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Chagas disease in Ecuador: a sylvatic focus in the Amazon region.

A sylvatic focus of Chagas disease is reported in the Amazon region of Ecuador (provinces of Napo and Sucumbios). During 1987-1989, 10 cases of acute infection were diagnosed by direct visualization of Trypanosoma cruzi in peripheral blood smears during routine malaria checks. Also in that region, three triatomine bugs, Rhodnius pictipes, Rhodnius robustus and Panstrongylus geniculatus were found naturally infected with T. cruzi suggesting that the human cases represent an autochthonous focus of active transmission.

Animals↗

Seasonal variation in onchocerciasis transmission in the Santiago focus of Ecuador.

Man-biting rates and natural infection rates with filariae were determined for anthropophilic black flies in a preliminary survey during the wet and dry seasons at three localities, either hypoendemic or hyperendemic for onchocerciasis, in the Santiago onchocerciasis focus of Ecuador. Simulium exiguum was an efficient vector associated with hyperendemicity whereas S. quadrivittatum was thought only to sporadically transmit the parasite. Parasite transmission by these two species varied seasonally. Two other man-biting species, S. bipunctatum and S. escomeli, were discounted as vectors because of their largely zoophilic habit and rarity, respectively. The need is emphasised to investigate species distributions thoroughly before entomological surveys to obtain baseline data for vector control are investigated.

Animals↗

Onchocerciasis and acquired groin hernias in Ecuador.

A prevalence of 4.3% (52) groin hernias were observed in 10 communities in the hyperendemic areas of onchocerciasis in Ecuador. Of the 31 patients in whom herniorrhaphy was performed, 87.1% presented with the acquired type of hernias; 15 (48.4%) with direct inguinal and 12 (38.7%) with femoral hernias, while only 12.9% (4) presented with indirect inguinal or the congenital type of hernias. This is in sharp contrast to the usual preponderance of indirect inguinal hernias reported in surveys of other population groups. Mechanisms for this association are discussed.

Ecuador↗

Operational studies on the control of Taenia solium taeniasis/cysticercosis in Ecuador.

A large-scale study in Loja and El Oro Provinces, Ecuador, demonstrated that population-based treatment of human taeniasis with a low dose of praziquantel is feasible and effective for the short-term control of transmission of Taenia solium in hyperendemic areas. Chemotherapeutic intervention also effectively promoted local preventive measures and contributed greatly to the elaboration of a long-term control programme.

Adolescent↗

Preschool child feeding, health and nutritional status in Gualaceo, Ecuador.

Anthropologic, survey, dietary recall and anthropometric techniques were used to study the correlates of nutritional status of preschool children under five years of age in Gualaceo Ecuador. A widespread stunting was found among the children. Nutritional status was worst among infants comprised between 12 and 23 months old but it improved between April and August, thus suggesting seasonality changes of nutritional status. The correlates of nutritional status (expressed as Z score of weight-for-age) were dietary diversity, birth-spacing, fertility, migration, household income, material goods owned, and parental education. A regression model with these variables predicted 63% of the variability in weight-for-age. The prediction of height-for-age was similar, but only predicted 43% of the variability in height-for-age. Correlates of dietary diversity, birth-spacing, fertility, and migration were child age, maternal age and arm circumference, parental education, use of birth control, household food expenditure, material goods owned, and the raising of animals. Parental education was a correlate of dietary diversity, fertility and migration. Parental education was related to change in weight-for-age in the longitudinal subset. Pre-harvest time and a pathway of illness leading to decreased dietary diversity and to decreased nutritional status in April, were suggested as important to preschool child nutritional status. Hot-cold ideology--resulting in food withdrawal during illness and restriction of high-protein and high-calorie foods--appears to be an important mechanism determining preschool child nutritional status. Breast-feeding, sanitary, higienic, birth control, and drinking (alcohol) practices were suggested as areas that could be improved, in order to improve preschool child nutritional status. Communication between parents and western health care providers was also suggested as an area for improvement.

Body Height↗

Onchocerciasis in Ecuador: absence of microfilaraemia.

Blood samples from 497 people positive for onchocerciasis in the hyperendemic onchocercal focus in Ecuador were analysed for the presence of microfilaraemia using the Knott technique. No evidence of Onchocerca volvulus microfilaraemia was found, nor that of any other microfilaria.

Adult↗

[Homes for the aged in Ecuador].

Following the presentation of some statistical data and information about homes for the elderly in Ecuador, findings from a short study of such institutions are presented. Here the various deficiencies and problems like financial problems, infrastructure, lack of experienced staff, are particularly stressed. As a conclusion it is stated that existing institutions for the elderly do not correspond to the requirements of modern social gerontology.

