Imi Get Real Work Package 1 Case Study: Challenges In Measuring Clinical Effectiveness In Copd And Potential Use Of Real-World Evidence To Reduce Uncertainty

Abstract

Objectives: Acute respiratory infections (ARI) are a great leading morbidity and mortality cause worldwide. The aim of this study was to describe ARI mortality inequalities in children under five years in Colombian municipalities. MethOds: Vital statistics from National Administrative Department of Statistics (DANE, in Spanish) were used to estimate ARI mortality rates per 100.000 children under five years (ARIMR< 5) in the Colombian municipalities with mortality registers during 2000, 2005, 2010 and 2013. ARIMR< 5 were compared between groups determined by unsatisfied basics needs (UBN) quintiles as a proxy of poverty (Q1, Q2, Q3, Q4 and Q5, being the last the poorest). Concentration curves were also used to show socioeconomic inequalities in ARIMR< 5. Results: Between 2000 and 2013 Colombia registered 18,012 deaths in children under five years old caused by ARI, 55.7% of cases were boys. The ARIMR< 5 for Colombian boys in 2000 and 2013 was 49.9 and 19.6 per 100.000, respectively. For girls, the rates were 45.2 and 17 per 100.000. At municipal level, ARI mortality rates in boys were higher in poorest municipal quintiles (Q4 and Q5) than Q1 (lowest poverty) for 2005, 2010 and 2013. ARI mortality rates in girls showed the same pattern than in boys. In 2000, an inverse relationship between poverty and ARI mortality in both, girls and boys. In boys, ARIMR< 5 was 1.6, 2.2 and 2.3 times greater in quintiles with high poverty (Q4 and Q5) versus Q1 (low poverty) for, 2005, 2010 and 2013, respectively. In girls, the differences were 1.7, 2.1 and 2.8. Concentration curves showed that 52% of the total IRA boys deaths were accumulated in the 15% of poorest population. In girls, the same proportion was accumulated in 22% of poorest population. cOnclusiOns: The current inequalities of the IRA mortality in Colombian municipalities continue to be a huge challenge for Colombian stakeholders.