Venezuelan Population Research Articles

Fleeing a failing state: Self-selection, earnings, and migration costs

Three-quarters of the global migrant population have fled fragile contexts, with 64 percent hosted by similarly vulnerable countries. These contexts account for about 75 percent of those living in extreme poverty. Despite the scale of this phenomenon, the extent to which the self-selection of South–South migrants differs from those migrating to more developed countries remains poorly understood. In this paper, I investigate the self-selection of Venezuelan migrants during the 2015–2021 crisis, which led to greater migration to less developed countries such as Colombia and Peru, compared to more developed ones like the United States and Chile. Using individual-level data representative of the Venezuelan population and similar data on Venezuelan migrants in these key destination countries, the study finds that migrants are generally positively selected in terms of education compared to those who remain in Venezuela, with migrants to developed countries being positively sorted with respect to those to developing countries. However, comparing the cumulative distribution functions of pre-migration predicted earnings reveals that migrants to developing countries are negatively selected relative to stayers, while migrants to developed countries are positively selected. This highlights the significant role of unobserved abilities in shaping South–South migration patterns. Furthermore, a discrete choice model shows that women and college graduates face lower migration costs, independent of expected earnings at the destination. Factors such as the distance to the destination country and pre-crisis networks also play a crucial role in shaping migration decisions.

The Demography of Crisis‐Driven Outflows from Venezuela

AbstractThe Venezuelan exodus represents the largest known displacement of people in recent Latin American history. The regional crisis caused by this mass Venezuelan migration drove the development of multiple interagency initiatives (such as the R4V platform) as well as academic attempts to keep track of outflow intensity. However, little is known about the age and gender composition of the emigrants since most existing literature to date has focused primarily on total volume and country‐specific shares of migration outflows. This study examines the demographics of recent outflows from Venezuela, the chronology of associated changes, and the demographic implications for those remaining in the country. Official counts of Venezuelan‐born populations compiled in seven main destinations are used to estimate annual outflows by age and gender from 2011 to 2021. Changes in the demographic composition of emigration are traced using parameters of the Rogers–Castro model, specifically the children‐to‐labor force dominance, and by decomposing the age contributions to the annual gross migraproduction rate. In the early phase of the crisis (2014–2017), emigration flows had high child dependency ratios. As the crisis entered its most acute phase (peaking in 2019), the mean age of migrants increased. Outward migration has resulted in the current Venezuelan population having 20 percent fewer women of reproductive age and 17.8 percent fewer individuals of working age. Consequently, the share of the population aged 60 or older has increased.

Physical fitness assessment of a Venezuelan industrial direct labor force population

Introduction The purpose of this research is to evaluate the physical fitness variables of Venezuelan workers, taking into account exercise batteries or submaximal tests that have been little used in the industrial environment.Methods: A quantitative, descriptive, cross-sectional, epidemiological and field study was conducted in a Venezuelan population of industrial direct labor workers in bipedestation. The sample consisted of 185 workers (M: 136, W: 49) in the main industrial areas of the state of Aragua-Venezuela.Results: Results were obtained on the physical fitness of Venezuelan industrial direct labor workers presenting average results in both sexes. Calculations for obtaining HRmax and RAC in ml O2 min-1 kg-1 were taken into account.Conclusions: A population of industrial direct labor was observed, of low physical capacity with values associated with age (42.87 M-38.43W), physical wear and tear, poor physical fitness habits, poor dietary habits and decrease in muscle mass.

Access to Contraceptives among Venezuelan Migrant Women Residing in Peru: Analysis on a Population-Based Survey.

Introduction: The emigration of Venezuelans has seen a significant increase in recent years. The aim of this study was to identify factors associated with access to contraceptives in migrant women from Venezuela residing in Peru. Methods: An exploratory cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru. Access to contraceptives (yes/no) was established as the dependent variable. A Poisson regression model was performed for complex samples, and crude (PRc) and adjusted (PRa) prevalence ratios were reported. Results: A total of 3617 migrant women were analyzed, with 50.12% reporting access to contraceptives. Factors associated with greater access to contraceptives included being between 20 to 29 years old, having a university education, the entry period after the declaration of COVID-19 quarantine was associated with lower access to contraceptives. Conclusions: Access to contraceptives for Venezuelan migrants should be provided to all, as it is a free service in Peru. Additionally, education and family planning should be provided from the basic or middle school level to prevent unintended pregnancies in the future. Complete coverage should be provided regardless of the time of entry into Peru.

