The impact of immigration on tuberculosis and HIV burden between Colombia and Venezuela and across frontier regions

Abstract

Historically, human migrations have determined the spread of many infectious diseases by promoting the emergence of temporal outbreaks between populations. We aimed to analyze health indicators, expenditure, and disability caused by tuberculosis (TB) and HIV/AIDS burden under the Colombian-Venezuelan migration flow focusing on the Northeastern border. A retrospective study was conducted using TB and HIV/AIDS data since 2009. We consolidated a database using official reports from the Colombian Surveillance System, World Health Organization, Indexmundi, the Global Health Observatory, IHME HIV atlas, and Joint United Nations Programme on HIV/AIDS (UNAIDS). Disability metrics regarding DALYs (disability adjusted life years) and YLDs (years lived with disability), were compared between countries. Mapping was performed on ArcGIS using official migration data of Venezuelan citizens. Our results indicate that TB profiles from Colombia and Venezuela are identical in terms of disease burden, except for an increase in TB incidence in the Colombian-Venezuelan border departments in recent years, concomitantly with the massive Venezuelan immigration since 2005. We identified a four-fold underfunding for the TB program in Venezuela, which might explain the low-testing rates for cases of multidrug-resistant TB (67%) and HIV/AIDS (60%), as well as extended hospital stays (150 days). We found a significant increase in DALYs of HIV/AIDS patients in Venezuela, specifically, 362.35 compared to 265.37 observed in Colombia during 2017. This study suggests that the Venezuelan massive migration and program underfunding might exacerbate the dual burden of TB and HIV in Colombia, especially towards the Colombian‐Venezuelan border.

Immigration And Tuberculosis In A Brazilian Border State: Epidemiological Characterization Of Cases Among Venezuelan Immigrants In The State Of Roraima, Brazil

“…In the study by Arenas-Suavez et al 1 it was observed that the tuberculosis profiles of Colombia and Venezuela are identical in terms of disease burden, except for an increase in the incidence of tuberculosis and Boa Vista-RR, the main places where the migrants stay. Another important component to consider is that many of them are of indigenous ethnicity and language and do not understand Portuguese and Spanish, which makes it difficult to be received by health units.…”

“…Historically, human migration has determined the spread of many infectious diseases by facilitating temporal outbreaks among populations 1 . In recent years, forced displacement of refugee people has increased in scope, scale, and complexity 2 .…”

Evidence on tuberculosis in migrants at Brazil's international borders: A scoping review

“…Currently, on the borders of South America, the largest migrations occur between Colombia, Venezuela, Chile and Brazil and are usually motivated by socioeconomic vulnerability conditions and violence that influence the social well-being and health of the population ( Arenas-Suarez et al., 2021 ). The political and socioeconomic situation in Venezuela aggravated a crisis in the health system and increased the resurgence and proliferation of various infectious diseases that may become a major public health problem in countries with which Venezuela has borders international.…”

Spatio-temporal clusters and patterns of spread of dengue, chikungunya, and Zika in Colombia

“…It is also close to the Venezuelan border, where there is an important and uncontrolled flow of people given the country's serious economic crisis. The environmental and socioeconomic conditions in this border region facilitate the transmission of infectious diseases including vector-borne diseases [50][51][52]. If a new pathogen was introduced in the Colombian Atlantic coastline region, its transmission and dispersion would likely be facilitated given these conditions [34].…”