Aged↗

[A new lung fluke from the coastal range of ecuador: Paragonimus ecuadoriensis n.sp. (paragonimidae, trematoda) (author's transl)].

P. ecuadoriensis in the first lung fluke described from Ecuador. The description is based on 10 adult flukes from a natural infected Coati (Nasua nasua), 23 adults from 2 experimentally infected cats, and 200 metacercariae from the second intermediate host, the freshwater crab Hypolobocera aequatorialis. The new species is characterized by the following features: mouth succer larger than acetabulum or nearly of the same size; integument spines ("cuticular" spines) single; ovary with 5-6 short branches, which divide into more or less short broad lobes; testes larger than ovary with 5-6 simple or polymorphic lobes; eggs longish-ovoid, shell thin and uniform in thickness; surface undulated. Metacercariae not encysted. The adults of the new species are differentiated from probably related lung flukes P. peruvianus, P. mexicanus, and P. inca by the different morphology of ovary and testes, and by the size and form of the eggs. The metacercariae of P. ecuadoriensis are located not only in the hepatopancreas of the crab host - as it is in the case of P. peruvianus - but also and more frequently in the musculature. Paragonimus-eggs from sputum of two patients show partly the same characteristics as the eggs from animal hosts. One may therefore assume that P. ecuadoriensis is infecting humans in the investigated area.

Animals↗

[Lymphomatoid papulosis. The first case reported in Ecuador].

We present the first case of lymphomatoid papulosis described in Ecuador. The clinicopathologic aspects of the disease are characteristic and make this entity different deserving its individualization . We discuss the different factors that may have some influence in clinical evolution and prognosis . The case presented is interesting because the lesions have only appeared once. Complete healing was observed after twenty days, and no relapse has been noted since then.

Adult↗

Infant feeding practices and beliefs in one community in the Sierra of rural Ecuador: a prevalence study.

Infant feeding practices and beliefs of 54 women in one rural community in the Sierra of Ecuador are described. Breastfeeding was nearly universal, with a mean duration of 16.9 months: males were weaned gradually, which was significantly different from the sudden weaning of females. Infants' diets were supplemented at a mean 9.7 months; first food included soup, meat broth, oats, and grains. Males' diets were supplemented significantly earlier than females. Mothers reported 16 months as the best weaning age. The best age to begin supplementing breast or bottle was 8.8 months. Milk, soup, meat, oats, "all foods," and vitamins were believed to help produce breastmilk. Most mothers said they would give a bottle if they were unable to produce breastmilk.

Adolescent↗

Onchocerciasis in Ecuador. I. Prevalence and distribution in the province of Esmeraldas.

In the province of Esmeraldas in Ecuador, 11 endemic foci of onchocerciasis were identified. The major focus, located on Rio Cayapas, consisted of 65 contiguous positive communities with an average infection rate of 51.1%. A distance-dependent characteristic of the onchocerciasis infection suggested that the transmission was centered principally in the areas near the head-waters of the river. This area, inhabited primarily by the indigenous tribe, Chachi, with an infection rate of 85%, was considered an area of hyperendemicity. Towards the river's mouth, where the majority of the inhabitants were Blacks, the rate of infection was 7%. The endemic focus located on Rio Santiago, populated entirely by Blacks and consisting of 17 contiguous positive communities, had an average infection rate of 18.8%. Again, the highest rate of infection, 33%, occurred in the upper reaches of the river. Resulting from the transient and migratory activity of some microfilariae-positive persons, 9 other isolated foci were found dispersed throughout the province. The infection rate of each focus was distinct, reflecting geographical location and ethnic composition. All foci other than the interior regions of Rio Cayapas were areas of hypoendemicity.

Adolescent↗

Onchocerciasis in Ecuador. II. Epidemiology of the endemic foci in the province of Esmeraldas.

The epidemiology of infection was studied in all endemic foci of onchocerciasis in the province of Esmeraldas in Ecuador. The incidence of infection and the density of microfilariae in the skin, both greater in males than females, increased with age, reaching highest levels at 40-45 years in males and at 60 years and older in females. In the hyperendemic area males and females had the same rate of infection, but the microfilarial density in males exceeded that in females. In the hypoendemic areas males had a higher infection rate than females, but females registered a higher density of microfilariae in the skin. The incidence and location of the onchocercal nodules correlated closely with the density of microfilariae. Adults, aged 50-54 had the highest prevalence of onchocercal nodules, which occurred primarily in the thorax and pelvic regions. Children aged 0-14 years showed a low prevalence of nodules, the head region being the primary site. Of the two diagnostic methods used to detect the presence of microfilariae, most of the diagnoses (85.6%) were made by skin biopsies as compared to those made by the Mazzotti test (14.4%).

