Peru has more than doubled its Covid death toll following a review, making it the country with the world's highest death rate per capita, according to Johns Hopkins University data.

The official death toll is now more than 180,000, up from 69,342, in a country of about 33 million people.

Prime Minister Violeta Bermudez said the number was increased on the advice of Peruvian and international experts.

This was in line with so-called excess deaths figures.

Excess deaths are a measure of how many more people are dying than would be expected based on the previous few years.

"We think it is our duty to make public this updated information," Ms Bermudez said.

The news, released on Monday, came just six days before Peru is set to hold a presidential run-off election between leftist Pedro Castillo and right-wing candidate Keiko Fujimori.

What went wrong for Peru?

Peru has been one of the worst-hit countries in Latin America, resulting in an overstretched healthcare system and a lack of oxygen tanks. It has registered 1.9 million infections in total.

Some of the reasons for it being so badly hit include an absence of fridges in people's homes - forcing many households to make frequent trips to markets to shop for food rather than stocking up - and overcrowding in homes and public places.

The president of the Peruvian Medical Federation, Godofredo Talavera, said the increased toll was not a surprise.

"We believe this occurs because our health system does not have the necessary conditions to care for patients.

"There has been no government support with oxygen, with intensive care beds. We do not have enough vaccines at the moment. The first line of care has not been reactivated. All this makes us the first country in the world in mortality," he said.

But experts say Peru has also had problems with its testing regime, as it lacks the resources to carry out widespread molecular tests, the most reliable type.

In the early days of the pandemic, Peru bought millions of cheap tests from China, most of which were designed to detect virus antibodies, not active cases, the Associated Press reported.

Some of these tests have been found by independent analysis to be sub-standard, the agency said.

The criteria for recording Covid deaths has now been broadened beyond people who tested positive for the virus to include "probable" cases - those with "an epidemiological link to a confirmed case" or who present "a clinical picture compatible with the disease".
Chart showing there have been more than 168 million coronavirus cases reported worldwide. Updated 28 May.

The official number of Covid deaths now stands at 180,764, a huge increase on the previous official figure of 69,342.

That makes more than 500 Covid deaths per 100,000 people, overtaking Hungary with 300 per 100,000.

In comparison, neighbouring Colombia, with a larger population than Peru, has registered 88,282 deaths.

Brazil has one of the world's highest death tolls with more than 460,000, but in a country of more than 211 million.

A true picture emerges
Analysis box by Will Grant, Mexico and Central America correspondent

Peruvians had long suspected they weren't getting the true picture of the country's dire coronavirus situation from the government.

The revised figure for Covid-19 related deaths shows they were right to be doubtful. In fact, the government has admitted the real number is more than twice the previous figure.

A government working group of experts, formed to analyse Peru's data, published the revised figures after establishing broader criteria by which deaths from coronavirus were recorded.

Now that the narrower definition has been abandoned, the country's per capita death toll is in fact much higher than Brazil's.

Such a figure coincides more closely to the anecdotal evidence coming from hospitals and intensive care units across the country and with the images of cemeteries struggling to find space for the high number of burials each day.

Meanwhile, the process of vaccination has been slow and beset with difficulties across most of South America.