Signatures of the Venezuelan Humanitarian Crisis in the First Wave of COVID-19: Fuel Shortages and Border Migration.

Testing and isolation have been crucial for controlling the COVID-19 pandemic. Venezuela has one of the weakest testing infrastructures in Latin America and the low number of reported cases in the country has been attributed to substantial underreporting. However, the Venezuelan epidemic seems to have lagged behind other countries in the region, with most cases occurring within the capital region and four border states. Here, we describe the spatial epidemiology of COVID-19 in Venezuela and its relation to the population mobility, migration patterns, non-pharmaceutical interventions and fuel availability that impact population movement. Using a metapopulation model of SARS-CoV-2 transmission dynamics, we explore how movement patterns could have driven the observed distribution of cases. Low within-country connectivity most likely delayed the onset of the epidemic in most states, except for those bordering Colombia and Brazil, where high immigration seeded outbreaks. NPIs slowed early epidemic growth and subsequent fuel shortages appeared to be responsible for limiting the spread of COVID-19 across the country.

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

In the past 5-10 years, Venezuela has faced a severe economic crisis, precipitated by political instability and declining oil revenue. Public health provision has been affected particularly. In this Review, we assess the impact of Venezuela's health-care crisis on vector-borne diseases, and the spillover into neighbouring countries. Between 2000 and 2015, Venezuela witnessed a 359% increase in malaria cases, followed by a 71% increase in 2017 (411 586 cases) compared with 2016 (240 613). Neighbouring countries, such as Brazil, have reported an escalating trend of imported malaria cases from Venezuela, from 1538 in 2014 to 3129 in 2017. In Venezuela, active Chagas disease transmission has been reported, with seroprevalence in children (<10 years), estimated to be as high as 12·5% in one community tested (n=64). Dengue incidence increased by more than four times between 1990 and 2016. The estimated incidence of chikungunya during its epidemic peak is 6975 cases per 100 000 people and that of Zika virus is 2057 cases per 100 000 people. The re-emergence of many vector-borne diseases represents a public health crisis in Venezuela and has the possibility of severely undermining regional disease elimination efforts. National, regional, and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders.

Genetic and Morphometric Variability of Triatoma sordida (Hemiptera: Reduviidae) from the Eastern and Western Regions of Paraguay.

Triatoma sordida is widely distributed throughout the Chaco and the Eastern Region of Paraguay. It is associated to palm trees and artificial ecotopes located in peridomestic environments. The aim of this work was to determine genetic and morphometric variability and feeding behavior among population of T. sordida captured in domicile and peridomicile areas of Paraguay. Feeding contents and levels of genetic and morphometric variation were determined in 124 T. sordida from domicile and peridomicile populations of San Pedro and Paraguarí departments of the Eastern Region and Boquerón and Presidente Hayes departments of the Western region using Double Diffusion Gel, random amplified polymorphic DNA (RAPD), and head and wings morphometry. Morphometric analysis revealed isolation of populations by geographic region and larger size in triatomine populations from the Western Region. RAPD showed no specific patterns for domicile and peridomicile populations. The estimator of diversity (F ST; 0.08) and high gene flow obtained (N m; 5.7) did not allow the establishment of genetic differentiation within the same region. The blood meal source showed that poultry feeding was 38% of host preferences, and human blood was the second feeding preference (24%) in the insects from the Eastern Region while poultry feeding was predominant in those from the Western Region (30%). This work showed homogeneity between T. sordida populations of the same region and between domicile and peridomicile. The genetic diversity was determined among T. sordida populations of both geographical regions suggesting differentiation associated to eco-geographical isolation by distance. It is important to notice that pattern feedings were different between the two regions. Further studies should be focused on how phenetic and genetic variations could be related to the adaptation capacity of these triatomine populations to domicile, increasing their vector potentiality in the transmission of Chagas disease.