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Spatial and temporal distribution of cholera in Ecuador between 1991 and 1996.

BACKGROUND: The seventh pandemic of cholera affected South America in 1991 after a century of absence. Favoured by local conditions, the epidemic of cholera in Ecuador had a rapid impact. The epidemic of cholera evolved with temporal and geographical variations. METHODS: The temporal and geographical variations of cholera in Ecuador between 1991 and 1996 have been analysed. The Ecuadorian epidemiological surveillance system is a semi-active one based on obligatory weekly declarations. A geographical representation of annual impact rate has been made. Using a smoothing technique by cross-validation, time curves were identified and spatial diffusion was studied by cartography. RESULTS: In 1991 and 1992, cholera in Ecuador evolved in an epidemic mode with two explosive epidemic peaks. Cholera then entered a phase of regression. The disease spread from two main epicentres, one in the South (El Oro, Guayas, Los Rios) and the other in the North (Esmeraldas and Imbabura). These focal outbreaks spread to neighbouring provinces during the peak outbreaks between 1991 and 1993. CONCLUSION: This study demonstrated that the epidemic spread from the affected provinces in the South and the North of the country.

Cholera↗

The socioeconomic impact of malaria in Colombia and Ecuador.

In-depth studies in three communities of Colombia and Ecuador, over a period of two to three months in each, were the basis of the economic analysis presented in this paper. In Santa Cruz, located at the rio Naya in Colombia, the average cost per case of malaria was US$17.30 (indirect costs US$15.80 and direct costs US$1.50); the loss corresponded to 20.1% of a minimum monthly wage (1986) or to a value of 5.6 days' work. In Perla de Sade, in the Cant6n Quininde of Ecuador, the average cost per case of malaria amounted to US$10.40 (indirect costs US$5.90 and direct costs US$4.50); the losses corresponded to 20.8% of a minimum monthly wage (1989) and to a value of 5.7 days' work. In Calder6n in the Cant6n of San Lorenzo in Ecuador, the average cost per case of malaria was US$4.80 (indirect costs US$3.50 and direct costs US$1.30); the losses corresponded to 16.0% of a minimum monthly wage (1991) with a value of 4.4 days' work. The results in these three communities, and in four additional ones, showed that the major economic impact of malaria is in the reduction of the labour force of families (indirect costs), and less so in the direct costs of care and cure. This emphasizes the economic importance of malaria because the rural familes with economies at subsistence level depend for survival particularly upon the maintenance of their labour force.

Adolescent↗

Health education for community-based malaria control: an intervention study in Ecuador, Colombia and Nicaragua.

A malaria study was undertaken in 98 rural communities of the Pacific coast of Ecuador (n = 14), Colombia (n = 22) and Nicaragua (n = 62). In-depth interviews on people's knowledge and practice regarding malaria aetiology, symptoms and treatment were conducted and complemented by formal household interviews. On the basis of this information, an educational programme was set up which included the training of village health promoters and community workshops organized by the health workers and used a set of methods of interactive learning. After the baseline survey the communities were paired and randomly allocated to the intervention and control groups. Malaria education took place only in the intervention communities. At the start of the project people's knowledge about malaria-transmitting mosquitoes and malaria symptoms was correct and widespread in those areas where the community exposure to formal health services was pronounced. However, knowledge of the recommended dose of chloroquine was poor everywhere, and self-treatment of malaria episodes deficient. The educational intervention achieved a high level of participant satisfaction which was expressed in a high and continuous attendance rate at the monthly workshops. The knowledge of malaria aetiology and symptoms was 33-61% better in the intervention group than in the control group. Knowledge of the recommended doses of chloroquine increased significantly (34% in Ecuador, 93% in Colombia but not in Nicaragua) and correct use of chloroquine in the treatment of malaria episodes also improved (26% in Ecuador, 85% in Colombia). In Nicaragua the results were less satisfactory due to the short period of promotional activities and the health services' policy of delivering only supervised treatment to the population. It is concluded that health education should play a major role in malaria control.

Colombia↗

Causes of blindness among hospital outpatients in Ecuador.

