Geographical Locations - Venezuela

• WHO
  -WHO Country Profile - Venezuela
  - PAHO - Pan American Health organisation / Organización Panamericana de la Salud
  - Regional Office for the Americas / Pan American Health Organization (AMRO / PAHO) in Washington, D.C. (USA)
  - WHO - Tobacco control: Country Profile - Venezuela
  - WHO - Environmental Burden of Disease: Country Profile – Bolivarian Republic of Venezuela
• UNDP - Venezuela

Government

• Government of Venezuela

Non-Government

Academic Institutions

• Universidad de Venezuela, Caracas (Distrito Federal)
  - Facultad de Medicina

National Policy and Related Documents

Reports, Guidelines, and Projects

• Characteristics of patients with venous thromboembolism and atrial fibrillation in Venezuela
  Background: Studies describing venous thromboembolic event (VTEE) and atrial fibrillation (AF) in South American populations are limited. The aim of this cross-sectional study was to describe the characteristics of Venezuelan patients admitted and treated for these conditions. Methods: A retrospective medical record review of 1397 consecutive patients admitted to three private hospitals or clinics between January 2000 and December 2005 was performed. Data was collected on demographics, anthropometrics, hospital visit, comorbidities and treatment. Results: Among 401 VTEE and 996 AF patients, men were more likely to have AF (58%) while more women experienced a VTEE (58%). Most patients were admitted via the emergency room (87%) and had only one event during the study period (83%). Common comorbidities included hypertension (46%), heart failure (17%), diabetes (12%) and congestive heart failure (11%). Characteristics of Venezuelan patients with VTEE and AF are similar to that reported in the literature for other populations. Conclusions: These results provide background characteristics for future studies assessing risk factors for AF and VTEE in South American populations. [author abstract] [BMC Public Health 2011, 11: 415]
• Confronting Health Disparities: Latin American Social Medicine in Venezuela
  Objectives: We explored the emergence and effectiveness of Venezuela's Misión Barrio Adentro, "Inside the Neighborhood Mission," a program designed to improve access to health care among underserved residents of the country, hoping to draw lessons to apply to future attempts to address acute health disparities. Methods: We conducted our study in 3 capital-region neighborhoods, 2 small cities, and 2 rural areas, combining systematic observations with interviews of 221 residents, 41 health professionals, and 28 government officials. We surveyed 177 female and 91 male heads of household. Results: Interviews suggested that Misión Barrio Adentro emerged from creative interactions between policymakers, clinicians, community workers, and residents, adopting flexible, problem-solving strategies. In addition, data indicated that egalitarian physician-patient relationships and the direct involvement of local health committees overcame distrust and generated popular support for the program. Media and opposition antagonism complicated physicians' lives and clinical practices but heightened the program's visibility. Conclusions: Top-down and bottom-up efforts are less effective than ‘horizontal’ collaborations between professionals and residents in underserved communities. Direct, local involvement can generate creative and dynamic efforts to address acute health disparities in these areas. [author abstract] [Am J Public Health. 2009; 99: 549-555. doi:10.2105/AJPH.2007.129130]
• Epidemiologic aspects of arterial hypertension in Maracaibo, Venezuela
  The purpose of this study was to determine the prevalence of arterial hypertension (HT) awareness and the influence of age, sex and body mass index on the degree of control of HT in the population of Maracaibo, State of Zulia, Venezuela. It included 7424 subjects, 3640 males (M) and 3784 females (F). Information was collected through domiciliary visits with a questionnaire designed for this purpose. Hypertension was defined as such when values were ≥ 140 mm Hg for systolic blood pressure (SBP) and ≥ 90 mm Hg for diastolic blood pressure (DBP). In the total sample, 36.9% were hypertensive. A higher prevalence in M (45.2%) than in F (28.9%), was observed. The percentage of HT increased with age in both genders. There was a high percentage of hypertensives with obesity (73.5%) which did not vary when discriminating for gender and age. Obese subjects were more prone to have HT until age 50. Those younger than 40 took less medication but were proportionally better controlled. Of the hypertensive population 54.3% were not aware of their condition, of 45.7% remaining, 22.8% did not have regular control visits, 18.4% inspite of medication were not controlled and only 4.5% were well controlled. Better control was observed in F (6.2%) than in M (3.3%), P < 0.001. It is concluded that HT is a serious public health problem because of its high prevalence and lack of control, and it is necessary to implement educational and medical programmes for the detection and control of this disease. [author abstract] [Journal of Human Hypertension (2000) 14, Suppl 1, S6–S9]
• Epidemiological aspects of human and canine visceral leishmaniasis in Venezuela