Anthropometric measurements of male and female workers in bipedestation in the Venezuelan industrial direct labor force

In the Venezuelan labor context, there is scarce information associated with anthropometric measurements, due to the existing gaps in the field of ergonomics in Latin America and the Caribbean, of which there are few professionals trained in ergonomics. In this sense, it has affected the proper achievement of anthropometric studies that allow an adequate follow-up in the population in general and more specifically in the labor world. General objective: to measure and determine the anthropometric variables in standing position of Venezuelan workers in order to obtain more results in the field of occupational health. Methods: A quantitative, descriptive, cross-sectional, epidemiological and field study was carried out in a Venezuelan population of industrial direct labor workers in standing. The sample consisted of 185 workers (M:131, W:54) in the main industrial areas of the state of Aragua-Venezuela. The measuring instruments used in the investigation were: anthropometric tables for standing measurements, flexible tape measure for perimeter measurements and a wall height meter with a scale for weight measurements. The minitab-17 statistical package was used for the analysis and statistical study. Results: The study group consisted of 185 workers with an age range between 20-59 years; 131 men (70.8%) and 54 women (29.2%). The people evaluated had an average age of 43 years, their height x: 170.08 m, they are workers with 10 to 15 years of work experience, with wear and tear and possible pre-existing diseases, likewise, the female workers have an age x: 40.33 years and their height x: 156.27 cm, as well as the male worker have an average work experience between 10 and 15 years and possible pre-existing diseases. Conclusion: The study provides an approximation of anthropometric measurements in standing position of Venezuelan industrial direct labor workers (MODIV), which will allow the adaptation of workstations

Abstract P454: Health Insurance Increases Access to Hypertension Treatment Among Venezuelan Migrants and Refugees: A Population-Based Survey in Peru

Introduction: Over 6 million migrants and refugees have left Venezuela because of an ongoing political instability and socioeconomic crisis. This unprecedented migration has led to an increase of over 1 million Venezuelan migrants and refugees in Peru. Migrants are considered a vulnerable population and are often faced with discrimination, financial distress, and restricted access to health services. According to the literature, chronic diseases, such as hypertension, are the leading cause of preventable morbidity and premature death. In Peru, according to a 2018 survey, only 10.8% of Venezuelan migrants receive regular treatment for chronic diseases. Hypothesis: We assessed the hypothesis that having health insurance is associated with access to hypertension treatment. Methods: Cross-sectional study based on a secondary analysis from the 2022 survey of Venezuelan Population Living in Peru (ENPOVE 2022). The survey included 12,487 participants. Our population included Venezuelan migrants and refugees over 18 years old with self-reported hypertension. The outcome variable was to receive regular treatment, while the independent variable was having health insurance. Complex samplings characteristics and sampling weights of ENPOVE 2022, as well as the subpop command were used. Crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs) were obtained using Poisson log generalized linear regression models. Results: A total of 419 Venezuelan adults with self-reported hypertension were included in our study, of whom only 26.5% (95% CI 20.1-33.0) received regular treatment. Mean age was 50.3 ±12.9 (standard deviation) years old. Moreover, 30% perceived discrimination (95% CI 24.5-36.0), 39.1% (95% CI 32.4-46.2) were undocumented and 69% (95% CI 62.1- 75.1) did not have health insurance. In the multivariate analysis, after controlling by sex, age, socio-economic status, perceived discrimination, immigration status and disability, having health insurance was associated with receiving regular treatment (aPR 2.33; 95% CI 1.47-3.70). Neither perceived discrimination (aPR 0.62; 95% CI 0.37-1.05) nor disability (aPR 1.46; 95% CI 0.08-2.55) were associated with receiving regular treatment. Conclusions: In conclusion, less than 1/3 of migrants and refugees with hypertension have access to regular treatment. Having health insurance was associated with receiving regular treatment for hypertension. There is a need to improve health insurance coverage among migrants and refugees regardless of the immigration status.

