Venezuela's humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region

Abstract

In recent years Venezuela has faced a severe economic crisis precipitated by political instability and a significant reduction in oil revenue. Public health provision has suffered particularly. Long-term shortages of medicines and medical supplies and an exodus of trained personnel have occurred against the backdrop of a surge in vector-borne parasitic and arboviral infections. Herein, we aim to assess comprehensively the impact of Venezuela's healthcare crisis on vectorborne diseases and the spillover to neighbouring countries. Methods Alongside the ongoing challenges affecting the healthcare system, health-indicator statistics have become increasingly scarce. Official data from the Ministry of Health, for example, are no longer available. To provide and update on vector-borne disease in Venezuela, this study used individualized data from nongovernmental organizations, academic institutions and professional colleges, various local health authorities and epidemiological surveillance programs from neighbouring countries, as well as data available through international agencies. Findings Between 2000-2015 Venezuela witnessed a 365% increase malaria cases followed by a 68% increase (319,765 cases) in late 2017. Neighbouring countries such as Brazil have reported an escalating trend of imported cases from Venezuelan from 1,538 (2014) to 3,129 (2017). Active Chagas disease transmission is reported with seroprevalence in children (<10 years) as high as 12.5% in one community tested (N=64). There has been a nine-fold rise in the mean incidence of dengue between 1990 to 2016. Estimated rates of chikungunya and Zika are 6,975 and 2,057 cases per 100,000 population, respectively, during their epidemic peaks. Interpretation The re-emergence of many arthropod-borne endemic diseases has set in place an epidemic of unprecedented proportions, not only in Venezuela but in the region. Data presented here demonstrates the complex determinants of this situation. National, regional and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders.

COVID-19 in Latin America: The implications of the first confirmed case in Brazil

“…In the Latin American region, there is a large heterogeneity of political and social development, economic growth, and political capacities. 2019 spreading measles, diphtheria, and vector-borne diseases, such as malaria, over the region [11][12][13], the impact of a COVID-19 outbreak will be more devastating than in the more developed economies, such as Brazil or Mexico.…”

Malaria in Southern Venezuela: The Hottest Hotspot in Latin America

“…Progress in reducing malaria morbidity and mortality between 2000-2015 stalled in 2016 and reversed in 2017 and 2018 [3,4,5] when cases climbed to ~1 million in both years [2,3]. This surge was mainly driven by the collapse of the Venezuelan economy since 2014, with the consequent crumble of its entire healthcare system [6,7]. In particular, Venezuela reported a total of 1,255,299 cases between 2015-2018, the highest number in Latin America, and in 2017 exhibited one of the most substantial increases in malaria cases worldwide [1,2,8].…”

“…Specifically, from 1990 onwards, the principal focus of malaria in Venezuela has been located in this region, contributing > 60% (1992-1995) to 88% (2000-2014) of the country’s total malaria cases [12,13]. The health situation in this region has worsened significantly in recent years, and the current limitations in malaria surveillance and control are a cause of major concern [7,13]. Additionally, since 2014, local malaria transmission has re-emerged in previously endemic and new areas across the whole country, including the northeastern region of Venezuela [7].…”

“…The health situation in this region has worsened significantly in recent years, and the current limitations in malaria surveillance and control are a cause of major concern [7,13]. Additionally, since 2014, local malaria transmission has re-emerged in previously endemic and new areas across the whole country, including the northeastern region of Venezuela [7].…”

“…At present, the uncontrolled upsurge of malaria compounded by the mass migration of Venezuelans to neighboring countries pose a serious threat to the wider region [6,7,14], jeopardizing the efforts of bordering malaria-endemic countries to achieve their goals for disease control. Human population movement among the countries that form the Guiana Shield (Guyana, French Guiana, Suriname, as well as parts of Colombia, Venezuela, and Brazil) serves to amplify the regional impact of the malaria increase in Bolívar state.…”