BACKGROUND: There is a lack of published information on the causes of blindness in Ecuador and the Latin American region in general. This study is designed to enumerate the proportions of ocular conditions contributing to blindness in an outpatient population of an ophthalmology hospital in the coastal region of Ecuador. METHODS: All cases presenting to an ophthalmology outpatient clinic over a 3-week period during September 2004 were reviewed (n = 802). Visual acuity was measured using a Snellen acuity chart and those who met the criteria for blindness were included in the study (n = 118). Blindness was defined under the World Health Organization protocol as visual acuity of <3/60. Both unilateral and bilateral blindness were included in the study. The diagnosis of ocular pathology contributing to blindness was recorded. RESULTS: Among those considered to have unilateral blindness (n = 88), cataract was the most common cause (43%). This was followed by corneal pathologies (17%) and glaucoma (15%). Among those considered to have bilateral blindness (n = 30), refraction was the most common cause (37%), followed by cataract (23%) and glaucoma (17%). CONCLUSION: The major causes of blindness found in this study reflected those in estimated data for the region. More studies are needed to improve the quality and quantity of epidemiological data on blindness in Ecuador and Latin America. Many obstacles to successful implementation of prevention of blindness programmes in South America still need to be overcome.

Adolescent↗

Investigating the zoonotic origins of ESBL-producing E. coli in community-acquired urinary tract infections in Ecuador.

Extended-spectrum &#x3b2;-lactamase-producing Escherichia coli (ESBL-producing E. coli) pose a growing global health threat. Although Latin America has been identified as a global hotspot of antimicrobial resistance, the zoonotic contribution to drug-resistant infections in the region remains poorly defined. We analyzed 137 clinical ESBL-producing E. coli isolates from urinary tract infections (UTIs) in Quito, Ecuador, applying a Bayesian latent class model informed by host-associated mobile genetic elements to estimate the fraction of infections attributable to food-animal sources. We estimated that 25.5% (35/137) of UTI isolates were putative zoonotic cases. This proportion rose to 42.5% after excluding ST131-H30, a human-associated pandemic lineage. Putative zoonotic isolates were enriched for animal-associated &#x3b2;-lactamase genes (e.g., blaTEM-1B, blaCTX-M-65), lacked human-associated markers such as blaOXA-1, and exhibited diverse antimicrobial resistance gene profiles resembling those observed among food-animal isolates. These isolates were also enriched for ColV-associated virulence genes typically linked to avian pathogenic E. coli. Putative zoonotic strains contributed substantially to third-generation cephalosporin-resistant UTIs in Quito, Ecuador, challenging assumptions derived from high-income settings that such infections are driven predominantly by human-to-human transmission. These findings highlight the importance of integrated One Health surveillance and mitigation, particularly in low- and middle-income countries where gaps in water, sanitation, and hygiene (WASH) may interact with antimicrobial use in food production to amplify antimicrobial resistance transmission.IMPORTANCEESBL-producing E. coli have rapidly emerged as a major global antimicrobial resistance threat. In Latin America, cephalosporins are commonly used in food-animal production, fueling the emergence of ESBL-producing E. coli. In low- and middle-income countries, excessive antimicrobial use driven by poorly regulated over-the-counter sales, combined with inadequate water, sanitation, and hygiene (WASH) infrastructure, can facilitate antimicrobial-resistant pathogen transmission from food animals to humans. Using a novel statistical-genomic approach, we found that over one in four cephalosporin-resistant UTIs in Quito, Ecuador, may be caused by E. coli strains originating from food animals. Our findings highlight the public health risks associated with antimicrobial use in food-animal production and the role of environmental and infrastructure-related vulnerabilities. As global demand for animal protein continues rising in middle-income countries, controlling zoonotic antimicrobial resistance transmission becomes increasingly urgent for protecting human health through integrated One Health strategies.

ESBL-producing E. coli↗

Malignant salivary gland tumors in Quito, Ecuador.