Access to HIV/STI testing among male and female Venezuelan migrants in Peru: evidence from a nationwide survey

BackgroundHuman immunodeficiency virus (HIV) infection and sexually transmitted infections (STIs) are major global public health issues. Migrants represent a vulnerable group that faces multiple barriers to access to healthcare services, including HIV/STI testing. This study aimed to assess the factors associated with access to HIV/STI testing in male and female Venezuelan migrants in Peru.MethodsThis was a cross-sectional study involving secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey. The study was conducted in the eight most populated cities inhabited by Venezuelan migrants and refugees. For each city, the sampling design was probabilistic, stratified, and independent. The outcome variable was whether participants had access to HIV or other STI testing during their stay in Peru. Statistical analysis was stratified by sex owing to potential effect modification. Crude and adjusted prevalence ratios were calculated using generalized linear models Poisson family with log link function. Confidence intervals were calculated to 95%.ResultsA total of 3,723 male and 3,984 female migrants were included. Access to HIV/STI testing among male and female migrants was 19.85% and 25.16%, respectively. Among male migrants, being LGBTI, health insured, and married or cohabiting were associated with increased access to HIV/STI testing. Among females, those aged 18–44 years, those who were married or cohabiting and were health insured, and those residing for more than 1 year in Peru were significantly more likely to have access to HIV/STI testing. Moreover, physical/mental disability and unemployed status were associated with a lower probability of HIV/STI testing in females.ConclusionsOnly two in ten Venezuelan migrants and refugees in Peru were screened for HIV/STI, with fewer males than females. Sex-specific sociodemographic, health-related, and migration-related variables were independently associated with access to HIV/STI testing.

Comparison of diagnostic techniques in patients with COVID-19-associated pulmonary aspergillosis (CAPA) in a Venezuelan population

Background: Invasive aspergillosis related to COVID-19 or CAPA is defined by the association of a group of histological, mycological, radiological and clinical criteria that establish this disease as a secondary infection of high morbidity without timely diagnosis. Clinical and histological methods, due to the non-specific characterization of the disease, have been supported by techniques based on microbiological methods, such as culture and direct examination, with a sensitivity close to 50%, allowing the identification of biomarkers such as the GM of the pathogen, being the immunological techniques of greater sensitivity and specificity, the use of radial immunodiffusion and ELISA with antigens secreted by Aspergillus spp. are recommended. The objective of this article was to compare three different serological diagnostic methods used in the mycology laboratory to diagnose CAPA in a Venezuelan population. Methods: Based on a longitudinal study, 77 patient samples diagnosed as positive for SARS-CoV-2 by RT-PCR were analyzed, of which 24 CAPA BAL samples were subsequently evaluated by conventional mycological diagnostic methods (direct examination and culture) and corresponding CAPA serum samples by three serological methods: DID, ELISA with Aspergillus pool antigen, and the Galactomannan detection with Lateral flow (GM- LFA) essay. Results: By microscopy, fungal structures were observed in 18/24 patients and 16/24 were positive for GM-LFA. Regarding the DID assays, precipitating bands were obtained in 21/24 patients with 86% sensitivity; and 97% specificity. To use ELISA technique, shows that 16/24 sera from patients with aspergillosis were positive, which represents 66% sensitivity and 97% specificity. As for GM- LFA, all sera were tested and 16/24 positive sera were obtained with the commercial kit, representing 66% sensitivity and 97% specificity. Conclusions: Finally, when comparing the three tests studied, all techniques were found to be highly sensitive and have excellent specificity, recommending that the diagnosis of CAPA and IPA be based on a combination of diagnostic assays.

A Community-Based Approach to Flood Vulnerability Assessment: The Case of El Cardón Sector

Flood pose a récurrent thread to the population of Venezuela, primarily due to the characteristics of its basins and human activities in alluvial zones. While hydrometeorological phenomena contribute to flooding, human decisions regarding land use intensify the impact. This research project aims to provide comprehensive information and tools to empower the inhabitants of the Cardón Sector to mitigate flood risks effectively. Through a structured approach comprising four chapters, the project seeks to establish a precedent for addressing flood-related challenges at both the research and community levels.

