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Print version ISSN 0123-9392

Infect. vol.26 no.2 Bogotá Jan./June 2022  Epub Dec 12, 2021 


Challenges and Visions for Infectious Diseases in Colombia during the COVID-19 Peripandemic Transition 2021-2023

Retos y Visiones para las Enfermedades Infecciosas en Colombia durante la Transición Peripandémica de la COVID-19 2021-2023

Alfonso J. Rodriguez-Morales1  2  3  * 

German Camacho-Moreno4  5 

Henry Mendoza-Ramírez6 

Iván Arturo Rodríguez-Sabogal7 

José Millán Oñate8  9 

1 Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Uni versitaria Autónoma de las Américas, Pereira, Risaralda, Colombia. Associate Editor, Infectio. President 2021-2023, ACIN.

2 Committee on Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología, Bogotá, DC, Colombia.

3 Committee on Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología Bogotá, DC, Colombia.

4 Deparment of Pediatrics, Universidad Nacional de Colombia, Bogotá, Co lombia. Vicepresident 2021-2023, ACIN.

5 Division of Infectious Diseases, Fundación Hospital de la Misericordia, Bo gotá, Colombia.

6 Hemera Unidad de Infectología IPS SAS, Bogota, Colombia. Secretary, 2021- 2023, ACIN.

7 Hospital San Vicente Fundación, Medellin, Antioquia, Colombia. Treasurer, 2021-2023, ACIN.

8 Clinica Imbanaco Grupo Quironsalud, Cali, Colombia. Fiscal, 2021-2023, ACIN.

9 Universidad Santiago de Cali, Cali, Colombia.

Keywords: infectious diseases; coronavirus; epidemics; pandemic; Colombia

Palabras clave: enfermedades infecciosas; coronavirus; epidemias; pandemia; Colombia.

After the first 20 months of the Coronavirus Disease 2019 (CO VID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), many lessons have been learnt in Colombia, Latin America and the world from many points of view1. When the COVID-19 arrived to Colom bia2, and other countries in the region3, many other infectious diseases concerned affected us, including previous epidemics of chikungunya4,5, Zika6,7, and most recently of dengue8, as well as, the impact of certain vaccine-preventable diseases, such as measles, particularly linked to the forced migration from Ve nezuela, and the persistent threat of malaria and other vector-borne diseases, HIV and tuberculosis, among many other9-11. Even more, in Colombia, as well as in other countries of Latin America, a envisioned challenge in pediatrics is to recover the appropriate vaccination coverage for other diseases different to COVID-19, that have decreased during the pandemic12. Such situation may impose a risk for reemergence of certain vacci ne-preventable diseases. During the pandemic, a drop in vac cination coverage was observed in the child population, one of the great challenges in the immediate future is to increase this coverage to avoid the appearance of outbreaks of preventable diseases such as measles, rubella, and chicken pox. Fortuna tely, as consequence of the public health measures took for COVID-19, a decrease on the incidence of many respiratory tract infections has been observed. Other pathogens that are transmitted by contact and drops, such as respiratory syncytial virus, influenza, adenovirus, pneumococcus, causing acute res piratory infection, have decreased. Then, the challenge is to maintain surveillance and establish prevention strategies for these agents, since it is very likely that they would increase in the post-pandemic era and will put pressure on the health system together with COVID-1913.

During February 202014, countries such as Colombia began the preparedness to the imminent arrival of the SARS-CoV-2/ COVID-19, as effectively occurred on March 6, 2020, with the first case in the country. Quickly in the country healthcare providers learn about the SARS-CoV-2 and the COVID-19, from its clinical manifestations to their management15, as well as, with the rapid development of evidence-based guidelines for this emerging disease16. The Colombian Association of In fectious Diseases (ACIN), lead by Dr. Carlos Saavedra, deve loped the COVID-19 Colombian Evidence-Based Guidelines, with the participation of more than 200 experts supported by more than 60 medical scientific societies in the country, addressing particularly the changes in the knowledge regar ding the therapeutical management of COVID-19 patients17, as well as, more recent issues such as vaccination, the post- COVID-19 syndrome and reinfection, among others16,18. Re garding vaccinations, up to September 14, 2021, less than a third of the Colombian population had been fully vaccinated, then many challenges include the enhancement of the natio nal vaccination plan, as well as the acceptability of vaccines by population, but also the potential impact of the variants of concern, such as the Delta, as well as of new variants of interest, as the case of Lambda and the Mu (B.1.621), the last firstly reported in Colombia19-22. Indeed, multiple lessons have been learnt from different points of view, including the improvement of healthcare facilities for attending and care of COVID-19 patients, including those at intensive care units23. Even more, in this context, the National Institute of Health, has announced that around 89% of the Colombian popula tion, based on their estimations and studies, had suffered or have been exposed to SARS-CoV-2/COVID-19. This would explain, the recent decrease (September 2021) that has been observed in COVID-19 cases in Colombia, joint with the ad vances of the national vaccination plan. Not least important, associated with vaccination is the correct and close epide miological and clinical monitoring of the potentially associa ted adverse effects, including the recent reports of cardiovas cular possibly linked consequences (e.g. myocarditis).

Hopefully, in the next months, particularly in the next two following years, 2021-2023, a peripandemic transition may overcome. And with this, still new challenges related and not related to COVID-19, will be in the national agenda for health authorities as well as for scientific societies as the ACIN. Re cently, a new guideline, based on scientific evidence for the care of HIV/AIDS infection in adults, pregnant women and adolescents, as well as in children, has been developed and published by the Ministry of Health of Colombia (, and now its implementation and di vulgation is a vital matter for the Ministry as well as for the society at wide national level.

