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PubMed1993

[Primitive Sjögren's syndrome in France and Ecuador. Possible involvement od HTLV 1].

The authors study the possible involvement of retrovirus in Sjögren's syndrome. They report a preliminary study of 20 French and 13 Ecuadorian patients with a primary Sjögren syndrome. A previous epidemiologic study showed a HTLV1 seroprevalence going from 0.04 to 6% on different regions of Ecuador. The results of this study show the presence of anti-HTLV1 antibodies only in 2 Ecuadorian patients and does not allow a final conclusion of the role of HTLV1 virus. Nevertheless other studies continue on the serie using minor salivary gland specimens obtained by biopsy. Recent publications and the notion of an "endogen" retrovirus will may be lighten a new day in this research.

Ecuador↗

PubMed1994

EcoRI, RsaI, and MspI RFLPs of the COL1A2 gene (type I collagen) in the Cayapa, a Native American population of Ecuador.

EcoRI, RsaI, and MspI RFLPs of the COL1A2 gene were analyzed, using the polymerase chain reaction technique, for the first time in a native American population: the Cayapa of Ecuador. These polymorphisms recently turned out to be good anthropological markers, both at the allele and at the haplotype frequency level. These data underline the well-known genetic affinity between the Cayapa and Asian populations. Moreover, our data on DNA polymorphisms agree with the indication of extremely low, if any, gene flow into the Cayapa gene pool from the neighboring black community, as already suggested not only by cultural data but also by protein polymorphisms.

Alleles↗

PubMed1995

Serendip deborahae n. gen. and n. sp. (Eucestoda: Tetraphyllidea: Serendipidae n. fam.) in Rhinoptera steindachneri Evermann and Jenkins, 1891 (Chondrichthyes: Myliobatiformes: Myliobatidae) from southeastern Ecuador.

Cestodes collected in spiral valves of Rhinoptera steindachneri from the southern coast of Ecuador represent an undescribed species of Tetraphyllidea. The new species has bothridia possessing septa but lacking apical suckers. It is diagnosably distinct from all other tetraphyllidean genera by possessing a scolex comprising 4 triangular bothridia that are fused together forming a platelike structure, each of which is subdivided by 2 simple and 1 bifurcating septa radiating from its base and ringed by marginal loculi; therefore, a new genus is proposed for it. By exhibiting some degree of bothridial fusion, testes arranged in 2 layers in the proglottis and postovarian testes, the new species appears to be a member of a clade containing Dioecotaenia, Duplicibothrium, and Glyphobothrium. The new species possesses vitelline fields that converge dorsally in each proglottis, except for the ovarian and terminal genitalia areas, a feature that has been reported previously only in Duplicibothrium and Glyphobothrium. Furthermore, Duplicibothrium and Glyphobothrium, like the new species, are markedly protandric. Therefore, we propose that Duplicibothrium, Glyphobothrium, and the new species comprise the sister group of the Dioecotaeniidae, and propose a new family name for the clade. Tritaphros is rejected as a possible sister group for the clade; suggested alternatives include some species of Caulobothrium, Rhodobothrium, or some members of the Phyllobothrium centrurum group.

Animals↗

PubMedDate not supplied

Integrating the Lactational Amenorrhea Method into a family planning program in Ecuador.

This paper reports the results of a 12-month implementation study documenting the process of integrating the Lactational Amenorrhea Method (LAM) into a multiple-method family planning service-delivery organization, the Céntro Médico de Orientación y Planificación Familiar (CEMOPLAF), in Ecuador. LAM was introduced as a family planning option in four CEMOPLAF clinics. LAM was accepted by 133 breastfeeding women during the program's first five months, representing about one-third of postpartum clients. Seventy-three percent of LAM acceptors were new to any family planning method. Follow-up interviews with a systematic sample of 67 LAM users revealed that the method was generally used correctly. Three pregnancies were reported, none by women who were following LAM as recommended. Service providers' knowledge of LAM resulted in earlier IUD insertions among breastfeeding women. Relationships with other maternal and child health organizations and programs were also established.