Maintaining measles elimination status in Colombia during outbreak control, 2019Manutenção do status de eliminação do sarampo na Colômbia durante o controle de surtos, 2019

Describe measles outbreaks caused by importation of multiple cases, and the corresponding control interventions. Descriptive study of measles outbreaks caused by the importation of multiple cases to Colombia in 2018-2019. Case definitions, classification of source of infection, collection of biological specimens, searches for suspected cases, case identification, and contact tracing were employed. Vaccination records were obtained from vaccination cards or from the Colombian information system. Nationality was determined from records found in the public health surveillance system. The incident command system was used, and response teams and action plans were activated to control outbreaks. In March 2018, the first case of measles imported from Venezuela was confirmed. Measles incidence in 2018 was 0.2 cases per 100 000 population, and it was 0.3 per 100 000 in 2019. The case fatality rate in 2019 was 0.4%. A total of 214 cases were confirmed in the Venezuelan population (91% with no vaccination history); and 69 outbreaks with no epidemiological link were studied. The MVi/Hulu Langat.MYS/26.11[D8] lineage was identified. Endemic circulation was prevented through innovative interventions such as infection surveillance and control, immediate notification, prioritization of field visits, and transmission risk level criteria. Colombia controlled measles outbreaks that resulted from imported cases, and it prevented endemic circulation, thereby maintaining certification of measles elimination in the country.

Socio-demographic, migratory and health-related determinants of food insecurity among Venezuelan migrants in Peru.

To evaluate the factors associated with food insecurity (FI) among Venezuelan migrants residing in Peru. Secondarily, to evaluate the psychometric properties of the Food Insecurity Experience Scale (FIES). A cross-sectional study based on secondary data analysis of the 2022 Venezuelan Population Residing in Peru Survey (ENPOVE-2022, from the Spanish acronym) was conducted. FI was measured with the FIES, whose properties were tested using the Rasch model. Multinomial logistic regression was performed to estimate relative prevalence ratios with their corresponding 95 % confidence intervals. This survey was conducted in February and March 2022 in the eight cities most populated by Venezuelan migrants and refugees in Peru. Venezuelan migrants and refugees over the age of 18 years living in Peru. A total of 7727 participants were included. Rasch reliability was adequate (0·73). The prevalence of mild, moderate and severe FI was 36·71 %, 31·14 % and 10·48 %, respectively. Being aged 25-34 and 35-44 years, unemployed, uninsured, having no formal education or secondary, illegal status, living in a dwelling with 2-4 and more than 4 people, presenting one or more than one chronic disease, residing in Peru for 0-6 months and perceived discrimination were associated with a higher probability of moderate FI. Furthermore, having secondary education, being unemployed, uninsured, never married, illegal, residing in Tumbes, presenting one or more than one chronic disease and perceived discrimination were significantly associated with severe FI. Four out of ten Venezuelan migrants residing in Peru presented moderate to severe FI. The FIES showed adequate psychometric properties. Differences in the socio-demographic, health and migratory factors associated with FI levels were found. Inter-sectoral and multi-sectoral interventions are needed and should be focused on addressing the determinants of FI.

Non-vaccination against COVID-19 Among Venezuelan Refugees and Adult Migrants Adults in Peru: A Cross-sectional Study from, 2022.

The purpose of this study was to identify determine factors associated with non-vaccination against coronavirus disease 2019 (COVID-19) among the Venezuelan immigrant population residing in Peru. A cross-sectional study was conducted using data obtained from the Second Survey of the Venezuelan Population Residing in Peru from in 2022. The dependent variable was vaccination status against COVID-19. The independent variables included sociodemographic, economic, and migratory characteristics of the included population. Crude and adjusted generalized linear Poisson-family models were used to calculate prevalence ratios (PRs) with 95% confidence intervals (CIs). A total of 7739 Venezuelan migrants aged 18 years or older were included. The proportion of non-vaccination against COVID-19 was 5.7%. Regarding associated factors, unemployment (adjusted prevalence ratio [aPR], 1.31; 95% CI, 1.04 to 1.65) was linked to an increased likelihood of not being vaccinated against COVID-19. In contrast, female sex (aPR, 0.76; 95% CI, 0.61 to 0.95), possessing a migration permit (aPR, 0.41; 95% CI, 0.31 to 0.54), and having health insurance (aPR, 0.47; 95% CI, 0.27 to 0.81) were associated with a decreased likelihood of being unvaccinated. The primary governmental and non-governmental institutions responsible for supporting and protecting the Venezuelan migrant and refugee population should improve vaccination access by issuing migration permits and providing health insurance.

