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MINI-GRANT CONGENITAL ANOMALIES
Characterization of the Congenital Anomalies in Embera-
Chami from Riosucio, Caldas
Eduardo Lozano Lorena Vargas
Mentor: Dora Cardona
Resguardos Cañamomo-Lomaprieta, La Population: San Lorenzo: 11,217 La Montaña: 18,292 Escopetera-Pirza: 7,856 Cañamomo-Lomaprieta: 22,391 Source: Cartografia de la diversidad-Dirección de poblaciones
Localization of the Native Reservations Embera-Chami in Colombia
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
National Statistics
Clinical Histories Riosucio Local Hospital
Pediatric Hospital Manizles
Mediintegral Hospital
Heart Small Heart
Foundation
Live Born with Congenital Anomalies
CASES
Indigenous Records
Results
Prevalence of congenital anomalies per 1,000 live birth by year, Riosucio, Caldas, Colombia 2007 - 2012
32.8
28.7
50.9
34.1
43.2
33.4
0
10
20
30
40
50
60
2007 2008 2009 2010 2011 2012 Years
Pre
vale
nce
of c
onge
nita
l ano
mal
ies
per
1,00
0 liv
e bi
rths
Prevalence of congenital anomalies in the indigenous community of Riosucio, Caldas, Colombia, by years, distributed by Reservations
0
50
100
150
200
250
300
350
2007 2008 2009 2010 2011 2012
Prev
alen
ce o
f con
geni
tal a
nom
alie
s per
1,
000
Live
birt
h
Year
La Montaña
Cañamomo-Lomaprieta
Escopetera-Pirsa
San Lorenzo
RESULTS Distribution of congenital anomalies organized by systems, by year, in the Native Reservations
of Riosucio, Caldas, Colombia
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012
FREC
UEN
CY
DISTRIBUTION BY YEARS
Nervous system
Eyes, face, Neck
Heart and vascular
Mouth, lips and palate
Digestive tract
Genital organs
Urinary organs
Osteomuscular
Total distribution of mayor congenital anomalies by systems, Riosucio 2007-2012
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%
Osteomuscular System 57,3%
Chromosomic Anomalies 2, 6%
60% major (rate 22,18 x 1,000) 40% minor (rate 14,75 x 1,000)
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
-Pirza Cañamomo-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
Age at diagnosis
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%
Congenital Malformation Prevalence rate X1,000 NB
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%
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 Escopetera-Pirsa) 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
Congenital
Anomalies 20 17 24 22 28 14
Rate X 1000
LB 32.8 28.7 50.9 34.1 43.2 33.4
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 2008 2009 2010 2011 2012 TOTAL CASES #
NB
Rate X 1,000
# NB
Rate X 1,000
# NB
Rate X 1,000
# NB
Rate X 1,000
# NB
Rate X 1,000
# NB
Rate X 1,000 # NB
Rate X 1,000
La Montaña 7 54 129.6 5 51 98,0 13 42 309,5 11 256 43,0 13 246 52,8 6 145 41,4 55 1118 49.19
Cañamomo-Lomaprieta
2 186 10,7 6 170 35,3 3 123 24,4 7 130 53,8 7 121 57,8 2 100 20,0 28 794 35.26
Escopetera Pirsa 7 139 50,4 3 143 21, 2 100 20,0 0 90 0,0 1 102 9,8 1 66 15,2
14 640 21.87
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
28 830 33.73
TOTAL 20 608 32.9 17
591
28.76 24
472
50.85 22
645
34.10 28
647
43.27 13 419 31.0 125
3382
36.96
RESULTS
• 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
Cañamomo-Lomaprieta (Quiebralomo-Tumbabarreto-
Sipirra)
• 1..Osteomuscular: Hip Dysplasia • 2.Genitourinary: Crypthorchidism • 3.Digestive: Pyloric hiperthrophy • 4.Cardiovascular: Tricuspid atresia • 5.Otolaryngology: Cleft lip
Escopetera-Pirza (Bonafont)
• 1.Osteomuscular: Hip Dysplasia, Foot deformations (talipes, equinus varo-valgo)
• 3.GentitoUrinary: Cropthorchidism • 4.Cardiovascular: Interauricular Communicacion, Ductus arteriosus • 5. Neurology: Hiyrocephalus
La Montaña (El Nevado-La Floresta)
San Lorenzo (Blandón-Lomitas)
•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 # SISTEMAS CRANEOSINOSTOSIS 1 Nervous system congenital anomalies HIDROCEFALIA CONGENITA 4 Nervous system congenital anomalies HOLOPROSENCEFALIA 1 Nervous system congenital anomalies NEUROFIBROMATOSIS (NO MALIGNA) 1 Nervous system congenital anomalies SINDROME DE DOWN, NO ESPECIFICADO 2 Nervous system congenital anomalies LABIO PALADAR HENDIDO 2 Eyes, face and neck congenital anomalies DUCTUS ARTERIOSO PERSISTENTE 4 Circulatory system congenital anomalies FORAMEN OVAL 1 Circulatory system congenital anomalies INSUFICIENCIA VALVULA MITRAL 1 Circulatory system congenital anomalies ATRESIA TRICUSPIDEA 1 Circulatory system congenital anomalies CARDIOPATIA CONGENITA 5 Circulatory system congenital anomalies COMUNICACIÓN INTERVENTRICULAR 2 Circulatory system congenital anomalies HIPERTROFIA PILORICA CONGENITA 1 Digestive system congenital anomalies HERNIA DIAFRAGMATICA CONGENITA 1 Digestive system congenital anomalies ESTENOSIS SUBGLOTICA 1 Digestive system congenital anomalies HIDROCELE CONGENITO 1 Genital system congenital anomalies AGENESIA RENAL, UNILATERAL 1 Urinary system congenital anomalies HIDRONEFROSIS DERECHA 1 Urinary system congenital anomalies MALFORMACION RENAL 1 Urinary system congenital anomalies DEFORMIDAD CONGENITA DEL MUSCULO ESTERNOCLEIDOMASTOIDEO 1 Osteomuscular system congenital anomalies DISPLASIA DE CADERA 19 Osteomuscular system congenital anomalies MALFORMACION CONGENITA DE LA RODILLA 1 Osteomuscular system congenital anomalies OTRAS DEFORMIDADES CONGENITAS DE LA CADERA 22 Osteomuscular system congenital anomalies