Adult↗

PubMed1994

Analysis of HLA class II haplotypes in the Cayapa Indians of Ecuador: a novel DRB1 allele reveals evidence for convergent evolution and balancing selection at position 86.

PCR amplification, oligonucleotide probe typing, and sequencing were used to analyze the HLA class II loci (DRB1, DQA1, DQB1, and DPB1) of an isolated South Amerindian tribe. Here we report HLA class II variation, including the identification of a new DRB1 allele, several novel DR/DQ haplotypes, and an unusual distribution of DPB1 alleles, among the Cayapa Indians (N = 100) of Ecuador. A general reduction of HLA class II allelic variation in the Cayapa is consistent with a population bottle-neck during the colonization of the Americas. The new Cayapa DRB1 allele, DRB1*08042, which arose by a G-->T point mutation in the parental DRB1*0802, contains a novel Val codon (GTT) at position 86. The generation of DRB1*08042 (Val-86) from DRB1*0802 (Gly-86) in the Cayapa, by a different mechanism than the (GT-->TG) change in the creation of DRB1*08041 (Val-86) from DRB1*0802 in Africa, implicates selection in the convergent evolution of position 86 DR beta variants. The DRB1*08042 allele has not been found in > 1,800 Amerindian haplotypes and thus presumably arose after the Cayapa separated from other South American Amerindians. Selection pressure for increased haplotype diversity can be inferred in the generation and maintenance of three new DRB1*08042 haplotypes and several novel DR/DQ haplotypes in this population. The DPB1 allelic distribution in the Cayapa is also extraordinary, with two alleles, DPB1*1401, a very rare allele in North American Amerindian populations, and DPB1*0402, the most common Amerindian DPB1 allele, constituting 89% of the Cayapa DPB1.(ABSTRACT TRUNCATED AT 250 WORDS)

Alleles↗

PubMed1994

[Leishmaniasis in Ecuador. 1. Incidence of cutaneous leishmaniasis on the Pacific coast].

A clinico-epidemiologic survey on cutaneous leishmaniasis, due to Leishmania panamensis, was carried out on 961 persons in two study areas of the Pacific coast of Ecuador, to estimate the prevalence and the incidence of the disease. In the preandean hills, at Paraiso Escondido, the prevalence of active lesions was 4.8%; in the hills of the coastal cordillera, at La Tablada, it was 3.6%. The incidence of new cases in 1991 was high: 147% in the first village, and 106% in the second. These data are far higher than the Health Ministry statistics. The cumulated prevalence, obtained by addition of the scars and active lesions of leishmaniasis, was as high as 66% at Paraiso Escondido, and 47% at La Tablada. Most of the patients (62%) had only one ulcer or scar. Most of the people are contaminated during the first five years they live in these endemic areas. Nevertheless, the incidence remains high in all the age groups, because large numbers of migrants coming from non endemic regions are continuously settling in these colonization areas. Interviews have shown that the contaminations had occurred in the dry season, between July and December. These findings were confirmed by passive case detection at the Hospital A. Egas of Santo Domingo which covered the region. Contamination of young children and position of the lesions on the face suggested a domiciliary transmission, like in Panama and on the Pacific coast of Colombia.

Adult↗

PubMed1994

[Leishmaniasis in Ecuador. 2. Man/vector contacts in leishmaniasis: the case of Lutzomyia trapidoi and Lu. Gomezi].

