SOCIAL VULNERABILITY AND LUPUS NEPHRITIS CLUSTERING IN BARRANQUILLA, COLOMBIA: INTEGRATING CLINICAL REGISTRY DATA WITH A POPULATION VULNERABILITY INDEX

 

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https://storage.unitedwebnetwork.com/files/1099/bb89a6f20cd29c451ea3d77726f00b71.pdf
SOCIAL VULNERABILITY AND LUPUS NEPHRITIS CLUSTERING IN BARRANQUILLA, COLOMBIA: INTEGRATING CLINICAL REGISTRY DATA WITH A POPULATION VULNERABILITY INDEX

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Maria-Paula
Aroca
Maria-Paula Aroca maroca@clinicadelacosta.co Centro de Investigación Clínica de la Costa CIDEACC Barranquilla Colombia *
Gustavo Aroca-Martinez garoca1@clinicadelacosta.co Centro de Investigación Clinica de la Costa Universidad Simon Bolivar Nephrology Barranquilla Colombia -
Santos Depine adepine@intramed.net Asociación Latinoamericana de Nefrología e Hipertención Nephrology Buenos Aires Argentina -
Kanery Camargo- Rodriguez kanery111104@gmail.com Centro de investigacion Clinica de la Costa CIDEACC Barranquilla Colombia -
Nicoll Fontalvo-Avila nicollfun@gmail.com Centro de investigacion Clinica de la Costa CIDEACC Barranquilla Colombia -
Valentina Pérez-Jiménez dra.valentia.perez.jimenez@gmail.com Centro de investigacion Clinica de la Costa Nephrology Barranquilla Colombia -
Esteban Vasquez itclinical@clinicadelacosta.co Centro de investigacion Clinica de la Costa CIDEACC Barranquilla Colombia -
Andres Cadena acadena@clinicadelacosta.co Clinica de la Costa Nephrology Barranquilla Colombia -
Joanny Sarmiento docenciaservicio@clinicadelacosta.co Clinica de la Costa Nephrology Barranquilla Colombia -
Karen Manjarres karen.manjarres.17f@gmail.com Clinica de la Costa Nephrology Barranquilla Colombia -
Valmore Bermúdez valmore.bermudez@unisimon.edu.co Asociación Latino Américana de Nefrología e Hipertencion Nephrology Maracaibo Venezuela -
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Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE), with its incidence and progression potentially influenced by structural socioeconomic inequalities. The Population Renal Health paradigm (Burgos-Calderón, Depine, and Aroca-Martínez, 2021) shifts from individual risk assessment to population and territorial vulnerability analysis by integrating social determinants of health (SDOH). To operationalize this approach, the Population Vulnerability Index (PVI) was developed as a quantitative geospatial tool that measures SDOH across the Colombian Caribbean region, enabling systematic comparison of territorial vulnerability. In parallel, the RENELUP registry collects and georeferences LN cases throughout Colombia. This study cross-references RENELUP data from the city of Barranquilla with PVI scores to examine how SDOH influence disease distribution patterns in this urban setting.

To analyze the spatial distribution of LN cases registered in RENELUP in Barranquilla, Colombia, and their relationship with social vulnerability levels defined by the PVI.  A density-based clustering algorithm (DBSCAN, 500m radius) was applied for spatial cluster analysis of LN cases registered in RENELUP in Barranquilla to identify high-concentration hotspots. The PVI was created by integrating 60 variables across nine vulnerability dimensions (economic, cultural, housing, health access, educational, environmental, technological, political, and geographic) using data from official sources such as the national census, quality of life surveys, health ministry records, water quality monitoring systems, victimization risk indices, and meteorological APIs. Social vulnerability distribution was evaluated in city blocks within neighborhoods with the highest case concentrations, categorized by PVI scores as follows: high vulnerability (PVI > 0.7), moderate vulnerability (PVI 0.3-0.7), and low vulnerability (PVI < 0.3).

Spatial analysis identified significant clustering patterns of LN cases in specific urban areas. The 12 neighborhoods with the highest concentration of RENELUP-registered cases exhibited a predominant distribution of high social vulnerability, as indicated by the PVI. In neighborhoods with high LN case concentrations, the vast majority of blocks showed high vulnerability: Las Malvinas (98.3% high vulnerability), Evaristo Sourdis (96.3%), and La Chinita (87.0%). The Kernel density analysis revealed hotspots coinciding with areas of elevated PVI scores, suggesting potential spatial correlation between disease concentration and social vulnerability.

This descriptive spatial analysis revealed a pattern of LN case clustering in neighborhoods with high social vulnerability, as indicated by the PVI. While these preliminary findings suggest that SDOH may influence disease distribution, further statistical analyses are needed to establish significant associations. Nevertheless, the integration of RENELUP clinical data with PVI scores demonstrates the potential of this approach for identifying at-risk populations. Future studies should employ inferential spatial statistics to quantify the relationship between social vulnerability and LN incidence, ultimately guiding evidence-based resource allocation in areas of greater need. 

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