OBJECTIVES: Malignant salivary gland tumors (MSGT) are uncommon. Age-standardized incidence rates are 0.5 and 0.3 per 100,000 in Quito, Ecuador; and 1.0 and 0.7 per 100,000 in the USA (SEER Program), for males and females, respectively. The goal of this study was to review a 16-year experience of a major general hospital in the treatment of these lesions. PATIENTS AND METHODS: From 1982 to 1998, 308 salivary gland tumors were surgically treated at the Hospital 'Carlos Andrade Marin' of the Ecuadorian Institute of Social Security in Quito, Ecuador, an Andean city of approximately 2 million inhabitants. Malignant lesions were found in 58 cases (19%): 37 out of 194 parotid gland tumors (19%), 7 out of 86 submandibular tumors (8%) and 14 out of 28 minor salivary gland tumors (50%). Adenoid cystic carcinoma and mucoepidermoid carcinoma were the most common histologic types. Twenty-two cases were classified as stage I, 13 as stage II, 1 as stage III and 20 as stage IV (UICC TNM staging classification). Thirty-one (53%) patients were treated by surgery alone; postoperative radiation therapy was additionally given to 22 (38%), and surgery, radiotherapy and chemotherapy were applied in 5 cases (9%). RESULTS: Local (LR) and/or regional recurrences were detected in 13 patients (22%). Twelve patients (21%) developed distant metastasis (DM; 2 in more than one site): 7 in the lungs, 2 in the brain, 2 in the bone and 1 each in the liver, subcutaneous tissue and pleura. Thirty-five patients are alive, 33 disease free. Twenty-three patients are deceased: 6 with LR, 7 with DM, 3 with both LR and DM, 1 with locoregional recurrence and DM, 2 with a second neoplasm, 3 with intercurrent disease and 1 from unknown causes. Five- and 10-year overall survival rates were 75 and 68%, respectively. There were no significant differences in mortality according to the site of the primary tumor or histologic type, but stage and involved surgical margins were important prognostic factors (p = 0.006 and 0.003). CONCLUSIONS: The surgical or multimodality treatment of MSGT has provided a good locoregional control (78%) and 68% 10-year survival in a series of patients treated at the oncology department of a general hospital in Quito, Ecuador. Stage and involved surgical margins were significant prognostic factors.

Adult↗

Correlates of condom use in a sample of MSM in Ecuador.

BACKGROUND: In Ecuador, the prevalence of HIV in the general population is approximately 0.3%. However, up to 17% prevalence has been reported among specific groups of homosexual and bisexual men. The objective of this study is to explore correlates of condom use among men who have sex with men (MSM) across eight cities in Ecuador. METHODS: A cross-sectional survey design was used. A questionnaire including variables on sexual behaviour, demographics, and socio-economic characteristics was distributed to a sample of MSM in eight Ecuadorian cities. RESULTS: Information was obtained for 2,594 MSM across the eight cities. The largest subcategory of self-identification was active bisexuals (35%), followed by those who described themselves as "hombrados" (masculine gays, 22%). The mean age was 25 years, and the majority were unmarried (78%), with a median of 10 years of schooling (IQR 7 - 12). Regarding condom use, 55% of those interviewed had unprotected penetrative sex with each of their last three partners, and almost 25% had never used a condom. The most important correlates of condom use were single status, high life-skills rating, and high socio-economic status (RP 5.45, 95% CI 4.26 - 6.37; RP 1.84, 95% CI 1.79 - 1.86, and RP 1.20, 95% CI 1.01 - 1.31, respectively). CONCLUSION: Our data illustrate the urgent need for targeted HIV-prevention programs for MSM populations in Ecuador. MSM have the highest HIV prevalence in the country, and condom use is extremely low. It is imperative that prevention strategies be re-evaluated and re-prioritized to more effectively respond to the Ecuadorian epidemic.

Adult↗

[Inconsistent condom use among sexual workers in Ecuador: results from a behavior survey].

