia began mass vaccination against COVID-19 using mainly BNT162b2 and CoronaVac vaccines. We aimed to estimate vaccine effectiveness (VE) to prevent COVID-19 symptomatic cases, hospitalization, critical care admission, and deaths in a cohort of 796,072 insured subjects older than 40 years in northern Colombia, a setting with a high SARS-CoV-2 transmission. METHODS: We identified individuals vaccinated between March 1st of 2021 and August 15th of 2021. We included symptomatic cases, hospitalizations, critical care admissions, and deaths in patients with confirmed COVID-19 as main outcomes. We calculated VE for each outcome from the hazard ratio in Cox proportionally hazards regressions (adjusted by age, sex, place of residence, diabetes, human immunodeficiency virus, cancer, hypertension, tuberculosis, neurological diseases, and chronic renal disease), with 95% confidence intervals (CI). FINDINGS: A total of 719,735 insured participants of 40 and more years were followed. We found 21,545 laboratory-confirmed symptomatic COVID-19 among unvaccinated population, along with 2874 hospitalizations, 1061 critical care admissions, and 1329 deaths, for a rate of 207.2 per million person-days, 27.1 per million person-days, 10.0 per million person-days, and 12.5 per million person-days, respectively. We found CoronaVac was not effective for any outcome in subjects above 80 years old; but for people 40-79 years of age, we found two doses of CoronaVac reduced hospitalization (33.1%; 95% CI, 14.5–47.7), critical care admission (47.2%; 95% CI, 18.5–65.8), and death (55.7%; 95% CI, 32.5–70.0). We found BNT162b2 was effective for all outcomes in the entire population of subjects above 40 years of age, significantly declining for subjects ≥80 years. INTERPRETATION: Two doses of either CoronaVac in population between 40 and 79 years of age, or BNT162b2 among vaccinated above 40 years old significantly reduced deaths of confirmed COVID-19 in a cohort of individuals from Colombia. Vaccine effectiveness for CoronaVac and BNT162b2 declined with increasing age. FUNDING: UK National Institute for Health Research, the European Union's Horizon 2020 research and innovation programme, and the Bill & Melinda Gates Foundation

Effectiveness of CoronaVac and BNT162b2 COVID-19 mass vaccination in Colombia: a population-based cohort study

Background In February 2021, Colombia began mass vaccination against COVID-19 using mainly BNT162b2 and CoronaVac vaccines. We aimed to estimate vaccine effectiveness (VE) to prevent COVID-19 symptomatic cases, hospitalization, critical care admission, and deaths in a cohort of 796,072 insured subjects older than 40 years in northern Colombia, a setting with a high SARS-CoV-2 transmission. Methods We identified individuals vaccinated between March 1st of 2021 and August 15th of 2021. We included symptomatic cases, hospitalizations, critical care admissions, and deaths in patients with confirmed COVID-19 as main outcomes. We calculated VE for each outcome from the hazard ratio in Cox proportionally hazards regressions (adjusted by age, sex, place of residence, diabetes, human immunodeficiency virus, cancer, hypertension, tuberculosis, neurological diseases, and chronic renal disease), with 95% confidence intervals (CI). Findings A total of 719,735 insured participants of 40 and more years were followed. We found 21,545 laboratoryconfirmed symptomatic COVID-19 among unvaccinated population, along with 2874 hospitalizations, 1061 critical care admissions, and 1329 deaths, for a rate of 207.2 per million person-days, 27.1 per million person-days, 10.0 per million person-days, and 12.5 per million person-days, respectively. We found CoronaVac was not effective for any outcome in subjects above 80 years old; but for people 40-79 years of age, we found two doses of CoronaVac reduced hospitalization (33.1%; 95% CI, 14.5−47.7), critical care admission (47.2%; 95% CI, 18.5−65.8), and death (55.7%; 95% CI, 32.5−70.0). We found BNT162b2 was effective for all outcomes in the entire population of subjects above 40 years of age, significantly declining for subjects ≥80 years. Interpretation Two doses of either CoronaVac in population between 40 and 79 years of age, or BNT162b2 among vaccinated above 40 years old significantly reduced deaths of confirmed COVID-19 in a cohort of individuals from Colombia. Vaccine effectiveness for CoronaVac and BNT162b2 declined with increasing age. Funding UK National Institute for Health Research, the European Union’s Horizon 2020 research and innovation programme, and the Bill & Melinda Gates Foundation