{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:07:28Z","timestamp":1789686448694,"version":"4.0.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":80,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Orphanet J Rare Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013rural residence, and interrupted time-series and excess mortality analyses assessed the COVID-19 period (2020\u20132021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2009=\u20091.03; 95% CI: 1.01\u20131.06;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Joinpoint analysis showed a rising trend among males (AAPC\u2009=\u2009+\u20098.20%; 95% CI: 0.98 to 15.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). 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\u2009=\u20093.00; 95% CI: 1.19\u20137.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), and this association strengthened after adjustment for sex and area of residence (RR\u2009=\u20094.00; 95% CI: 1.60\u20139.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). During 2020\u20132021, observed deaths were lower than expected based on pre-pandemic trends (standardized mortality ratio\u2009=\u20090.80; 95% CI: 0.68\u20130.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13023-026-04475-3","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:40:17Z","timestamp":1782816017000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mortality trends and socioeconomic inequalities in sickle cell disease in Colombia, 2012\u20132023: a population-based study"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-0353","authenticated-orcid":false,"given":"Uriel","family":"Palacios-Barahona","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-6091","authenticated-orcid":false,"given":"Juan Felipe","family":"Combariza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"4475_CR1","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1056\/NEJMra1510865","volume":"376","author":"FB Piel","year":"2017","unstructured":"Piel FB, Steinberg MH, Rees DC. 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