Migration Status and Utilization of Healthcare Services Among Venezuelan Immigrants in Peru.

In general, migrants in illegal situations encounter a greater barrier to accessing medical care because of their migration status due to not having the required documentation to be able to obtain insurance in the receiving country. To evaluate the association between migration status and the use of health services in the Venezuelan population residing in Peru. Data from the second Survey Directed to the Venezuelan Population Residing in Peru (ENPOVE) of 2022 were analyzed. The dependent variable was use of health services in the last month. The exposure variable was migration status (legal/illegal). Generalized linear models of the Poisson family with link log function were used to obtain crude and adjusted prevalence ratios (aPR), for potential confounding variables. Additionally, we evaluated the association of interest, stratified by gender. Data from 1569 migrants were analyzed. Participants with illegal migration status represented 32.4% (men: 24.3%; women: 36.7%); likewise, 58.1% did not use health services. Illegal migration status was associated with lower health care use (aPR: 0.75; 95%CI: 0.61-0.92). Likewise, after stratifying by sex, the association was maintained only in male migrants (aPR: 0.53; 95%CI: 0.39-0.82) but not in women (aPR: 0.84; 95%CI: 0.67-1.05). 58.1% of Venezuelan migrants in Peru did not seek medical attention despite having health problems. Having an illegal immigration status leads to a lower probability of using these services, especially in men.

Is using the Gail model to calculate the risk of breast cancer in the Venezuelan population justified?

To evaluate the accuracy of the Gail model (GM) in women who already have a diagnosis of breast cancer (BC) from the Breast Pathology Service, Hospital Oncology Department of the Venezuelan Social Security Institute (SOH-IVSS) in the period 2004-2014. To compare the accuracy of the GM in women aged above and below 40 years with a diagnosis of BC. Descriptive, retrospective, cross-sectional, 830 records of patients diagnosed with BC were reviewed between 2004 and 2014. The mean age for diagnosis of the disease was 46 ± 13 years; menarche age was 13 years ± 2; age at first birth 22 ± 5 years, with a history of biopsy 32 ± 11, the percentage of relatives with a primary history of BC reported (PHBC) 9.3%. Only 41% of women with a diagnosis of BC reported Gail >1.67 (positive Gail). In the dichotomous logistic regression that related positive Gail with the independent variables, it was observed: greater probability of positive Gail if menarche age <11 years (p < 0.036), PHBC (p = 0.005), previous biopsy (p = 0.007), age at first birth 25-29 years (p = 0.019). When stratifying by age, unlike the bivariate analysis, women over 40 years of age are more likely to have a positive Gail in menarche age <11 years (p = 0.008), PHBC (p = 0.001), previous biopsy (p = 0.025) when compared with younger women, the age at first birth between 25 and 29 years was statistically significant for both groups; however, the probability was higher in younger women (p = 0.008). There is no conclusive evidence to consider that the GM is applicable to Venezuelan women due to its low precision since it only identified 41% of the patients who had BC as high risk; however, when the factors are analysed separately, we found a higher probability of a positive Gail with statistical significance in EM <11 years, PHBC, previous biopsy and age at first birth 25-29 years; When stratifying by age, we observed that the age at first birth 25-29 years in women aged 40 or less increases the probability of a positive Gail. It is necessary to develop new risk assessment models that are adapted to our female population.

Migration and Human Capital: The Effect of Education on the Qualified Employment of Venezuelan Immigrants in Peru

This study analyzes the impact of Venezuelan immigrants’ human-capital on their occupational choice in Peru, in terms of job qualifications. Cross-sectional data were sourced from the National Survey to the Venezuelan Population in Peru, using ordered probit models for 2018 and 2022. The results show that immigrants with university education or previous job experience are overeducated for jobs requiring university education, in the Peruvian labor market, for both years, since they are more likely to obtain jobs with technical education requirements, the intensity of the phenomenon reduced in 2022. The study verifies the Venezuelan immigrants’ overeducation in the Peruvian labor market.

