Publication date: Jun 30, 2026
Sickle cell disease (SCD) is one of the most common monogenic disorders worldwide and remains associated with substantial mortality in low- and middle-income countries. In Colombia, population-level evidence on long-term mortality trends and socioeconomic inequalities in SCD is limited. We conducted an ecological time-series study using death certificate data from the Colombian National Administrative Department of Statistics (DANE). Age-standardized mortality rates (ASMRs) were calculated using the WHO world standard population. Temporal trends were assessed using joinpoint regression and mixed-effects Poisson models. Departments were classified into tertiles of socioeconomic development using the Multidimensional Poverty Index. Additional analyses examined differences by sex and urban-rural residence, and interrupted time-series and excess mortality analyses assessed the COVID-19 period (2020-2021). A total of 675 SCD-related deaths were recorded between 2012 and 2023. The national ASMR increased from 0. 055 per 100,000 in 2012 to 0. 143 per 100,000 in 2023. In mixed-effects Poisson models, mortality increased (rate ratio [RR] per year = 1. 03; 95% CI: 1. 01-1. 06; p = 0. 002). Joinpoint analysis showed a rising trend among males (AAPC = + 8. 20%; 95% CI: 0. 98 to 15. 24; p = 0. 029). Mortality varied across departments, with the highest rates in Caribbean regions. Departments with low socioeconomic development had higher mortality than those with high development (RR = 3. 00; 95% CI: 1. 19-7. 61; p = 0. 020), and this association strengthened after adjustment for sex and area of residence (RR = 4. 00; 95% CI: 1. 60-9. 97; p = 0. 003). During 2020-2021, observed deaths were lower than expected based on pre-pandemic trends (standardized mortality ratio = 0. 80; 95% CI: 0. 68-0. 95). SCD mortality in Colombia increased between 2012 and 2023, marked by territorial and socioeconomic inequalities. The apparent decline during the COVID-19 period likely reflects under-registration rather than a true reduction in mortality.
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| Concepts | Keywords |
|---|---|
| Colombia | Colombia |
| Deaths | Mortality |
| Socioeconomic | Multidimensional poverty |
| Sickle cell disease | |
| Socioeconomic inequalities | |
| Temporal trends |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | sickle cell disease |
| disease | MESH | SCD |
| disease | MESH | death |
| disease | MESH | COVID-19 |
| disease | MESH | Rare Diseases |
| disease | MESH | Dis |
| pathway | REACTOME | Reproduction |
| disease | MESH | included |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | stroke |
| drug | DRUGBANK | Hydroxyurea |
| disease | MESH | ICD |
| disease | MESH | APC |
| disease | MESH | AIC |
| drug | DRUGBANK | Flunarizine |
| drug | DRUGBANK | Pentaerythritol tetranitrate |