Oscar Alexander Gutiérrez Lesmes

Background: Anxiety disorders are among the leading contributors to non-fatal health loss worldwide. However, subnational evidence on their burden and territorial distribution in Colombia remains limited. This study estimated the burden of anxiety disorders across Colombian departments and assessed temporal trends, geographic inequalities, and differences by sex and age between 2016 and 2022. Objective: To estimate the subnational burden of anxiety disorders in Colombia between 2016 and 2022 using disability-adjusted life years (DALYs), and to assess temporal trends, territorial inequalities, and differences by sex and age. Methods: A longitudinal ecological study was conducted using official national administrative databases. Disability-adjusted life years (DALYs) were estimated according to the World Health Organization Global Health Estimates framework using ICD-10 codes F40–F44. Morbidity data were obtained from the Individual Health Service Provision Records (RIPS), mortality data from the Single Registry of Affiliates (RUAF), and population denominators from the National Administrative Department of Statistics (DANE). Crude and age-standardized DALY rates were calculated by department, sex, and age group. Temporal trends were assessed using annual percent change (APC) models. Results: During 2016–2022, 3,055,505 cases and 21 deaths attributable to anxiety disorders were identified, corresponding to an estimated 1,266,489 DALYs. The national age-standardized DALY rate increased from 177.9 per 100,000 population in 2016 to 687.4 per 100,000 in 2022, with an APC of 25.41% (95% CI 19.48–31.63). Women consistently showed higher burden than men throughout the study period. Marked territorial inequalities were identified, with the highest burden concentrated in departments of the Andean region, particularly Risaralda, Caldas, and Bogotá, D.C. whereas lower rates were observed in Amazonian and Orinoquía territories. Conclusions: Anxiety disorders accounted for a substantial and increasing estimated burden among individuals recorded in the Colombian health system during 2016–2022, with marked territorial heterogeneity and important differences by sex and age. These findings provide subnational evidence to support population health monitoring and burden-of-disease assessment, while recognizing that administrative health records reflect treated morbidity and healthcare utilization rather than population prevalence.

Alcohol and psychoactive substance use represent a major burden for global public health, increasing the risk of non-communicable diseases, violence, road traffic injuries, dependence, and mental disorders, and generating impacts on productivity and social welfare. This study aimed to estimate the burden of disease attributable to alcohol and other psychoactive substances in the departments of Colombia from 2016 to 2022. A burden-of-disease study was conducted using the Disability-Adjusted Life Years (DALYs) indicator, following the methodology of the World Health Organization Global Health Estimates. Official morbidity and mortality databases were used. An estimated 236,154.42 DALYs were attributable to alcohol and psychoactive substance use in Colombia during the study period, increasing from 14,158.7 DALYs in 2016 to 40,190.7 DALYs in 2022. The burden was heterogeneous across departments, with values above 1000 DALYs in Quindío (1779.5), Nariño (1624.3), and Norte de Santander (1008.0) and below 132 DALYs in La Guajira, Casanare, and Vaupés. Men accounted for 73.5% of total DALYs. The mean age of morbidity records associated with alcohol and psychoactive substance use disorders was 30.67 years in men and 32.37 years in women. The burden associated with psychoactive substance use is increasing in Colombia, with differences by sex and department of residence.

El cáncer constituye uno de los principales desafíos para la salud pública, pero sus efectos no se viven de la misma manera en todos los territorios. Cáncer en la Orinoquia colombiana: años de vida saludable perdidos entre los años 2019 y 2022 presenta un análisis integral de la carga de esta enfermedad en los cuatro departamentos de la Orinoquia colombiana, a partir del indicador de Años de Vida Ajustados por Discapacidad (AVAD). La investigación permite dimensionar el impacto de los diferentes tipos de cáncer según territorio, edad y sexo, y revela patrones que van más allá de las cifras de mortalidad, al incorporar también los años vividos con discapacidad. Más que presentar datos epidemiológicos, esta obra propone una mirada territorial sobre uno de los grandes desafíos de la salud pública. Sus hallazgos aportan evidencia científica para comprender las particularidades epidemiológicas de la región y fortalecer la toma de decisiones, ofreciendo elementos para la formulación de políticas públicas más pertinentes, equitativas y sensibles a las realidades de las comunidades de la Orinoquia. Asimismo, abre nuevas perspectivas para abordar el cáncer desde una visión que articula las dimensiones biomédica, social, económica y humana de la salud. Una obra de interés para investigadores, profesionales de la salud y tomadores de decisiones que buscan transformar la información en conocimiento útil para mejorar la salud y el bienestar de la población.