Food Insecurity and Mental Health among Venezuelan Migrants and Refugees Living in Peru: Secondary Data Analysis of a Cross-Sectional Survey.

The objective of this study was to analyze the association between food insecurity and mental health in Venezuelan migrants and refugees residing in Peru using data from the Survey Directed at the Venezuelan Population Residing in the Country (ENPOVE) conducted in 2022. The analysis included 7739 Venezuelan adults. The presence of mental health problems was self-reported, and household food insecurity was measured using the Food Insecurity Experience Scale. The study found that 4 out of 10 participants lived in households with moderate to severe food insecurity, and around 10% reported experiencing some mental health problem in the last month. The study identified a positive association between living in households with moderate to severe food insecurity and having some mental health problem compared to living in households without food insecurity. The findings suggest that food insecurity is a common problem among the Venezuelan migrant population residing in Peru, and measures are required to address this problem and mitigate its consequences on mental health and other health problems. The study highlights the need for international organizations to provide assistance and support to these populations and ensure adequate and sustainable follow-up of food insecurity at the national level. It is also necessary to implement early detection tests for mental health problems in the migrant population, especially in individuals exposed to food insecurity. This study provides relevant evidence for addressing public health in the Venezuelan migrant population residing in Peru.

Differential NRAMP1gene’s D543N genotype frequency: Increased risk of contracting tuberculosis among Venezuelan populations

NRAMP1 and VDR gene polymorphisms have been variably associated with susceptibility to tuberculosis (TB) amongst populations having different genetic background. NRAMP1 and VDR gene variants’ association with susceptibility to active infection by Mycobacterium tuberculosis (Mtb) was analyzed in the Warao Amerindian population, an ethnic population from Venezuela’s Orinoco delta region. Genomic DNA was extracted from individuals with and without TB to evaluate genetic polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Four NRAMP1 gene polymorphisms were analyzed: D543N (rs17235409), 3′ UTR (rs17235416), INT4 (rs3731865), and 274C/T (rs2276631), and one VDR gene polymorphism: FokI (rs2228570). The results showed that the genotypes D543N-A/A, 3′UTR-TGTG+/+, INT4-C/C, and 274C/T-T/T of known polymorphism in the NRAMP1 gene, as well as the genotypes FokI-F/f and FokI-f/f in the VDR gene were most often found in indigenous Warao with active TB. Binomial logistic regression was used for evaluating associations between polymorphisms and risk of contracting TB, an association between NRAMP1-D543N-A/A genotype distribution and TB susceptibility was found in Warao Amerindians. Regarding Venezuelan populations having different genetic backgrounds; statistically significant TB associations concerning NRAMP1-D543N-A/A, INT4-C/C and 3′UTR-TGTG+/+ variant genotype distributions in Warao Amerindians (indigenous) compared to Creole (admixed non-indigenous population) individuals were found. In conclusion, the results thus indicated that the association between NRAMP1-D543N-A/A genotype and TB in Warao Amerindians could support such allele’s role in host susceptibility to Mtb infection.

The Impact of Plant-Based Diets on Dietary Acid Load Metrics in Venezuela: A Cross-Sectional Study.

Dietary acid load (DAL) is an important determinant of the acid-base balance in humans and has been associated with several chronic non-communicable diseases. Plant-based diets, including vegetarian and vegan diets, decrease DAL-although their alkalizing potential varies substantially. Their net effect on common DAL scores, including potential renal acid load and net endogenous acid production, has been insufficiently quantified and is poorly understood-particularly in populations outside of Europe and North America. We assessed the associations between three plant-based dietary patterns (flexitarian vs. lacto-ovo-vegetarian vs. vegan diet) and DAL scores in a healthy Venezuelan population in the metropolitan area of Puerto La Cruz, Venezuela. Substantial differences in DAL scores were observed, whereby the vegan diet yielded the highest alkalizing potential, followed by the lacto-ovo-vegetarian and the flexitarian diet. DAL scores were substantially lower in comparison to European and North American plant-based populations, probably due to the higher potassium intake (exceeding 4000 mg/d in vegans), the higher magnesium intake (390.31 ± 1.79 mg/d in vegans) and the lower intake of protein in vegans and lacto-ovo-vegetarians. Additional studies in other non-industrialized populations are warranted to allow for a better understanding of the (numeric) impact of plant-based dietary patterns on DAL scores, potentially allowing for an establishment of reference ranges in the near future.

