Faculdad de Ciencias, Universidad Antonio Nariño, Bogotá, Colombia.
Facultad de Ciencias Agropecuarias, Universidad de Cundinamarca, Fusagasugá, Colombia.
Cad Saude Publica. 2021 May 28;37(5):e00078820. doi: 10.1590/0102-311X00078820. eCollection 2021.
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.
从历史上看，人类迁徙通过促进人群之间暂时爆发传染病，决定了许多传染病的传播。我们旨在分析在哥伦比亚-委内瑞拉移民流背景下，重点关注东北部边境地区，结核病（TB）和艾滋病毒/艾滋病负担所带来的健康指标、支出和残疾情况。本研究采用回顾性研究方法，使用了 2009 年以来的结核病和艾滋病数据。我们使用哥伦比亚监测系统、世界卫生组织、Indexmundi、全球卫生观察站、IHME HIV 地图集和联合国艾滋病规划署（UNAIDS）的官方报告，整合了一个数据库。对 DALYs（残疾调整生命年）和 YLDs（残疾生存年）进行了残疾指标比较。使用官方的委内瑞拉公民移民数据，在 ArcGIS 上进行了制图。我们的结果表明，哥伦比亚和委内瑞拉的结核病概况在疾病负担方面是相同的，除了近年来哥伦比亚-委内瑞拉边境地区的结核病发病率有所增加，这与 2005 年以来大规模的委内瑞拉移民潮同时发生。我们发现委内瑞拉的结核病方案资金严重不足，这可能解释了耐多药结核病（67%）和艾滋病（60%）检测率低以及住院时间延长（150 天）的原因。我们发现委内瑞拉艾滋病毒/艾滋病患者的 DALYs 显著增加，特别是 2017 年委内瑞拉的 362.35 比哥伦比亚的 265.37 显著增加。本研究表明，委内瑞拉的大规模移民和方案资金不足可能会使哥伦比亚的结核病和艾滋病双重负担恶化，特别是在哥伦比亚-委内瑞拉边境地区。
