San Lorenzo

MINI-GRANT
CONGENITAL ANOMALIES
Characterization of the Congenital Anomalies in EmberaChami from Riosucio, Caldas
Eduardo Lozano
Lorena Vargas
Mentor: Dora Cardona
Localization of the Native Reservations
Embera-Chami in Colombia
Resguardos Cañamomo-Lomaprieta, La
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Source: Cartografia de la diversidad-Dirección de poblaciones
Population:
San Lorenzo: 11,217
La Montaña: 18,292
Escopetera-Pirza: 7,856
Cañamomo-Lomaprieta: 22,391
RIOSUCIO
SAN LORENZO
BONAFONT
GENERAL OBJECTIVE
Characterize the congenital anomalies of the
population born between 2007 and 2012 of the
Embera-Chamí community resident in Riosucio
SPECIFIC OBJECTIVES
1- Identify native children born with congenital anomalies
between 2007 and 2012 in Riosucio
2- Calculate the prevalence rate by year of congenital
anomalies in children born between 2007 and 2012 in
Riosucio, according to the regional lists of the native
organizations
3- Classify the congenital anomalies identified, according to
the protocol of the Colombian National Institute of Health
4- Perform geo-referencing of congenital anomalies by Native
Reservations of Riosucio
METHODS
Design: Retrospective descriptive study, aimed at identifying newborns
with congenital anomalies between 2007 and 2012
Population: Clinical histories of the children with congenital anomalies
born in Riosucio between 2007-2012, based on the lists of the native
organizations.
Inclusion criteria: Indigenous individuals with a congenital anomaly, born
between 2007 to 2012
Tools: The data collection tool used was the form of the Colombian
National Institute of Health developed for congenital anomalies
Data collection: We convened a group of stakeholders from institutions
and health care providers within Riosucio and Manizales
Observation
Congenital anomalies in the Indigineous community
Clinical Histories Riosucio
Local Hospital
National
Statistics
Pediatric
Hospital
Manizles
Indigenous
Records
Mediintegral
Hospital
Heart Small
Heart
Foundation
Live Born with Congenital Anomalies
CASES
Results
Prevalence of congenital anomalies per
1,000 live births
Prevalence of congenital anomalies per 1,000 live birth by year,
Riosucio, Caldas, Colombia 2007 - 2012
60
50.9
50
43.2
40
32.8
30
33.4
34.1
28.7
20
10
0
2007
2008
2009
Years
2010
2011
2012
Prevalence of congenital anomalies per
1,000 Live birth
Prevalence of congenital anomalies in the indigenous community of
Riosucio, Caldas, Colombia, by years, distributed by Reservations
350
300
250
200
La Montaña
150
Cañamomo-Lomaprieta
100
San Lorenzo
Escopetera-Pirsa
50
0
2007
2008
2009
2010
Year
2011
2012
RESULTS
Distribution of congenital anomalies organized by systems, by year, in the Native Reservations
of Riosucio, Caldas, Colombia
25
Nervous system
Eyes, face, Neck
20
Heart and vascular
Mouth, lips and palate
FRECUENCY
15
Digestive tract
Genital organs
10
Urinary organs
Osteomuscular
5
0
2007
2008
2009
2010
DISTRIBUTION BY YEARS
2011
2012
Total distribution of mayor congenital anomalies by systems,