In two leishmaniasis endemic foci of the Pacific coast of Ecuador, where the primary forest is severely attacked by human settlements, intradomiciliary sandfly catches, with light trap and human bait, have been carried out from August 1991 to October 1992. The presumed vector Lutzomyia trapidoi was by far the dominant species inside dwellings at Paraiso Escondido in the preandean hills (86% of the anthropophilic sandfly population, and 8.5 females/night catch by light trap). Not a single Lu. gomezi was caught in this village. At La Tablada, Lu. gomezi was the dominant anthropophilic species in the coastal cordillera (83% of anthropophilic sandfly population and 3.7 females/night catch by light trap); Lu. trapidoi accounted only for 4.6% of the total catches in this village. On human bait, catches were variable depending on the day and on the season, but dominant species were always the same. The percentage of Lu. trapidoi was higher on human bait than in light trap. Blood meal identifications of engorged Lu. gomezi and Lu. trapidoi confirmed the anthropophily of these two species in the houses.

Animals↗

PubMed1994

[Leishmaniasis in Ecuador. 3. Lutzomyia trapidoi, vector of Leishmania panamensis].

Lutzomyia trapidoi, the more abundant anthropophilic species, is a presumed leishmaniasis vector in the Pacific foothills of Ecuador. Three biotopes have been sampled (dwelling, and nearby coffee crop and primary forest) in the focus of Paraiso Escondido, by human bait catches, from August 1991 to October 1992. A large number of sandflies, 6,965 specimens, have been dissected to estimate peri and hypopyloric infections. All the peripyloric infections, characterized by isoenzyme electrophoresis, were Leishmania panamensis. The percentage of these infections was low, around 3%, but they were massive. They occurred only in dry season. Hypopyloric infections were observed in Lu. trapidoi all the year round in the three biotopes. Their percentage was high, reaching 40%. Despite of many trials to cultivate the parasite on NNN medium, no stain could be isolated. It is suggested that the parasite could be L. equatorensis.

Animals↗

PubMed1994

[Leishmaniasis in Ecuador. 4. Natural infestation of the dog by Leishmania panamensis].

In two endemic leishmaniasis foci of the Pacific coast of Ecuador 34 dogs suspected of having the disease have been surveyed clinically, serologically and parasitologically; immunofluorescence and electrosyneresis tests, lymph node aspirates, biopsies and smears have been performed. From two dogs with ulcers only one had ulcers on the muzzle and the scrotum infected by Leishmania (L. guyanensis complex). The isolated strain was identified as Leishmania panamensis. The disease was strictly cutaneous. In the study area the dog seems to be more a victim-host than a reservoir.

Animals↗

PubMed1994

[Leishmaniasis in Ecuador. 6. Epidemiological and entomological note on the focus of leishmaniasis in Zumba].

The Zumba focus of tegumentary leishmaniasis lies in the southwards Amazonian region of Ecuador. A clinico-epidemiological study has been carried out in the area on 83 patients attending health centers. All the biotopes suitable for sandflies, including dwellings, have been sampled from February to September 1992 by light trap and human bait catches. The number of sandflies caught amounts to 2,547. Anthropophilic sandfly fauna is poor and only three species have been recorded. Lutzomyia serrana abounds inside dwellings where it bites men even during daytime. The parasite was identified as an intermediate form between Leishmania panamensis and L. braziliensis. It will be described elsewhere. The high proportion of facial lesions suggests a domiciliary transmission for which Lu. serrana could be a good vector candidate.

Adolescent↗

PubMed1994

Cutaneous leishmaniasis in subtropical Ecuador: popular perceptions, knowledge, and treatment.

Popular perceptions and knowledge about cutaneous leishmaniasis and its treatment were studied in an endemic area of subtropical Northwest Ecuador. Although most of the adults surveyed were familiar with the disease, the vector, and traditional treatments, many showed a lack of knowledge about transmission of the disease, ulcer healing, and conventional treatment. Gender was found to have a significant impact on disease risk, perceptions, and treatment knowledge. Males experienced a risk of contracting cutaneous leishmaniasis that was almost triple that of women. Men were also more likely to perceive that the disease seriously diminished the victim's capacity to work. Women, on the other hand, were more prone to perceive that cutaneous leishmaniasis was a serious disease that significantly decreased self-esteem. Although 80% of the subjects knew at least one method of treating the disease, women tended to know more methods than men. Most of 150 different therapies reported involved the use of indigenous plants, chemicals, acids, antibiotics, heat treatments, or petroleum by-products. Some of these treatments could have clinical value. However, only 7% of the subjects knew about pentavalent antimonials. Almost 70% of the subjects with a past or present infection history were treated solely by traditional methods; only 12% received a full course of Glucantime, while 7.5% got an incomplete course. The findings indicate that it will be important to consider the identified gaps in knowledge and gender perceptions regarding the disease and its treatment when planning future control programs.