Mental disorders encompass conditions that affect cognition, emotions, and behavior, representing a major public health challenge. In Colombia, there are no studies that estimate the burden of disease caused by mental and behavioral disorders. This study aimed to determine the burden of disease attributable to these conditions in the departments of Colombia in 2022. A burden of disease analysis was conducted using official national data sources, including the Individual Health Service Delivery Records and death certificates from the Vital Statistics System, consolidated by the Ministry of Health and Social Protection within the Integrated Social Protection Information System. Estimation methods followed the World Health Organization’s Global Health Estimates framework. Disability-Adjusted Life Years were used as the summary measure, integrating mortality and non-fatal outcomes to quantify the overall population impact. A total of 296,010.6 Disability-Adjusted Life Years were estimated (95% UI: 279,343.2–312,678), representing a rate of 572.7 (95% UI: 540.5–605) per 100,000 population. Anxiety accounted for 47.26%. Women represented 60.86% of the total burden, with 180,157.6 (95% UI: 165,046.3–195,268.9). Overall, 99.27% of the burden from mental and behavioral disorders was due to Years Lived with Disability, underscoring the substantial impact on quality of life, particularly among women.

Introducción: las concentraciones adecuadas de yodo son necesarias para la producción normal de las hormonas tiroideas, el crecimiento físico y el neurodesarrollo en niños menores de once años. Sin embargo, sus niveles exhiben una dualidad nutricional, dado que tanto el déficit como el exceso conllevan efectos deletéreos. Objetivo: estimar la prevalencia de déficit y exceso de yodo en orina en niños colombianos menores de once años, y describir los factores asociados. Materiales y métodos: estudio analítico de diseño transversal, derivado de un análisis secundario de la Encuesta Nacional de la Situación Nutricional de Colombia 2015, en el cual se estimaron los niveles de yodo urinario según variables sociodemográficas y económicas. Las asociaciones fueron establecidas con modelos de regresión logística multinomial multivariable. Resultados: la edad promedio fue de 6,19 años (DE 3,14) y el 48,2 % eran niñas. El 5,8 % de la población presentó déficit, mientras que el 70,1 % presentó exceso. Tener entre 0 y 5 años (OR: 1,29; IC95 %: 1,03-1,61) y ser hijo de indígena (OR: 1,92; IC95 %: 1,28-2,90) mostraron ser un factor de riesgo para déficit; por otro lado, ser hombre (OR: 1,16; IC95 %: 1,04-1,30), y que el jefe de hogar sea mujer (OR: 1,12; IC95 %: 1,01-1,26) mostraron asociación con el exceso de yodo. Conclusión: la prevalencia de déficit de yodo en niños colombianos es baja, mientras que la prevalencia del exceso es alta. Es importante desarrollar una normativa con el objetivo de prevenir los efectos deletéreos en la salud infantil.

Introduction: Ferritin is important in the storage of intracellular iron, in a non-toxic soluble form. Its levels during pregnancy are related to the health of the mother and her offspring. Objective: To describe the serum ferritin levels and the prevalence of ferritin deficiency, and the associated sociodemographic factors in pregnant women in Colombia. Methodology: Cross-sectional study; secondary analysis of the Nutritional Situation Survey of Colombia, 2015. The following were evaluated in 1,234 pregnant women aged between 12 and 48 years: their sociodemographic and anthropometric characteristics, the distribution of serum levels, and the prevalence of ferritin deficiency. To estimate the association between the different sociodemographic variables and serum levels, or the prevalence of ferritin deficiency, multivariate regression models were used. Results: The prevalence of ferritin deficiency was 44.5% (95% CI 40.1% to 49.0%), serum ferritin levels ranged from 4 μg/L to 295.7 μg/L, with a average of 29.3 μg/L (95% CI 26.5 μg/L - 32.2 μg/L). Pregnant women in the second (OR (OR 2.19 95% CI 1.50 to 3.19) and third trimester (OR 3.84 95% CI 2.68 to 5.50), those residing in the Atlantic region ( OR 2.18 95% CI 1.25 to 3.82) and in the Orinoquia region (OR 2.41 95% CI 1.19 to 4.88), showed an association with ferritin deficiency. Conclusion: A high prevalence of ferritin deficiency was found in Colombian pregnant women.

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 DALYs (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.

Objetivo: estimar los años de vida ajustados por discapacidad en mujeres atribuibles a Tuberculosis, Colombia 2010-2018. Métodos: Estudio descriptivo retrospectivo. Se estudiaron las variables: año de ocurrencia, grupos de edad y procedencia. Se incluyeron 41.354 mujeres que con¬sultaron en la red hospitalaria y 2530 casos de mortalidad en mujeres, registrados en el sistema de estadísticas vitales del país. Mediante la metodología abreviada propuesta por la Organización Mundial de la Salud para la medición de la carga de la enfermedad, se estimaron los años de vida perdidos, años de vida con discapacidad y años de vida saludable perdidos por mujeres a nivel subnacional. Resultados: La tasa de años de vida ajustados por discapacidad del periodo de estudio fue de 427,2 (II95% 353-492,3) por cada 100.000 mujeres. Las mujeres en edad reproductiva (10 a 49 años) concentran el 57,9% de estos. Amazonas 1.426 (725,4-2541,4) y Guajira 1.001,1 (693,3-1260) presentaron las tasas más altas. Doce entidades territoriales tienen aumento de la carga de enfermedad. Conclusiones: La tasa de años de vida ajustados por discapacidad por tuberculosis en mujeres durante nueve años, fue alta y presenta diferencias subnacionales quizás debidas a las grandes brechas sociales o económicas o déficit de capacidades institucionales o programáticas.