Riosucio 2007-2012
Chromosomic
Anomalies 2, 6%
60% major (rate 22,18 x 1,000)
40% minor (rate 14,75 x 1,000)
Osteomuscular
System 57,3%
Central Nervous
System, 8%
Genital
Organs 1,3%
Circulatory System,
18,7%
Respiratory System
1, 3%
Digestive System
2, 6%
Lips and Palate
2,6%
Eyes, Face and
Neck 1,3%
Urinary System, 4%
GEOREFERENCIATION: Distribution of congenital anomalies by systems in
the indigenous population of Riosucio, Caldas, Colombia 2007-2012
LA
MONTAÑA
SAN LORENZO
CAÑAMOMO-LOMAPRIETA
ESCOPETERA-PIRZA
Characteristics of congenital anomalies,
Riosucio, Caldas, Colombia 2007 - 2012
All
San
Lorenzo
La
Montaña
Escopetera Cañamomo-Pirza
Lomaprieta
Mean maternal age, yrs
25.3
24.9
25.1
27.2
25.0
Mean gestational age, wks
38.4
38.0
38.5
39.10
38.3
0 to < 1 year 58.4%
42.8%
41.8%
28.6%
46.4%
1 year to < 2 year 19.2%
39.3%
29.1%
35.7%
21.4%
2 year to < 3 year 12.0%
10.7%
14.5%
0%
28.6%
≥ 3 years 10.4%
7.1%
14.5%
35.7%
3.6%
36.96
33.73
49.19
21.87
35.26
Osteomuscular 50.4%
35.7%
63.6%
42.9%
42.9%
Genital and Urinary System 18.4%
28.6%
16.4%
21.4%
28.6%
Other 31.2%
35.7%
20.0%
35.7%
28.5%
Age at diagnosis
Congenital Malformation
Prevalence rate X1,000 NB
SUMMARY RESULTS
-THE DIAGNOSTIC IN CONGENITAL ANOMALIES WAS LOW IN THE FIRST
YEAR OF LIVE, IN ALL THE NATIVE REGION STUDIED, PROBABLY
BECAUSE THIS REGION DOESN´T HAVE A SURVEILLANCE FOR THIS
CONDITION
- WE FOUND THE RATE IN CONGENITAL ANOMALIES IN THE NATIVE
REGION, ABOVE THE AVERAGE OF COLOMBIA
- THE OSTEOMUSCULAR SYSTEM AND THE GENITAL URINARY SYSTEMS
WHERE THE SYSTEMS WITH MOST OF THE ANOMALIES FOUND
•
Strengths:
Our study only includes indigenous population of the 4 areas of Riosucio
(La Montaña, Cañamomo-Lomaprieta, San Lorenzo and EscopeteraPirsa) It doesn´t include other ethnic groups
•
Limitations:
Difficulty to access the information in the hospitals
Inconsistencies in the records of the data of the local, regional and
national systems
•
Challenges:
Maintain surveillance of congenital anomalies in the embera-chami
population
Further studies to clarify the etiology of congenital anomalies
Improve information systems.
CONCLUSIONS
1. A prevalence rate of congenital anomalies in the indigenous
population of the Embera-Chami of Riosucio, Caldas, (37 X
1,000), is higher than average for the population.
2.
A similar prevalence rate of congenital anomalies in all four
indigenous reservations of Riosucio, Caldas, except in the
Reservation of La Montaña, that was higher in 2009
3.
The most common congenital anomalies in our study were
the congenital anomalies found in the osteomuscular
system.
¡THANK YOU !
!
EXTRA SLIDES
RESULTS
Rate of congenital anomalies in the indigenous community of Riosucio by years, per 1,000 Live
Births, in the years 2007-2012.
YEARS
2007
2008
2009
2010
2011
2012
Born Alive
608
591
472
645
647
419
20
17
24
22
28
14
32.8
28.7
50.9
34.1
43.2
33.4
Congenital
Anomalies
Rate X 1000
LB
RESULTS
Rate of Congenital anomalies in the indigenous community of Riosucio, by years per
1,000 Live Birth in the years 2007-2012, distributed by Reservations.