Adolescent↗

PubMed1994

Genetic characterization of the Cayapa Indians of Ecuador and their genetic relationships to other Native American populations.

One-hundred sixty-four Cayapa Indians living in the Esmeraldas Province (northwest Ecuador) were studied for several erythrocyte genetic markers (ACP1, ADA, AK1, CA2, ESD, GLO1, G6PD, PGD, PGM1 subtyping and thermostability, PGM2, SODA, and HB). The Cayapa show allele frequencies typical of those of South American Indians. The absence of the CA2*2, G6PD*A, G6PD*A-, HBB*S, and HBB*C alleles and the low PGM1*1A and PGM1*2A and high PGM1*1B allele frequencies indicate that very little (no more than 2%), if any, genetic admixture has occurred with the black community living in the same area. Correspondence analysis was used to study the genetic relationships between the Cayapa and other linguistically defined Amerind populations and between the Amerinds and the other two native American groups, the Na-Dene and Eskimo-Aleut. The results of this analysis, obtained on the basis of some erythrocyte and serum markers and some blood group systems, show (1) the close affinity between the Cayapa and other South American populations, (2) the absence in the Amerind group of a clear-cut correspondence between linguistic classification and genetic relatedness, and (3) the evident distinctiveness of the Amerinds from other native American people.

Adult↗

PubMed1993

Establishing the first family medicine program in Ecuador.

The first family medicine residency program in Ecuador was founded in 1987 by a private evangelical mission hospital under the auspices of the Catholic University of Cuenca. Currently, general medicine is an empiric and poorly respected profession, and medical care is fragmented among multiple specialties and competing systems. This paper reviews the basic principles that guided the development of the program and some of the major challenges and difficulties it has faced. The most important principle of this program is the development of family physician role models who work among other health care professionals and contextualize the basic principles of family medicine to fit Ecuadorian society and its medical needs.

Curriculum↗

PubMedDate not supplied

Asthma and its relation with Dermatophagoides pteronyssinus and Dermatophagoides farinae in Andean altitudes (Quito, Ecuador).

Previous investigations in alpine altitudes suggest a very low etiopathogenic relation between house-dust mites and bronchial asthma in these geographical zones. Our purpose was to analyze the relationship between asthma and sensitization to the house-dust mites D. pteronyssinus and D. farinae in Andean altitudes. We studied 587 asthmatic patients, residents in Quito, Ecuador, (2800 m above sea level), ranging in age from 8 months to 84 years. The patients were divided into five age groups. We investigated the prevalence of house-dust mite sensitization by skin prick tests in each group. Fifty asymptomatic students with ages between 6 to 20 years old were studied as a control group. Three hundred and thirty asthmatic patients (56.2%) were sensitized to house-dust mites while only 15 (30%) of the 50 asymptomatic students were sensitized (p < 0.01). The percentage of asthmatics sensitized followed an age-dependent curve that began with the children under 6 years old (45.1%), reached its maximum between 12 and 19 years old (79.0%) and decreased to 25.8% in asthmatics older than 40 years. The differences among these groups were statistically significant (p < 0.01). Also, we observed a significant prevalence in sensitization (p < 0.01) in males versus females. The mean size of the skin reaction obtained with D. pteronyssinus and D. farinae was larger (p < 0.001) in the 12-19 year olds than in the group of asthmatics over 40 years old. It was also greater in the asthmatics with chronic rhinitis than in the group of asthmatics without nasal symptoms (p < 0.01). We suggest that the house-dust mites D. pteronyssinus and D. farinae are an important source of allergens in the pathogenesis of bronchial asthma in patients who live in the high Andes.