Many other examples, including prevalent diseases, such as toxoplasmosis, enteric parasitic infections, vector-borne and zoonotic diseases, especially those more neglected, required more attention, especially considering the coming Public Health 2022-2031 Ten-Year Plan of the Ministry of Health, with their multiple implications for prevalent infectious di seases in the country24. In this context, climate change, the OneHealth approach, among other social aspects, including the Venezuelan migrant, will be persistent for the next years, and should be considered on the actions, research and miti gation and control approaches and initiatives25-30. For exam ple, a national study of prevalence of enteric parasite infec tions, needs to be done again in the country. Other neglected infections, such as toxocariasis, should be also considered31,32.

Old foes, such as the antimicrobial resistance to antimicro bials33-35, including not only the one from bacteria but also fungi, compromising the emerging Candida auris36-39, among other emerging pathogens, are still a matter of great concern in the country40. Even more, after the misuse highly promoted during the COVID-19, an increase in antimicrobial resistance, is not only expected, but already observed in many countries, including Colombia41,42. The fight against antimicrobial resis tance, promotion of antimicrobial stewardship programs and education, are key in this context43-46.

Then, from an institutional point of view, ACIN should con tinue its work, and its journey in the fight against infectious diseases, from different battle fields, healthcare, research, teaching, management, among others, through their wor king thematic committees, as well as their regional chapters, which may increase in number over the next years, to cover new topics/diseases, as well as new territories. Finally, and not least important, is to continue promoting more deeply our relationships and collaborations with other related scientific societies in Latin America and abroad, as is the case of other national infectious diseases societies from Venezuela, Ecua dor, Panama, Brazil, Argentina, Chile, Peru, among others, as well as with regional and international societies, such as the Pan-American Infectious Diseases Association (API), the Latin American Society of Pediatric Infectious Diseases (SLIPE), the Latin American Society of Travel Medicine (SLAMVI), the In fectious Disease Society of the America (IDSA), the European Society for Clinical Microbiology and Infectious Diseases (ESCMID), the International Society for Antimicrobial Che motherapy (ISAC), among many other.

At this time when the number of infected and dead people is in full decline, it is important to strengthen epidemiological surveillance and take all measures to move to a stage of eli mination of the virus, this includes redoubling the number of daily tests, active search for cases, facilitate the implementa tion of the auto-test, grant the population relief in this enor mous social and humanitarian crisis.

With the pandemic, the enormous deficiencies in health care were revealed, where we can highlight the shortcomings in the primary care of the main diseases that overwhelm our country, some of them immunopreventable, others such as cardiovascular and oncological with late diagnoses that in crease morbidity, mortality, and health care costs. For exam ple, the number of new diagnoses of people living with HIV increased, tuberculosis testing decreased, cancer care was altered, and no surgeries were performed, among others.

With the implementation of molecular biology in many of the remote regions, it is feasible that we can better unders tand our epidemiology and with the proper management of knowledge to be able to provide solutions to our main pro blems, all efforts aimed at improving health must be trans lated into a constant phenomenon to improve our quality of life and also to encourage the development of science, technology and vaccination in Colombia.

The main concern that we must combat is the population’s distrust in science, it is key to improve communication, main tain clear and timely messages, using simple language and recognizing our mistakes so that the entire community can trust the advances of science and can adhere to the recom mendations. Empathy is mandatory at all times.

There are many issues or areas in which the country requi res development, some more important or achievable than others. The pandemic revealed the profound influence of education, poverty, technology and governance on health. Colombia should refocus policies on science, technology and research, for example producing vaccines, improving the development of molecular biology and sequencing la boratories. Many processes present today are supported by resolutions that must be updated now and once the health emergency ends, it seems that the some changes will disap pear overnight when someone says “the pandemic is over,” probably the World Health Organization.

Finally, the pandemic taught us to be more supportive, more inclusive and also more humane. There should be no di fferences between the citizens of the world, globalization, climate change, wars, famine and inequality is a great task that science and society must focus on eliminating promptly. More pandemics will come, although at present we expect a resurgence of forgotten diseases that deserve a humanistic look to control and eradicate them.


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43. Gill CM, Aktathorn E, Alfouzan W, et al. Elevated MICs of Susceptible Anti-Pseudomonal Cephalosporins in Non-Carbapenemase-Producing, Carbapenem-Resistant Pseudomonas aeruginosa: Implications for Dose Optimization. Antimicrob Agents Chemother 2021:AAC0120421. [ Links ]

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45. Appel TM, Quijano-Martinez N, De La Cadena E, Mojica MF, Villegas MV. Microbiological and Clinical Aspects of Raoultella spp. Front Public Health 2021;9:686789. [ Links ]

46. Villegas MV, Esparza G, Reyes J. Should ceftriaxone-resistant Enterobacterales be tested for ESBLs? A PRO/CON debate. JAC Antimicrob Resist 2021;3:dlab035. [ Links ]

Cómo citar este artículo: A.J. Rodriguez-Morales, et al. Challenges and Visions for Infectious Diseases in Colombia during the COVID-19 Peripandemic Transi tion 2021-2023. Infectio 2022; 26(2): 103-106

Conflict of Interest.


Received: March 30, 2021; Accepted: March 30, 2021

* Autor para correspondencia. Correo electrónico:

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