2007
C
A
S
E
S
2008
2009
Rate
X
1,00
0
N
B
Rate
X
1,000
7
54
129.6
5
51
98,0
2
186
10,7
6
170
35,3
#
N
B
2010
N
B
Rate
X
1,000
13
42
309,5
3
123
24,4
#
2011
N
B
Rate
X
1,00
0
11
256
43,0
7
130
53,8
#
2012
N
B
Rate
X
1,00
0
13
246
52,8
7
121
57,8
#
TOTAL
N
B
Rate X
1,000
6
145
41,4
2
100
20,0
#
NB
Rate
X
1,000
55
1118
49.19
28
794
35.26
640
21.87
830
33.73
3382
36.96
#
#
La
Montaña
Cañamom
oLomapriet
a
Escopeter
a Pirsa
7
139
50,4
3
143 21,
2
100 20,0
0
90 0,0
1
102 9,8
1
66 15,2
San
Lorenzo
4
229
17,5
3
227 13,2
6
207 29,0
4
169 23,7
7
178 39,3
4
108 37,0
32.9
17
TOTAL
2
608
0
591 28.76
24
472
50.85
22
645 34.10
28
647
43.27
13
419
31.0
14
28
125
RESULTS
Cañamomo-Lomaprieta
(Quiebralomo-TumbabarretoSipirra)
Escopetera-Pirza (Bonafont)
La Montaña
(El Nevado-La Floresta)
San Lorenzo
(Blandón-Lomitas)
•
•
•
•
•
1.Osteomuscular: Hip Dyspllasia, foot deformations
2.Genitourinary: Criypthochiidism, Chordee,
3.Cardiovascular: Interventiricular comunicación, valvular insufficiency
4.Digestive; Diafphagmatic hernia
5.Otolaryngology: Preauricular cyst, Preauricular appendix, Ankyloglossia
• 1..Osteomuscular: Hip Dysplasia
• 2.Genitourinary: Crypthorchidism
• 3.Digestive: Pyloric hiperthrophy
• 4.Cardiovascular: Tricuspid atresia
• 5.Otolaryngology: Cleft lip
• 1.Osteomuscular: Hip Dysplasia, Foot deformations (talipes, equinus
varo-valgo)
• 3.GentitoUrinary: Cropthorchidism
• 4.Cardiovascular: Interauricular Communicacion, Ductus arteriosus
• 5. Neurology: Hiyrocephalus
•1.Osteomuscular: Hip dysplasia , Foot Deformations
•.2.Genito Urinary: Crypthorchidism
•.3. Cardiovascular: Interventrricular communication, Ductus
arteriosus, foramen ovale
• 4.Otolaryngology: Ankyloglossia
•5.Nneurologico: Down Syndrome, Neurofibromatosis, Hydrocephalus.
RESULTS
DX PRINCIPAL
CRANEOSINOSTOSIS
HIDROCEFALIA CONGENITA
HOLOPROSENCEFALIA
NEUROFIBROMATOSIS (NO MALIGNA)
SINDROME DE DOWN, NO ESPECIFICADO
LABIO PALADAR HENDIDO
DUCTUS ARTERIOSO PERSISTENTE
FORAMEN OVAL
INSUFICIENCIA VALVULA MITRAL
ATRESIA TRICUSPIDEA
CARDIOPATIA CONGENITA
COMUNICACIÓN INTERVENTRICULAR
HIPERTROFIA PILORICA CONGENITA
HERNIA DIAFRAGMATICA CONGENITA
ESTENOSIS SUBGLOTICA
HIDROCELE CONGENITO
AGENESIA RENAL, UNILATERAL
HIDRONEFROSIS DERECHA
MALFORMACION RENAL
DEFORMIDAD CONGENITA DEL MUSCULO
ESTERNOCLEIDOMASTOIDEO
DISPLASIA DE CADERA
MALFORMACION CONGENITA DE LA RODILLA
OTRAS DEFORMIDADES CONGENITAS DE LA CADERA
# SISTEMAS
1
4
1
1
Nervous system congenital anomalies
Nervous system congenital anomalies
Nervous system congenital anomalies
Nervous system congenital anomalies
2
2
4
1
1
1
5
2
1
1
1
1
1
1
1
Nervous system congenital anomalies
Eyes, face and neck congenital anomalies
Circulatory system congenital anomalies
Circulatory system congenital anomalies
Circulatory system congenital anomalies
Circulatory system congenital anomalies
Circulatory system congenital anomalies
Circulatory system congenital anomalies
Digestive system congenital anomalies
Digestive system congenital anomalies
Digestive system congenital anomalies
Genital system congenital anomalies
Urinary system congenital anomalies
Urinary system congenital anomalies
Urinary system congenital anomalies
1
19
Osteomuscular system congenital anomalies
Osteomuscular system congenital anomalies
1
Osteomuscular system congenital anomalies
22
Osteomuscular system congenital anomalies