  Objective: To report recent data on the distribution of human and canine visceral leishmaniasis (VL) in Venezuela, and to highlight problems associated with effective control measures. Methods: We report the number of cases, incidence rate, age and sex distribution, and mortality rates for human VL (HVL) for the period of 1995 through 2000, based on National Registry of Leishmaniasis data. We carried out serological studies on a total of 3 025 domestic dogs from the 12 states in Venezuela reporting cases of human VL in this 1995–2000 period and also from the state of Yaracuy, where cases were reported earlier during the decade of the 1990s. Results: From 1995 through 2000, 242 cases of HVL were reported from 12 states, in various sections of Venezuela. There was a relatively stable national incidence rate of 0.2 cases per 100 000 persons per year. Of the 242 cases, 26.0% were from Margarita Island, one of the three islands that make up the state of Nueva Esparta (Margarita Island was the only one of the Nueva Esparta islands that had HVL cases). Over the 1995–2000 period, the annual incidence rates for Nueva Esparta ranged from 1.7 to 3.8 cases per 100 000 population. Males in Venezuela were more frequently affected (59.5%) than were females (40.5%). In terms of age, 67.7% of the VL patients were ≤ 4 years of age, and 80.6% were younger than 15 years. The mortality rate among the persons with VL was 7.85% during the 1995–2000 period. Serological screening with rK39 antigen of 1 217 dogs from Margarita Island found a 28.5% positivity rate (testing of dogs was not done on the two other islands of Nueva Esparta). In contrast, the rate was 2.8% in the 1 808 samples from dogs from 12 states on the mainland. Conclusions: Human and canine VL are unevenly distributed in Venezuela. The distribution may reflect such factors as differences among the states in human population density, vector density, and the presence or absence of other trypanosomatidae. Particularly high infection rates in very young children as well as in domestic dogs occur in semiurban communities of Nueva Esparta, where other human-infecting trypanosomatidae have not been reported. Control measures related to limiting canine infection might contribute to disease control where VL infections are frequent. Reducing VL mortality requires increased awareness among medical professionals of the possibility of VL in the differential diagnosis of hepato-splenic syndromes, particularly in children. [author abstract] [Rev Panam Salud Publica/Pan Am J Public Health 13(4), 239-245, 2003]
• Health in the Americas 2007: Venezuela
  As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Venezuela addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Venezuela, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
• Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study
  Background: The proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide. Aims: To estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America. Method: A one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression. Results: For DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode. Conclusions: The treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector. [author abstract] [The British Journal of Psychiatry 2009 195: 510-515]
• Low prevalence of hepatitis C virus infection in Amerindians from Western Venezuela
  Previous studies have not found hepatitis C virus (HCV) infection in Amerindians from Western Venezuela. A survey of 254 Bari and Yukpa natives aged 10-60 years (mean ± SD age = 35 ± 5.4 years) from four communities, two Bari and two Yukpa, in this area were studied to assess the prevalence of antibodies to HCV (anti-HCV) and HCV RNA among these indigenous populations. Serum samples were examined initially for anti-HCV by a four generation enzyme-linked immunosorbent assay (ELISA). Reactive samples were then tested using a third generation recombinant immunoblot assay (RIBA-3). Viral RNA was investigated in all immunoblot-reactive samples by a nested polymerase chain reaction (PCR) method. Six (2.3%) of 254 natives were positive by ELISA, one (2.2%) of these reactive samples were positive by RIBA, and four (1.5%) were indeterminate. Only two (0.8%) were positive by PCR, corresponding to 1 (2.1%) of 47 inhabitants of a Yukpa community and to 1 (2.2%) of 45 subjects of a Bari community. Iatrogenic is thought to play a role in acquisition of the infection. The findings indicate a HCV focus of low endemicity and are compatible with a low degree of exposures of the natives to the virus. Studies are necessary to assess the risk factors for infection in these Amerindians. [author abstract] [Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 102(1): 107-110, February 2007]
• National Training Program for Comprehensive Community Physicians, Venezuela
  Introduction: Through the 1990s, wide disparities in health status were recorded in Venezuela, a mirror of poor social conditions, decreasing investment in the public health sector and a health workforce distribution unable to meet population health needs or to staff effective, accessible public health services. Venezuelans’ health status deteriorated as a result. In 2003-2004, the Venezuelan government launched Barrio Adentro, a new national public health model aimed at assuring primary health care coverage for the entire population of an estimated 26 million. Cuban physicians staff Barrio Adentro clinics, mainly in poor neighborhoods, until enough Venezuelan physicians can be trained to fill the posts. Intervention: Cuban experience with community-oriented medical education and global health cooperation was drawn upon to develop curriculum and provide faculty for the new National Training Program for Comprehensive Community Physicians, begun in 2005 in cooperation with six Venezuelan universities. The program differs from previous Venezuelan medical education models by adopting a stated goal of training physicians for public service, recruiting students who had no previous opportunity for university-level education, and concentrating the weight of their training on a service- and community-based model of education, relying on practicing physician-tutors. Results: Over 20,000 students have been enrolled in three years. The six-year program has been extended to all 24 Venezuelan states, relying mainly on Cuban faculty who are practicing Barrio Adentro doctors and who receive postgraduate training in medical education. This “university without walls” has accredited 