Adolescent↗

PubMed1997

Apolipoprotein B and E genetic polymorphisms in the Cayapa Indians of Ecuador.

Three DNA polymorphisms (XbaI, EcoRI, and Ins/Del) of the apolipoprotein B (APOB) gene and the CfoI polymorphism of the APOE gene were investigated in a sample of 96 Cayapa Indians from Ecuador. The frequencies of the X+ (0.182), R+ (1.000), and Del alleles (0.432) at the three APOB sites were found to be higher than and to differ significantly from those reported for East Asians. No comparisons could be made between the Cayapa and other native Americans because of the lack of data on these sites. We observed in our sample that, like native American populations but unlike East Asians, the APOE allele frequencies were characterized by the absence of the APOE*2 allele and by a high frequency of the APOE*4 allele (0.280). Besides a probable drift effect, the high APOE*4 value was tentatively attributed to an effect of selection. Because this allele enhances the absorption of cholesterol by the intestine, it could confer an advantage to carriers in an unfavorable environment (i.e., diet poor in cholesterol).

Adult↗

PubMed1997

[Cancer of the larynx in Ecuador].

A retrospective review was made of 75 cases of laryngeal cancer evaluated and treated at the Social Security Hospital of Quito (Ecuador). No exclusively supraglottic lesions were found; 67% of cases, were glottic or glottic-supraglottic. Thirty-two per cent of cases were T1 and T2 and 23% had palpable lymph nodes in neck. Most T1 and T2 tumors were treated with radiotherapy (RT) and most T3 and T4 tumors with a combination of surgery and RT. The 5 and 10-year overall survival rates were 55% and 47%, respectively. The 5-year survival rates were: 81% for T1 and T2 tumors and 36% for T3 and T4 tumors (p = 0.0008), 76% for N- and 42% for N+, 53% for well-differentiated and 58% for moderately or poorly differentiated tumors, 85% for T1 and T2 lesions treated with RT and 67% for T1 and T2 lesions treated with partial surgery, and 14% for T3 and T4 lesions treated with RT and 49% for T3 and T4 lesions treated surgically (non-significant differences).

Ecuador↗

PubMedDate not supplied

A learning partnership in Ecuador.

Recognizing the need to provide community-based experiences for its undergraduates, the US' Spalding University of Louisville, Kentucky, teamed up with Catholic University in Quito, Ecuador, to fulfil this need and at the same time meet its School of Nursing's curriculum goal of developing concepts of caring and diversity. Below, how this partnership helped meet the objectives of a community health course in a diverse setting.

Community Health Nursing↗

PubMed1998

Principal causes of poisoning in Quito, Ecuador: a retrospective epidemiology study.

At present there are no poison center or toxicology services available in Ecuador. In preparation to begin such a service it was decided to evaluate the occurrence and causes of poisoning in Quito (population 1.5 million). A retrospective chart review was performed for all of 1995 of all the patients admitted to the emergency departments of 3 main public hospitals of Quito for poisoning, excluding those who had ethanol and food poisoning. We analyzed sex, age, socio-economic status, origin and principal causes of poisoning; 850 cases were located. Predominant age groups seen were 15-30 y and 31-45 y. Poisoning with drugs was the major cause with 211 cases, followed by organophosphate and phosphorus poisoning. Principal drugs seen in poisoning were benzodiazepine, acetaminophen and aspirin. The occurrence of poisoning in Quito showed unique regional differences that will help prepare local health officials to establish intervention strategies for the reduction of morbidity and mortality from poisoning. Significant efforts in both public and professional education will need to be made to both reduce occurrence and better treat poisonings.

Adolescent↗