Deaths due to malnutrition in children under five in Colombia, 2015–2023: a spatiotemporal analysis

Introduction: In Colombia, child mortality due to malnutrition persists as a public health problem that has not been comprehensively analyzed over the past decade. Objective: To provide a comprehensive analysis of the spatiotemporal behavior of mortality due to malnutrition in children under 5 years of age (CU5) in Colombia at the national and subnational levels disaggregated by sex and age group from 2015 to 2023. Methodology: An ecological study was conducted using secondary sources. Mortality due to malnutrition was defined as any death in CU5 whose underlying cause was coded as D50-D53, E40-E64, or P07 of the ICD-10. The study period begins in 2015 to ensure data uniformity and provide a stable baseline following the implementation of the 2018 National Population and Housing Census projections. The mortality rates were calculated in CU5, children under 1 year of age (CU1), children aged 1-4 years of age (C1-4) per 100,000 children. A descriptive analysis was performed, maps were created, and temporal trends were identified using joinpoint regression. Results: From 2015 to 2023, there were 75,068 deaths from all causes in CU5, of which 2,694 (3.6%) were due to malnutrition. The most affected age group was CU1 (57.8-70.2% of annual malnutrition deaths), with males accounting for 54.1% of deaths. The national mortality rate due to malnutrition in CU5 fluctuated between 3.1 and 5.0 deaths per 100,000 children, with the highest value occurring in 2022. Notable increases in mortality rates were observed in La Guajira, Vichada, and Chocó Departments, with the latter rising from the 4th to the 1st national rank (reaching 77.9 deaths per 100,000 children in 2023), indicating marked geographical disparities. Conclusion: Deaths from malnutrition in CU5 in Colombia demonstrated disparities by sex, age, and geographical location, with heterogeneous trends observed over the period. A comprehensive understanding of these disparities can inform targeted interventions aimed at reducing child mortality from malnutrition in the country.