Children Growing Gap: Discovering the Truth in the Colombian Health System

OBJECTIVES: Growth hormone deficiency (GHD) is a rare disease caused by impaired secretion of growth hormone and is one of the most common endocrine-related cause of short stature. In 2021, the prevalence of GHD in children was estimated to range from 1:8,646 to 1:3,458 children worldwide. The objective of this analysis is to generate evidence related to the situation of GHD in children in Colombia to support decision-making in public health.

METHODS: A retrospective data analysis was carried out regarding the ICD-10 E343, E230, E893 and M892 codes that may be associated with GHD in children between 2018 and 2023 in Colombia. The medicines were extracted from the local guidelines. Sociodemographic information was obtained from the Public Health Surveillance System (SIVIGILA).

RESULTS: On average, 61,033 cases associated with GHD in children occur annually, mostly in the departments of Bogotá (24%), Antioquia (10%), and Valle del Cauca (6%), but the number of cases has increased relatively in Guainía (900%), Guaviare (875%) and San Andres (483%). The age of diagnosis is 0 – 11 years old (86%). 55% of the cases are affiliated to the contributory regime, 38% to the subsidized regime, and the remaining 7% to another type of affiliation. 86% of the cases are diagnosed in the urban perimeter and the remaining 14% are rural. Human recombinant growth hormone is the standard of care and is reimbursed by the National Benefit Plan. The only diagnostic test for GHD is the pre–post stimulation growth hormone.

CONCLUSIONS: The ICD-10 used to diagnose GHD in children is not standardized in Colombian Health system. It is essential to create evidence about the importance of an early diagnosis not only for the symptoms associated with the pathology but the negative impact on physical, social, and emotional well-being in children. Finally, diagnosis is growing in remote areas in Colombia.