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PubMed1994

Immunity to onchocerciasis: identification of a putatively immune population in a hyperendemic area of Ecuador.

The existence of immunity to Onchocerca volvulus (Ov) infection is suggested by the presence of uninfected persons in hyperendemic areas. A major barrier to the study of immunity has been the correct identification of putatively immune (PI) subjects. To identify a PI group in a hyperendemic area in Ecuador, clinical and epidemiologic information was combined with a polymerase chain reaction (PCR)-based assay identifying Ov DNA in skin snips and a recombinant antigen-based ELISA. Comparison of immune responses revealed that PI subjects had significantly lower levels of Ov-specific IgG, IgG subclasses, and IgE than infected (INF) subjects. Female subjects were significantly more likely to be PI than male subjects, and INF female subjects had significantly lower levels of Ov-specific IgG, IgG1, and IgG3 than INF male subjects. Thus, the use of molecular-based techniques has helped to define more precisely the PI state in onchocerciasis.

Adolescent↗
PubMed2002

Increasing compliance with maternal and child care quality standards in Ecuador.

OBJECTIVE: To determine the effects of hospital quality assurance interventions on compliance with clinical standards, availability of essential drugs, client satisfaction, and utilization. DESIGN: Quasi-experimental, prospective study with four intervention hospitals and four control hospitals. All eight facilities were purposively selected and of comparable complexity. SETTING: Ministry of Health secondary care facilities in Ecuador. INTERVENTIONS: Facility-based quality improvement teams, job clarification, standards communication, refresher training, strengthening hospital pharmacy committees, monthly monitoring of compliance indicators, and formation of users' committees. MEASURES: Compliance with input and process standards, utilization of services, and patient satisfaction were measured monthly in both groups through review of clinical and administrative records, exit interviews, and patient satisfaction surveys. RESULTS: After 12 months, the quality assurance interventions produced rapid increases in compliance with clinical standards in the intervention hospitals as compared with the control group. These improvements appeared as early as 2 months after the onset of the interventions. No differences were found between intervention and control groups in terms of trends in utilization patterns or client satisfaction. CONCLUSION: Quality assurance interventions made a difference in technical quality of care. Patient satisfaction and utilization do not appear to be directly associated with short-term improvements in compliance with clinical standards. Quality improvement interventions may require longer periods and a specific aim at clients' needs to demonstrate effects on utilization and satisfaction outcome variables.

Adult↗
PubMed2005

High household infestation rates by synanthropic vectors of Chagas disease in southern Ecuador.

Entomological surveys were conducted in five rural communities (138 domiciliary units [DUs]) in the southern Andes of Ecuador. Adobe walls and ceramic tile roofs were predominant construction materials. A 35% house infestation rate with Panstrongylus chinai (Del Ponte, 1929) (0.7%), Panstrongylus rufotuberculatus (Champion, 1899) (0.7%), Rhodnius ecuadoriensis (Lent & León, 1958) (27%), and/or Triatoma carrioni (Larrousse, 1926) (7%) was found. Adults and nymphs of R. ecuadoriensis and T. carrioni were found in intradomiciliary and peridomiciliary areas. Breeding triatomine colonies were present in 85% of infested DUs, and the average insect crowding was 52+/-113 triatomine bugs per infested house. T. cruzi-like organisms were found by microscopic examination in the feces or hindgut but not the salivary glands of 4% of examined R. ecuadoriensis and 12% T. carrioni. Serological tests detected a general anti-T. cruzi antibody seroprevalence of 3.9% (n = 1136). Only 2% of individuals had heard of Chagas disease, and although triatomines were reported as a major nuisance by the population they were not considered vectors of disease. Additional baseline field research is needed for the design and implementation of a Chagas disease control program in the region.

Animals↗
PubMed1975

Epidemiologic investigations of the 1969 epidemic of Venezuelan encephalitis in Ecuador.

An epizoodemic of Venezuelan equine encephalitis (VEE), subtype I variant B, occurred in Ecuador during the rainy and hot season of 1969. In this paper, a general description of the epidemic is given and virus isolations from humans are reported. A serologic survey was performed in order to determine the extension of the epidemic along the coastal zone of the country. It is not clear whether the higher antibody rate in older people was because they were at greater risk of infection or was the result of an accumulated immunity with time. The latter could be an indication of endemic virus activity, not yet proven for the VEE IB virus variant. Mosquito surveillance and attempted control by aerial spraying were carried out.

Adolescent↗
PubMed1999

The health status of rural school children in the Amazon basin of Ecuador.

