Discussion
Over the last twenty years, Venezuela´s public health quality has been declining due to political and socioeconomic factors, causing an ongoing humanitarian crisis. With a decaying healthcare infrastructure, a mass departure of trained medical personnel, and the decline of all public health programs, including disease surveillance and reporting, Venezuela is experiencing a surge and expansion of vector-borne diseases. Once recognized as a regional leader for public health and vector-control policies and programming, the country is facing a significant increase in incidence of malaria, Chagas, and leishmaniasis, among others.
In fifteen years (2000-2015) Venezuela reported a 365% increase in malaria cases and it has contributed with 53% (2017) and 51% (2018) of the almost 1 million per year of reported cases in the Latin American region. In 2017 Plasmodium vivax accounted for the majority of reported cases (76%) followed by Plasmodium falciparum (17.7%), mixed P. vivax/P. falciparum infections (6%) and Plasmodium malariae (<1%).
Recent focal seroprevalence estimates for Chagas disease are 15.7% compared with Colombia’s estimates (0.2% in Santander in 2013-2014) indicating resurgence. Due to consumption of food and beverages contaminated with infected triatomines or feces, oral Chagas disease transmission has also become an issue of great concern with 16 outbreaks (321 cases) reported nationwide between 2007-2018, half of them occurred in peri-urban and urban areas.
Finally, cutaneous and mucocutaneous leishmaniasis (CL-MCL) is dispersed throughout the country and visceral leishmaniasis (LV) in three foci. In spite of a report of almost 61600 CL cases between 1990-2016 and the substantial expansion of its endemic areas, nothing in the available data suggests the clinical cases have been a consequence of the crisis. However, migratory trends might be contributing to the spread of the disease.