5,131 Barrio Adentro clinics as teaching institutions; its infrastructure includes other health care delivery facilities plus 855 multipurpose classrooms throughout the country. For the 2006-2007 academic year, the pass rate was 82% for first-year students and 94% for second-year students. Some difficulties persist in student selection, pre-medical preparation, and achieving optimum use of existing resources. Academic, institutional, and external evaluations are ongoing. Conclusion: This is the most ambitious example of scaling up of physician training in a single country. The program has been made possible by considerable political will from the Venezuelan and Cuban governments; by the experience acquired through development of the Cuban health system and medical education programs; by the individual commitment of Cuban curriculum developers and physician-tutors; and by ever-more-organized Venezuelan communities. The size of the undertaking, coupled with significant innovations in curriculum, present challenges. The Venezuelan experience — emphasis on training physicians for a revitalized public health sector, accompanied by a paradigm shift in primary care — warrants attention from the international community in the context of the global shortage of health workers and efforts to achieve a more equitable distribution of health services worldwide. [author abstract] [MEDICC Review, Fall 2008, Vol 10, No 4, pp.35-42]
• Occurrence of Proteus mirabilis associated with two species of Venezuelan oysters
  The fecal contamination of raw seafood by indicators and opportunistic pathogenic microorganisms represents a public health concern. The objective of this study was to investigate the presence of enteric bacteria colonizing oysters collected from a Venezuelan touristic area. Oyster samples were collected at the northwestern coast of Venezuela and local salinity, pH, temperature, and dissolved oxygen of seawater were recorded. Total and fecal coliforms were measured for the assessment of the microbiological quality of water and oysters, using the Multiple Tube Fermentation technique. Analyses were made using cultures and 16S rRNA gene sequencing. Diverse enrichment and selective culture methods were used to isolate enteric bacteria. We obtained pure cultures of Gram-negative straight rods with fimbriae from Isognomon alatus and Crassostrea rhizophorae. Our results show that P. mirabilis was predominant under our culture conditions. We confirmed the identity of the cultures by biochemical tests, 16S rRNA gene sequencing, and data analysis. Other enterobacteria such as Escherichia coli, Morganella morganii and Klebsiella pneumoniae were also isolated from seawater and oysters. The presence of pathogenic bacteria in oysters could have serious epidemiological implications and a potential human health risk associated with consumption of raw seafood. [author abstract] [Rev. Inst. Med. trop. S. Paulo 49(6): 355-359, November-December, 2007]
• Potential influence of climate variability on dengue incidence registered in a western pediatric Hospital of Venezuela
  Climate change and variability is affecting human health and disease direct or indirectly through many mechanisms. Dengue is one those diseases that is strongly influenced by climate variability. In this study we assess potential associations between macroclimatic variation and dengue cases in a western pediatric hospital of Venezuela in an eight-year period. Between 2001 and 2008, 7,523 cases of dengue were reported in the Hospital Agustin Zubillaga, Barquisimeto, Venezuela. Climatic periods marked a difference of 23.15% in the mean incidence of cases, from El Niño weeks (-14.16% of cases below the mean incidence) to La Niña months (+8.99% of cases above it) (p=0.0001). Linear regression showed significantly higher dengue incidence with lower values of Oceanic Niño Index (ONI) (El Niño periods) and lower dengue incidence with higher values of ONI (La Niña periods) (p=0.0002). As has been shown herein, climate variability is an important element influencing the dengue epidemiology in Venezuela. However, it is necessary to extend these studies in this and other countries in the region, because these models can be applied for surveillance as well for prediction of dengue. [author abstract] [Tropical Biomedicine 27(2): 280–286 (2010)]
• Venezuela’s Barrio Adentro: an alternative to neoliberalism in health care
  Throughout the 1990s, all Latin American countries but Cuba implemented health care sector reforms based on a neoliberal paradigm that redefined health care less as a social right and more as a market commodity. These reforms were couched in the broader structural adjustment of Latin American welfare states as prescribed by international financial institutions since the mid-1980s. However, since 2003, Venezuela has been developing an alternative to this neoliberal trend through its health care reform program, Misión Barrio Adentro (Inside the Neighborhood). In this article, the authors review the main features of the Venezuelan health care reform, analyzing, within their broader sociopolitical and economic contexts, previous neoliberal health care reforms that mainly benefited transnational capital and domestic Latin American elites. They explain the emergence of the new health care program, Misión Barrio Adentro, examining its historical, social, and political underpinnings and the central role played by popular resistance to neoliberalism. This program not only provides a compelling model of health care reform for other low- to middle-income countries but also offers policy lessons to wealthy countries. [author abstract] [International Journal of Health Services, Vol. 36, No. 4, pp. 803–811, 2006]

Educational Resources

• Association of Caribbean States, Port of Spain, Trinidad and Tobago
• CDC - Travel Information : Tropical South America
• Library of Congress, Country Study: Venezuela