A time-series analysis of morbidity and mortality of viral hepatitis in Venezuela, 1990–2016

BackgroundViral hepatitis (VH) is a leading contributor to morbidity and mortality worldwide, constituting a public health problem associated with the level of human development. In recent years, Venezuela has experienced a political, social, and economic crisis and has been impacted by natural disasters that have led to the deterioration of sanitary and health infrastructures modifying the determinants of VH. Despite epidemiological studies conducted in specific regions of the country or populations, the national epidemiological behaviour of VH remains unclear.MethodsThis is a time series study involving records of morbidity and mortality by VH in Venezuela reported during the period from 1990 to 2016. The Venezuelan population was taken as the denominator of the morbidity and mortality rates, according to the Venezuelan National Institute of Statistics and the 2016 population projections from the latest census published on the website of the responsible Venezuelan agency.ResultsDuring the study period, 630,502 cases and 4,679 deaths from VH in Venezuela were analysed. Most of the cases (n = 457,278; 72.6%) were classified as unspecific VH (UVH). The deaths were mainly attributed to VHB (n = 1,532; 32.7%), UVH (n = 1,287; 27.5%), and sequelae of VH (n = 977; 20.8%). The mean rates of cases and deaths from VH in the country were 95 ± 40.4 cases per 100,000 inhabitants and 0.7 ± 0.1 deaths per 100,000 inhabitants, respectively, showing a large dispersion that is evident from the calculation of the coefficients of variation. There was document a strong correlation between UVH and VHA cases (0.78, p < 0.01) morbidity rates. VHB mortality rate was very strongly correlated with sequelae of VH (–0.9, p < 0.01).ConclusionsVH is a major burden of morbidity and mortality in Venezuela with an endemic-epidemic trend and an intermediate prevalence for VHA, VHB, and VHC. Epidemiological information is not published in a timely manner and diagnostic tests are insufficient in primary health services. There is an urgent need to resume epidemiological surveillance of VH and to optimise the classification system for a better understanding of UVH cases and deaths due to sequelae of VHB and VHC.

Migration and integration of middle-class Venezuelans in Costa Rica: Drivers, capitals, and livelihoods

The current Venezuelan crisis has spurred one of the largest mass migrations in Latin American history, with estimates of more than 7 million migrants leaving Venezuela (UNHCR, 2023). Most Venezuelans leaving the country are economically disenfranchised migrants fleeing to neighboring countries with limited economic resources. However, there are upper- and middle-class well-educated Venezuelans migrating to other parts of Latin America whose socio-economic status allows for a different migration experience. This paper draws on qualitative research conducted in 2020–2022 which investigated the dynamics of the upper- and middle-class Venezuelan diaspora settled in the suburbs of San José, Costa Rica. Specifically, the research focused on the migration and integration experiences of Venezuelans in Escazú and Santa Ana, modern, upscale suburbs, due to their rapid increase of Venezuelan population. This paper draws on 14 semi-structured interviews in an effort to contribute to the theoretical understanding of the migration and integration process and answer the questions: (1) What are the factors influencing migrants’ decisions to migrate; (2) what capitals do migrants have and how do they mobilize them; and (3) what do the personal accounts of migration decisions and experiences reveal about the overall well-being of migrants? We build on the Push/Pull Plus Migration Drivers (Van Hear et al., 2018) and the Sustainable Livelihoods Framework (Sen, 1981; Chambers, 1983) as analytical frameworks. Findings suggest that our composite framework provides a useful lens through which to understand the decision to migrate for upper and middle class Venezuelan migrants to Costa Rica, and sheds light on the initial stages of their integration process. The addition of cultural and political capitals as assets relevant for understanding migration livelihoods is critical in migratory contexts and shed light on the ways in which migrants navigate the formal and informal integration process. More research is needed on the roles well-being and trauma play in all phases of the migration and integration processes.