OBJECTIVE: Whilst existing data suggests that the HIV epidemic in Ecuador is concentrated amongst men who have sex with men (MSM), there is very little available information on the situation of key populations, i.e. those most at risk of HIV infection and/or transmitting the infection. In particular, there is very little known about sex workers (SWs), their rate of condom use and other behaviors and characteristics with respect to the risk of acquiring sexually transmitted infections (STIs). This study presents findings from a survey carried out with SWs in eight cities in Ecuador. MATERIAL AND METHODS: Using a cross-sectional design, a questionnaire focusing on behaviours, attitudes and socio-economic and demographic characteristics was administered to SWs in eight cities in Ecuador. These eight cities together account for the majority of the population in the country, and they were also identified as the locations with high reported levels of HIV. RESULTS: Information from a total of 2867 SWs was obtained, the majority were captured in their workplaces. Most of SWs interviewed carry out their activities in closed settings dedicated to sex work (i.e. not in the street). The average age of respondents was 28 (95%CI 27-29), and around half of them live with a male partner (married or not). The rate of condom use with the last client was 88% (82% consistently with the last three), whilst with regular partners it was 6%. A high index of life-skills, high socio-economic status and having an official document that allows them to work, were positively associated with condom use with clients (PR [CI95%] 1.40 [1.40-1.40], 1.37 [1.36-1.37], y 7.26 [6.87-7.46], respectively). CONCLUSIONS: Whilst condom use with clients amongst Ecuadorian SWs is high, this diminishes if one analyzes consistent condom use and is notably low with respect to regular partners. Condom use appears to be related to variables that can be linked to interventions, e.g. life-skills and official permission to carry out sex work. It is, therefore, important to tailor interventions for this population so they maximize the likelihood to increase consistent condom use.

Adult↗

Epidemiology of leishmaniasis in Ecuador: current status of knowledge -- a review.

Although leishmaniasis is regarded as a significant health problem in Ecuador by the Ministry of Health, and the incidence has increased over the last years, an official map on the geographic distribution of disease and sand fly vectors or a control strategy do not exist yet. This article reviews the current situation based on published information to improve our knowledge and understand the epidemiological situation of leishmaniasis in Ecuador in order to help future research and to develop a national control strategy. The disease is endemic in most provinces throughout Pacific coastal region, Amazonian lowlands, and some inter-Andean valleys with a total 21,805 cases reported during 1990-2003. Whereas cutaneous leishmaniasis (CL) is found throughout Ecuador, mucocutaneous leishmaniasis (MCL) appears to be restricted to the Amazon region; one, parasitologically unconfirmed case of visceral form was reported in 1949. Most human infections are caused by Leishmania (Viannia) spp., which is distributed in the subtropical and tropical lowlands; infections due to L. (Leishmania) spp. are found in the Andean highlands and in the Pacific lowlands as well. The proven vectors are Lutzomyia trapidoi and Lu. ayacuchensis. Canis familiaris, Sciurus vulgaris, Potos flavus, and Tamandua tetradactyla have been found infected with Leishmania spp. It is estimated that around 3000-4500 people may be infected every year, and that 3.1 to 4.5 millions people are estimated to be at risk of contracting leishmaniasis.

Animals↗

The traditional and conventional medical treatment of cutaneous leishmaniasis in rural Ecuador.

OBJECTIVE: To explore the knowledge, beliefs, and practices (KBPs) regarding cutaneous leishmaniasis (CL) treatment held by an endemic population in Ecuador. METHODS: A follow-up to research done several years before, this study used random cluster sampling to select 529 adults who lived in rural northwestern Ecuador. Data were collected over a 24-month period using in-depth interviews supplemented with qualitative methods. RESULTS: Most of the subjects were familiar with CL. The interviewed persons described a large, diverse ethnomedical treatment inventory. Contrary to expectations, few treatment KBPs were predicted by gender, age, or prior CL experience. Factors reported as important in treatment decisions included female reproductive status, CL "type" (perceived form of the illness), lesion location, number of other infected household members, cost of the various treatments, treatment availability, and perceived treatment effectiveness. Subjects' strong motivation for prompt treatment appeared to be associated with beliefs regarding the inability of CL lesions to heal spontaneously, the disease's propensity to progress into fatal illnesses, and disfigurement. Despite increased familiarity with Glucantime (meglumine antimonate), the conventional pentavalent antimonial drug used to treat CL in Ecuador, the proportion of subjects who had used it in their treatment remained low (20%) while the prevalence of premature drug discontinuance appeared to have doubled in comparison to our earlier study. CONCLUSIONS: By itself, increased access to Glucantime is unlikely to increase usage of the drug and to reduce its frequent premature discontinuance unless public health planners accommodate the health and illness world views of local populations. Efficacy and safety studies should be undertaken to investigate promising traditional remedies as possible alternatives to Glucantime.

