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Deaths due to malnutrition in children under five in Colombia, 2015-2023: a spatiotemporal analysis
Deissy R Agudelo-Ibáñez1, Daniel Diaz2, Maylen L Rojas-Botero3
1Escuela de Salud Pública de México, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
Insights
Child malnutrition deaths in Colombia disproportionately affect infants and males, with significant geographical disparities. Understanding these trends is crucial for targeted interventions to reduce child mortality.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Child mortality due to malnutrition remains a significant public health issue in Colombia.
- Previous analyses have not comprehensively addressed this problem over the last decade.
Purpose of the Study:
- To conduct a comprehensive spatiotemporal analysis of malnutrition mortality in children under 5 years (CU5) in Colombia.
- To examine national and subnational trends disaggregated by sex and age group from 2015 to 2023.
Main Methods:
- Ecological study utilizing secondary data sources.
- Malnutrition mortality defined by ICD-10 codes (D50-D53, E40-E64, P07).
- Analysis included descriptive statistics, mapping, and joinpoint regression for temporal trends.
Main Results:
- Between 2015-2023, 2,694 (3.6%) of 75,068 CU5 deaths were due to malnutrition.
- Children under 1 year (CU1) and males were most affected.
- Significant geographical disparities were noted, with Chocó Department showing a marked increase in mortality rates.
Conclusions:
- Malnutrition deaths in Colombian children exhibit disparities by sex, age, and geography.
- Heterogeneous trends over the study period highlight the need for nuanced understanding.
- Findings can inform targeted interventions to reduce child malnutrition mortality.
Introduction:
In Colombia, child mortality due to malnutrition persists as a public health problem that has not been comprehensively analyzed over the past decade.
Objective:
To provide a comprehensive analysis of the spatiotemporal behavior of mortality due to malnutrition in children under 5 years of age (CU5) in Colombia at the national and subnational levels disaggregated by sex and age group from 2015 to 2023.
Methodology:
An ecological study was conducted using secondary sources. Mortality due to malnutrition was defined as any death in CU5 whose underlying cause was coded as D50-D53, E40-E64, or P07 of the ICD-10. The study period begins in 2015 to ensure data uniformity and provide a stable baseline following the implementation of the 2018 National Population and Housing Census projections. The mortality rates were calculated in CU5, children under 1 year of age (CU1), children aged 1-4 years of age (C1-4) per 100,000 children. A descriptive analysis was performed, maps were created, and temporal trends were identified using joinpoint regression.
Results:
From 2015 to 2023, there were 75,068 deaths from all causes in CU5, of which 2,694 (3.6%) were due to malnutrition. The most affected age group was CU1 (57.8-70.2% of annual malnutrition deaths), with males accounting for 54.1% of deaths. The national mortality rate due to malnutrition in CU5 fluctuated between 3.1 and 5.0 deaths per 100,000 children, with the highest value occurring in 2022. Notable increases in mortality rates were observed in La Guajira, Vichada, and Chocó Departments, with the latter rising from the 4th to the 1st national rank (reaching 77.9 deaths per 100,000 children in 2023), indicating marked geographical disparities.
Conclusion:
Deaths from malnutrition in CU5 in Colombia demonstrated disparities by sex, age, and geographical location, with heterogeneous trends observed over the period. A comprehensive understanding of these disparities can inform targeted interventions aimed at reducing child mortality from malnutrition in the country.
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