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