Adolescent↗

[The prevalence of and attitudes toward smoking among physicians in Azuay, Ecuador].

OBJECTIVES: To learn the prevalence of smoking among physicians in the province of Azuay, Ecuador, as well as their attitudes toward the habit. METHODS: This descriptive cross-sectional study was conducted using a survey that was based on models used in previous research. The survey consisted of 14 questions on the physicians' sociodemographic characteristics, issues related to the use of tobacco, and the physicians' attitudes toward smoking among their patients. The survey was delivered to 884 physicians and answered by 687 of them (77.7%). The results were entered into an electronic database, and multivariate analysis was carried out with the SPSS version 7.5 software package. Subgroups were compared using stratified analysis. Even though the study was descriptive, parametric statistical tests were applied with the quantitative variables, and Pearson's chi-square test was used to compare associations between discrete variables. A P level < 0.05 was considered statistically significant. RESULTS: Of the 687 physicians who responded to the survey, 8 of them did not answer all the questions and so were excluded from the sample. Of the remaining 679, 509 of them (75%) were men and 170 (25%) were women. Their average age was 43, and the prevalence of smoking for the group overall was 32.4%. The large majority of the smokers were between 36 and 55 years old. The male physician smokers smoked more cigarettes per day than did the female physician smokers (P < 0.05). Of the physician smokers, 68% of the men had been smoking for more than 10 years, but this was true for only 46% of the women. In terms of when the smokers began smoking, 47.1% of the men started when they were between 16 and 20 years old, while the single largest group of women smokers (40.5%) began when they were between 21 and 25 years old. Of the physicians who smoked, 60% of them said they did so in the workplace, and 67.6% of them said they had tried to quit smoking at some point. The physician smokers were less critical of smoking than were the physician nonsmokers, and the smokers also less frequently advised their patients to stop smoking (53.2% vs. 71.6%; P < 0.01). CONCLUSIONS: The prevalence of smoking among the physicians in the province of Azuay, Ecuador, is one of the highest among physicians in Latin America, and it is also similar to the overall rate for adults in Ecuador. These patterns make it difficult to expect a reduction in smoking in the province. There is an urgent need to implement preventive and therapeutic actions to control this scourge.

Adult↗

Unintended pregnancy and low birthweight in Ecuador.

OBJECTIVES: This study assessed the relationship between unintended pregnancy and infant birthweight in Ecuador, differentiating between unwanted and mistimed pregnancies. METHODS: Analyses focused on a subsample of women (n = 2490) interviewed in the 1994 Ecuador Demographic and Maternal-Child Health Survey. Logistic regression was used to assess the relationship between pregnancy intention status and low birthweight after control for other factors. RESULTS: Infants from unwanted pregnancies were more likely than infants from planned pregnancies to have low birthweight (odds ratio = 1.64, 95% confidence interval = 1.22, 2.20). Mistimed pregnancy was not associated with low birthweight. CONCLUSIONS: Unwanted pregnancy, but not mistimed pregnancy, is associated with low birthweight in Ecuador. Further research is needed to understand the mechanism through which pregnancy intention status affects birthweight.

Ecuador↗

Molecular karyotype characterization of Leishmania panamensis, Leishmania mexicana, and Leishmania major-like parasites: agents of cutaneous leishmaniasis in Ecuador.

