ArticleOrphanet journal of rare diseases2026
Mortality trends and socioeconomic inequalities in sickle cell disease in Colombia, 2012-2023: a population-based study.
Article in Orphanet journal of rare diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSickle cell disease (SCD) is one of the most common monogenic disorders worldwide and remains associated with substantial mortality in low- and middle-income countries. In Colombia, population-level evidence on long-term mortality trends and socioeconomic inequalities in SCD is limited.
methodsWe conducted an ecological time-series study using death certificate data from the Colombian National Administrative Department of Statistics (DANE). Age-standardized mortality rates (ASMRs) were calculated using the WHO world standard population. Temporal trends were assessed using joinpoint regression and mixed-effects Poisson models. Departments were classified into tertiles of socioeconomic development using the Multidimensional Poverty Index. Additional analyses examined differences by sex and urban-rural residence, and interrupted time-series and excess mortality analyses assessed the COVID-19 period (2020-2021).
resultsA total of 675 SCD-related deaths were recorded between 2012 and 2023. The national ASMR increased from 0.055 per 100,000 in 2012 to 0.143 per 100,000 in 2023. In mixed-effects Poisson models, mortality increased (rate ratio [RR] per year = 1.03; 95% CI: 1.01-1.06; p = 0.002). Joinpoint analysis showed a rising trend among males (AAPC = + 8.20%; 95% CI: 0.98 to 15.24; p = 0.029). Mortality varied across departments, with the highest rates in Caribbean regions. Departments with low socioeconomic development had higher mortality than those with high development (RR = 3.00; 95% CI: 1.19-7.61; p = 0.020), and this association strengthened after adjustment for sex and area of residence (RR = 4.00; 95% CI: 1.60-9.97; p = 0.003). During 2020-2021, observed deaths were lower than expected based on pre-pandemic trends (standardized mortality ratio = 0.80; 95% CI: 0.68-0.95).
conclusionsSCD mortality in Colombia increased between 2012 and 2023, marked by territorial and socioeconomic inequalities. The apparent decline during the COVID-19 period likely reflects under-registration rather than a true reduction in mortality.
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