Adolescent↗

[Onchocerciasis in Ecuador. First endemic focus discovered in the country, clinical, parasitological, and entomological findings (author's transl)].

The first endemic focus of onchocerciasis in Ecuador has been established in the province of Esmeraldas. It is on the Cayapas River about 85 kilometer upstream from the town of Borbón. The endemic focus as far as it is currently known, appears to be localized between the settlements of Sapallo Grande and San Miguel de Cayapas. 87 persons were examined in both settlements. Onchocerciasis was detected in 72 (83%) persons; 62 (86%) were negroes and 10 were Cayapas indians; 42 (58%) were males and 30 were females. 29 (74%) of the weighed skin snips taken from 39 individuals showed a higher microfilarial density from the iliac crest than from the scapula. The following clinical manifestations were found in the positive cases: 45 (63%) with onchocercoma; 31 (43%) with dermatitis, pigmentary changes, atrophy of the skin; 19 (26%) with lymphoadenopathy and lymphoedema of the external genital organs; 32 (44%) with corneal opacities; 49 (68%) with itching of the skin and dermatitis and 23 (32%) without itching but with dermatitis. 274 Simulium were collected biting man. Three species were identified, although the specific names used must be considered as provisional. 59 S. exiguum, 206 S. quadrivittatum and 9 S. antillarum. The black flies were attracted with human bait inside the houses, outside and around the houses and at 500 meters far from the house near a creek. It seems that the three species are anthropophilic and endophilic.

Adolescent↗

[On the occurrence of human paragonimiasis in Ecuador (1972--76) (author's transl)].

During 1972 and 1976 316 cases of human paragonimiasis were stated in the following provinces of Ecuador: 19 cases in El Oro, 16 cases in Los Rios, 74 cases in Pichincha, and 206 cases in Manabi. 153 patients were males and 163 females. For localization of the probable origin of the infections the data of 192 patients could be utilized. The home villages and towns of these persons have been marked on a map. The majority of the patients were between 10 and 29 years of age. The youngest case was 4 years, the oldest 75 years old.

Adolescent↗

[Participation of the Association of Nursing Schools of Ecuador in the development of the profession].

A brief summary is given of the development of nursing in Ecuador, particularly since the introduction of the national nursing policy in 1972. The training course is divided into two parts. The first qualifies the nurse to give comprehensive care to the patient in the areas of mental health, maternal and child health, surgical medicine, community health, and administration--after which she engages in rural practice for one year. The second part involves further studies in the areas mentioned and research by those who wish to go on to the licenciate degree. Also described are the functions of the Association in regard to teaching the nursing service, and the interests of the profession.

Ecuador↗

Housing and health in the process of cultural adaptation: a case study among jungle and highland natives of Ecuador.

A household survey was undertaken among four Indian groups in Ecuador. Family housing conditions were related to dwelling development (from traditional to modern type) in data obtained from 727 family interviews. Measurements of the physical characteristics of the shelter completed the study. It is shown that: 1. The protection against the elements (temperature and humidity) is best in traditional houses and becomes worse with development; 2. The floor area per person is the highest in the traditional and the lowest in the modern houses; 3. Development does not mean improvement of domestic equipment; 4. New construction materials have many disadvantages when compared with traditional ones; 5. The more intensely a person is exposed to cross cultural influence the more likely he is to build a modern house. The findings are used to develop the argument that housing related health education should be adapted to the environment and the culture of the local population.

Acculturation↗

HLA class II linkage disequilibrium and haplotype evolution in the Cayapa Indians of Ecuador.

DNA-based typing of the HLA class II loci in a sample of the Cayapa Indians of Ecuador reveals several lines of evidence that selection has operated to maintain and to diversify the existing level of polymorphism in the class II region. As has been noticed for other Native American groups, the overall level of polymorphism at the DRB1, DQA1, DQB1, and DPB1 loci is reduced relative to that found in other human populations. Nonetheless, the relative evenness in the distribution of allele frequencies at each of the four loci points to the role of balancing selection in the maintenance of the polymorphism. The DQA1 and DQB1 loci, in particular, have near-maximum departures from the neutrality model, which suggests that balancing selection has been especially strong in these cases. Several novel DQA1-DQB1 haplotypes and the discovery of a new DRB1 allele demonstrate an evolutionary tendency favoring the diversification of class II alleles and haplotypes. The recombination interval between the centromeric DPB1 locus and the other class II loci will, in the absence of other forces such as selection, reduce disequilibrium across this region. However, nearly all common alleles were found to be part of DR-DP haplotypes in strong disequilibrium, consistent with the recent action of selection acting on these haplotypes in the Cayapa.

Alleles↗