Résumé
Objectives: To describe the use of economic evaluation to update the antigens dispensed by the Colombian Expanded Program on Immunization (EPI) from 2000 and 2021. Method(s): a review of economic evaluation of vaccines (EEV) studies conducted by the Expanded Program of Immunization in Colombia between 2000 and 2021. A literature search was carried out in different databases complemented with information obtained from different stakeholders who participated in the updating process. Result(s): In 2000, sponsored by the Pan-American Health Office of the World Health Organization (PAHO/WHO), was conducted the cost-effectiveness analysis of vaccination against Hemophilus influenzae type b was the first economic evaluation of vaccines (EEV) conducted ever in Colombia. Between 2005 and 2007, 4 EEV (Rotavirus, Heptavalent Pneumococcus, Influenza and Hepatitis A) were carried out in order to inform the decision process at local level in Bogota DC, the Colombian capital. Between 2007 and 2010, the Ministry of Health sponsored 8 EEV (Rotavirus, 7- and 10-valent pneumococcus, Influenza, Hepatitis A, chickenpox, tetanus in men, and HPV) which were used to decide about the introduction of new vaccines at national level. Subsequently, with the support of PAHO's PROVAC initiative, Colombia went from having 6 EPI vaccines in the 1990s, to 21 EPI vaccines that currently protect against 29 diseases, not including the vaccines used against COVID-19 which Colombia have been using since March 2021. Conclusion(s): Colombia has been one of the middle-income countries with the highest number of vaccines included in its EPI in the last 20 years and the use of the EEV has been essential for decision-making.Copyright © 2023
Résumé
Objectives: To describe the mortality from diabetes mellitus before and after the first year of the COVID 19 pandemic in Colombia. Method(s): We conducted an ecological study to describe mortality from DM in Colombia by sex and age groups, before and in the first year of the pandemic in Colombia. We obtained DM mortality data from the national agency for population statistics (known as DANE for its initials in Spanish) which collects vital statistics in Colombia. We analyzed anonymized mortality records coded as DM (code 601 from causes of mortality grouped according to the list 6/67 of the PAHO for ICD, 10th revision) for 2019-2020 considering only the underlying cause of death. The variables considered were year of registration of death, number of deaths per year, sex, age, and underlying cause of death. Result(s): In 2019 and 2020 there were 244,355 and 300,853 deaths by all causes respectively. Out of 56,498 (23.1%) excess deaths, 46,019 were due to COVID-19 (code U071). Deaths from DM for were 7,967 (3.26% out of total;2.71% men - 3.94% women) in 2019 and 10,198 (3.39% out of total;2.82% men - 4.15% women) in 2020. The increase for deaths from DM was 28% (n=2,231) 32.7% for men(n=1,193) and 24% for women (n=1,038). Conclusion(s): The COVID-19 pandemic increased deaths from DM in Colombia with a greater impact on men. Priority should be given to rebuild health care services for chronic diseases.Copyright © 2023