# Adherence to the American Academy of Pediatrics Health Supervision Guidelines for Children With Down Syndrome in a Tertiary Care Institution in Northeastern Colombia

## TL;DR

This study evaluates how well a hospital in Colombia follows health guidelines for children with Down syndrome, finding significant gaps in care.

## Contribution

The study provides a detailed assessment of adherence to AAP guidelines for Down syndrome in a specific Colombian region.

## Key findings

- Overall adherence to health guidelines was 57%, with significant variation by age group.
- Timely hearing and ophthalmologic evaluations were notably underperformed in early childhood.
- Non-adherence was most pronounced during the first year of life.

## Abstract

Health surveillance of children with Down syndrome is often insufficient. We assessed adherence to the 2011 American Academy of Pediatrics (AAP) health supervision guidelines at a tertiary pediatric care institution in northeastern Colombia. This descriptive, cross-sectional study analyzed electronic medical records of 124 children under 13 years (59.7% were males, and 66% resided in a metropolitan area) seen between 2012 and 2023. Overall adherence was 57%. Adherence rates varied by age: high in neonates and school-aged children (>80%), moderate in infants and preschoolers (68%), and low in toddlers (39%). While most children underwent echocardiogram (99%), complete blood count (90%) and karyotype testing (78%) within the first month, fewer received timely hearing evaluations by six months (60%) or ophthalmologic evaluation by six months (34%). Significant non-adherence occurred during the first year and persisted through early childhood, highlighting the need to identify barriers and improve guideline compliance.