“All these forms of tuberculosis that we forget about are starting to reappear,” Dr. de Waard said.

Experts now fear that the nation is teetering on the brink of a tuberculosis epidemic that could spill over its borders as Venezuelans flee in record numbers to escape the economic and political crisis, potentially exporting the illness with them.

And as the Venezuelan health system has fallen apart, the government’s ability to respond to epidemics has collapsed.

Some parts of the country have started to report shortfalls in tuberculosis medications in recent months, including in Bolívar, one of the states hardest hit by the illness.

Specialists said the government had recently suspended the national distribution of the antibiotics used to treat the disease, supposedly out of concern that it was disappearing into the international black market. After a three-week halt, doctors said, distribution slowly resumed, but not without interruptions in the treatment of patients.

The lack of equipment and skilled medical personnel has led some health clinics and hospitals that once had robust testing programs to shut down part or all of those programs, and some of those that remain open have documented worrisome trajectories.

From 2013-2015, about 5 percent of adult patients evaluated each year in the outpatient center and the tuberculosis clinic at Dr. José Ignacio Baldó Hospital in Caracas were found to have the disease, according to Dr. Zhenia M. Fuentes, the coordinator of the clinic. But by the last trimester of 2017, that rate had risen to about 9 percent, and then climbed even further in January, to about 14 percent, she said.