An assessment of the health status among school children of the Naporuna ethnicity was conducted in north-eastern Ecuador. Prevalence of protein-energy malnutrition (PEM), parasitic infections, and pathology was investigated among 511 school children. The overall nutritional status of the school children was found to be good despite a high prevalence of helminthic infections. The prevalence of stunting was 1.4 per cent and of wasting 1.8 per cent. Sixty-four per cent of the children surveyed were found infected with one or more of the soil-transmitted helminths. In the clinical examination high prevalence of pterigium (89.2 per cent) was found. Upper respiratory infections (5.2 per cent), septic skin lesions (4.4 per cent), mycotic otitis (3.8 per cent), tinea (3.4 per cent) and bronchitis (2 per cent) were the main infectious pathology found. Likely explanations of these findings are discussed.

Adolescent↗
PubMedDate not supplied

Impact of massage therapy on health outcomes among orphaned infants in Ecuador: results of a randomized clinical trial.

Diarrhea is the second leading cause of death among infants and young children in the developing world. This project investigated whether therapeutic infant massage could reduce diarrheal episodes and decrease overall illness of infants. Infants living in 2 orphanages in Quito, Ecuador, were matched by age and randomly assigned to an experimental or a control condition. The experimental group received an intervention, daily infant massage therapy by orphanage staff or volunteers, which lasted an average of 53 days, and symptoms of illness data were documented daily by volunteers in the orphanages. Results indicated that control group infants had a 50% greater risk of having diarrhea than experimental infants (rate ratio [RR] = 1.54, 95% confidence interval [CI] = 1.18, 2.03, P < 0.001). Control group infants were also 11% more likely than experimental infants to experience illness of any kind (RR = 1.11, 95% CI = 0.96, 1.28, P = 0.17). The implications for the use of therapeutic infant massage, a remarkably inexpensive intervention, are discussed, and the need for further research is highlighted.

Diarrhea↗
PubMed2002

Community resilience and volcano hazard: the eruption of Tungurahua and evacuation of the faldas in Ecuador.

Official response to explosive volcano hazards usually involves evacuation of local inhabitants to safe shelters. Enforcement is often difficult and problems can be exacerbated when major eruptions do not ensue. Families are deprived of livelihoods and pressure to return to hazardous areas builds. Concomitantly, prevailing socio-economic and political conditions limit activities and can influence vulnerability. This paper addresses these issues, examining an ongoing volcano hazard (Tungurahua) in Ecuador where contextual realities significantly constrain responses. Fieldwork involved interviewing government officials, selecting focus groups and conducting surveys of evacuees in four locations: a temporary shelter, a permanent resettlement, with returnees and with a control group. Differences in perceptions of risk and health conditions, and in the potential for economic recovery were found among groups with different evacuation experiences. The long-term goal is to develop a model of community resilience in long-term stress environments.

Adult↗
PubMed2006

Long-term effects of an educational intervention on self-medication and appropriate drug use in single-sex secondary public schools, Quito, Ecuador.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: *Self-medication is extensively practised in both developed and less-developed countries, sometimes inappropriately. *Educational intervention in secondary schools has been proven to be useful. *Most educational interventions in adolescent populations have focused on the reduction of addictive substance abuse. WHAT THIS STUDY ADDS: *Educational intervention can improve knowledge about self-medication and reduce misconceptions about diarrhoea, common cold and vitamins in an adolescent population. *A specific lecture followed by small working-group seminars produces better results than a general lecture alone in terms of 'knowledge' and 'attitude'. *The positive effects of the intervention are detectable even 1 year later. Yearly reinforcing interventions while in secondary school would allow long-lasting effects. AIM: Improving knowledge about rational drug use at an early age may be a good way to increase the population's awareness of health, medicines and self-medication. We set out to evaluate the short- and long-term effects of an educational intervention to promote rational drug use and self-medication in secondary school students. METHODS: A non-randomized, controlled clinical trial. The participants were 367 female students (10-13 years old) from two secondary public schools of the metropolitan district of Quito (Ecuador). The educational campaign had two components [a specific lecture (intervention and control schools) and subsequent small working group seminars (intervention school)] providing short and clear messages of five topics related to rational drug use. The main outcome measures were an increase in 'knowledge' short term (1 month) and long term (up to 1 year) after intervention and the relative risk (RR) reduction in misconceptions or wrong ideas about medicine use. RESULTS: The intervention group showed a significant increase in knowledge both short and long term and in comparison with the control group, mainly regarding oral rehydration salts preparation (+59.4%; P < 0.001), lack of multivitamin energizer action (+57.4%; P < 0.001), healthy growth effects (+53.3%; P < 0.001) and the perception that medicines' promotional activities do not teach how to take care of health (+54.0%; P < 0.001). A RR reduction in misconceptions about drugs was found short term and long term. The intervention group was less predisposed to consume antidiarrhoeals [RR = 0.75, 95% confidence interval (CI) 0.62, 0.92], cough suppressants (0.44, 95% CI 0.35, 0.55) and other medicines for the common cold (0.56, 95% CI 0.45, 0.70). Misconceptions concerning the benefits of multivitamin preparations were reduced in 73%; additionally, the intervention group showed a decrease in their consumption (43.9% basal; 25.3% short term and 25.6% long term; P < 0.001). CONCLUSION: It is possible to achieve a favourable modification of attitudes to appropriate use of medicines in a teenage population and this modification lasts at least 1 year. Continuous reinforcing interventions would allow better and long-lasting effects and could help to fill the gap in health education of the general population.

Adolescent↗
PubMed1989

Onchodermatitis--correlation between skin disease and parasitic load in an endemic focus in Ecuador.

Onchocerciasis is a chronic parasitic infection in which infiltration of the skin by microfilariae has been associated with a number of different pathological changes. This survey compared the prevalence of different forms of skin disease in two villages, one of which was located within the endemic zone for onchocerciasis (Zapallo Grande), in a lowland rain forest area of western Ecuador. The commonest skin diseases in both villages were scabies, pyoderma and pityriasis versicolor. In addition changes closely correlated with the presence of microfilariae in skin snips were found in Zapallo Grande--such as atrophic gluteal changes, and acute and chronic papular dermatitis. The only other skin disease associated with onchocerciasis was widespread tinea corporis due to T. rubrum. The Amerindians in the endemic onchocerciasis area were more likely than Negroes to have generalized atrophic changes of the skin, whereas in the latter group significant numbers of individuals had no obvious skin lesions but large numbers of microfilariae were detected in skin snips. Acute papular dermatitis was common in both groups and in biopsied lesions microfilariae could usually be identified within the epidermis or close to the dermo-epidermal junction. One patient had developed severe reactive onchodermatitis (Sowda). Swabs taken from onchocercal skin lesions showed no evidence of skin surface carriage of Staphylococcus aureus. Changes classically associated with onchocerciasis such as pretibial hypopigmentation (leopard skin) and hanging groin were notably absent in this population.

Adolescent↗
PubMed1994

Heterogeneity of IgG antibody responses to cloned Onchocerca volvulus antigens in microfiladermia positive individuals from Esmeraldas Province, Ecuador.

The prevalence of IgG antibodies to three recombinant O. volvulus antigens, OvMBP/10, OvMBP/11 and OvMBP/29 was determined in a group of 94 microfilaria positive (mf+) individuals resident in the hyperendemic onchocercal area of Esmeraldas Province, Ecuador. Clone OvMBP/11 was the antigen most frequently recognized by patients sera followed by OvMBP/10 and OvMBP/29. When a cocktail of the three recombinant antigens was used the proportion of positive sera increased to 100%. Antibody responses to the fusion partner maltose binding protein (MBP) were low in comparison with those to the cloned antigens and no correlation of responses between individual antigens was observed. The relative level of antibody response to each of the clones in the cocktail varied between individuals. The distribution of IgG responses to OvMBP/11 was bimodal and those to OvMBP/29 and OvMBP/10 were positively and negatively skewed, respectively. When the three recombinant antigens were used in combination this variation was minimized and the pattern of responses showed a normal distribution as was also seen to crude O. volvulus antigen. The cocktail of recombinants thus offers excellent diagnostic sensitivity in combination with the parasite specificity demonstrated previously.

Adolescent↗
PubMed2006

Leishmaniasis recidiva cutis due to Leishmania (Viannia) panamensis in subtropical Ecuador: isoenzymatic characterization.

BACKGROUND: Information regarding leishmaniasis recidiva cutis (LRC), a clinical variant of cutaneous leishmaniasis, in the New World is scarce. LRC is characterized by slowly progressing lesion(s) that appear after a variable period of time, from months to years, in or around the scar of an apparently clinically healed sore. PATIENTS AND METHODS: Six patients are reported who presented with crusted, papular lesions located on the edge of a healed scar, with a mean of 18.2 months of slowly progressive evolution. The isolated strains of Leishmania parasites were characterized by enzyme electrophoresis. Eleven enzyme systems were assayed. Skin biopsies from the active border of the lesions were taken for histopathology. RESULTS: Tissue sections showed a granulomatous, lymphohistiocytic, dermal infiltrate containing Langhans' giant cells. The anamnestic data, together with the clinical and histopathologic findings, support the diagnosis of LRC. The isoenzyme profile of Leishmania parasites isolated from five of the six patients identified them as Leishmania (Viannia) panamensis. CONCLUSIONS: These findings are the first reported evidence of LRC within the clinical spectrum of American tegumentary leishmaniasis in Ecuador, and of its causative agent. The existence of LRC has future implications for both disease treatment and vaccine development.

Adolescent↗
PubMed1991

Migration and circulation in Ecuador.

"This study investigates labor mobility in Ecuador as a function of the socioeconomic structure of places and personal attributes of migrants and circulators (short-term movers).... Particular attention is given to the role of agrarian change in altering established migration and circulation patterns." The author finds that "circulation may significantly alter family organization and the role of women in many Ecuadorian communities."

Agriculture↗
PubMed2006

Sebacinales form ectendomycorrhizas with Cavendishia nobilis, a member of the Andean clade of Ericaceae, in the mountain rain forest of southern Ecuador.

Cavendishia nobilis var. capitata is an endemic member of the Ericaceae growing as a hemiepiphyte in the tropical mountain rain forest of southern Ecuador. Mycorrhizas were collected from 20 individuals along an altitudinal gradient between 1850 and 2300 m. Transmission electron microscopy was used to study the symbiotic association in detail, and phylogenetic analyses based on nuclear rDNA coding for the ribosomal large subunit (nucLSU) were carried out to identify the associated mycorrhizal fungi. Microscopic and ultrastructural investigations showed the formation of a hyphal sheath, intercellular penetration of fine hyphae and colonization of the cortical cells by swollen hyphae of the same fungus. These structures were formed by hymenomycetes and ascomycetes. Molecular phylogenetic analysis detected seven groups of mycorrhizal fungi belonging to the Sebacinales. This is the first study to obtain evidence of ectendomycorrhizas in the Vaccinioideae. The ascomycetous nucLSU sequences belonged to members of the Leotiomycetes. The ectendomycorrhiza of C. nobilis with Sebacinales is discussed as a specific, hitherto undescribed mycorrhizal subcategory of ectomycorrhizas. We propose the term 'cavendishioid mycorrhiza'. This subcategory is most likely specific for the Andean clade of Ericaceae.

Ecosystem↗
PubMedDate not supplied

Evidence for hybridization by multilocus enzyme electrophoresis and random amplified polymorphic DNA between Leishmania braziliensis and Leishmania panamensis/guyanensis in Ecuador.

The taxonomic attribution of four Leishmania stocks isolated from humans in Ecuador has been explored by both multilocus enzyme electrophoresis and random amplified polymorphic DNA. For three loci, MLEE results showed patterns suggesting a heterozygous state for a diploid organism, while the corresponding homozygous states are characteristic of the Leishmania panamensis/guyanensis complex and Leishmania braziliensis, respectively. Other enzyme loci showed characters attributable to either the L. panamensis/ guyanensis complex or L. braziliensis. RAPD profiles exhibited for several primers a combination of the Leishmania panamensis/ guyanensis complex and L. braziliensis characters. These data hence suggest that the four stocks are the result of hybridization between L. panamensis/guyanensis and L. braziliensis. MLEE data show that the results cannot be attributed to either mixture of stocks, or an F1 in the framework of a simple Mendelian inheritance.

Animals↗
PubMed1995

EEG abnormalities, malnutrition, parasitism and goitre: a study of schoolchildren in Ecuador.

We report on data collected in a sample of 194 schoolchildren (9-13 years of age) residing in a mountainous community in Ecuador. This study was part of an ongoing epidemiological inquiry into the prevalence of parasitism, malnutrition, neurocysticercosis, goitre, iodine levels and EEG abnormalities, and the relationships among these factors. Data were obtained by a local medical team supported by specialized personnel. The results showed that 34% of the EEG tracings were abnormal, with higher rates among girls. The best fitted log-linear model to explain the results was the combination of EEG status, parasite infection, goitre and gender. The best predictor of EEG abnormalities was found to be a diagnosis of goitre.

Adolescent↗
PubMed1996

The Cayapa Indians of Ecuador: a genetically isolated group with unexpected complement C7 M/N allele frequencies.

The Cayapa Indians live in north-western Ecuador in close proximity to a Black population of African ancestry. C7 M/N allotyping has proved to be a good technique for plasma genetic analysis in several populations. Investigation of 124 Cayapa plasma samples revealed the highest allele frequency of C7*N observed in any population examined so far (0.36 versus 0.225 or lower). The marked difference in frequency compared with several Oriental populations, which are believed to have been derived from the same Asian population as native Amerindians, may reflect the effect of a small founder population followed by a high degree of genetic isolation. The allele frequency of 0.12 for C7*N determined for the neighbouring Black population supports the conclusion that there has been a lack of genetic admixture of Cayapas with other populations, confirming the results of ethnohistorical investigations and other protein polymorphism studies.

Alleles↗