Molecular karyotypes of Leishmania isolates from patients with cutaneous leishmaniasis in Ecuador were analyzed by pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization. The DNA karyotypes of L. major-like parasites were similar between two human isolates from a lowland coastal and a highland Andean region, but were apparently different from those of eleven World Health Organization reference strains including L. major. The smallest chromosome of 240 kilobases in L. major-like parasites was found to belong to the 715-class of small linear chromosomal DNAs, which have been shown to appear in some lines of Leishmania. Chromosome banding patterns of L. mexicana isolates exhibited a novel, ordered, chromosomal ladder, and were identical among four human isolates and one canine isolate from a restricted geographic region in the Andes. On the other hand, minor chromosome size polymorphisms were observed among three L. panamensis isolates from different endemic regions near the Pacific Coast. Chromosomal locations of dihydrofolate reductase-thymidylate synthetase and P-glycoprotein genes revealed further differences in chromosomal organizations among these Leishmania species in Ecuador. These results indicate that karyotype analysis by PFGE is useful for epidemiologic studies of leishmaniasis in Ecuador.

Animals↗

Ocular linguatuliasis in Ecuador: case report and morphometric study of the larva of Linguatula serrata.

Linguatula serrata is a pentastomid, a cosmopolitan parasite belonging to the Phylum Pentastomida. Humans may act as an intermediate or accidental definitive host of this parasite, manifesting the nasopharyngeal or visceral form, with the latter having been described more frequently. The occurrence of ocular linguatuliasis is extremely rare, but it has been reported in the United States and Israel. The objective of the present paper was to report the first case of ocular linguatuliasis in Ecuador and to extend the morphologic study of L. serrata by morphometric analysis. The patient studied was a 34-year old woman from Guayaquil, Ecuador who complained of ocular pain with conjunctivitis and visual difficulties of two-months duration. Biomicroscopic examination revealed a mobile body in the anterior chamber of the eye. The mobile body was surgically removed. The specimen was fixed in alcohol, cleared using the technique of Loos, stained with acetic carmine, and mounted on balsam between a slide and a coverslip. It was observed with stereoscopic and common light microscopes in combination with an automatic system for image analysis and processing. The morphologic and morphometric characteristics corresponded to the third-instar larval form of L. serrata. To our knowledge, ocular linguatuliasis has not been previously described in South America, with this being the first report for Ecuador and South America. The present study shows that computer morphometry can adequately contribute both to the morphologic study and to the systematic classification of Pentastomids, and L. serrata in particular.

Adult↗

Anti-tuberculosis drug resistance in two clinics in Ecuador.

SETTING: Two private hospitals, one in the capital city and one in the eastern rainforest of Ecuador. OBJECTIVE: To document the prevalence of anti-tuberculosis drug resistance in Ecuador in patients who had not received prior treatment and in those who had. DESIGN: Drug resistance was determined using the proportion method with solid medium on the first isolate of Mycobacterium tuberculosis from all patients who attended the two hospitals between 1989 and 1996. Documentation of prior treatment was obtained by patient interview. RESULTS: Resistance was identified in 39 of 161 patients (24%) who had had no prior treatment. Resistance was 14.2% to isoniazid, 11.8% to rifampin and 8.7% to both (multidrug-resistant tuberculosis). Among 60 patients who had received prior treatment, 18 (30%) were resistant to isoniazid, and 14 (23.3%) to rifampin, while multidrug resistance was seen in 10 (16.7%). CONCLUSION: In these populations the prevalence of resistance both in patients with no prior treatment and in patients with prior treatment was ominously high. The initial treatment regimens and patient management in Ecuador should be re-evaluated in an effort to prevent further increases in drug resistance.

Ambulatory Care Facilities↗

[A tuberculosis project in Ecuador].

OBJECTIVE: Determination of the frequency of pulmonary tuberculosis in an Indian community in Ecuador among symptomatic patients and contacts of patients with tuberculosis. Pulmonary tuberculosis was defined as the presence of acid fast rods in sputum. SETTING: Pontificia Universidad Catolica del Ecuador, Quito, Ecuador. DESIGN: Sputum samples were collected with the aid of an educational drama. About 5000 persons were informed on tuberculosis by this performance. The sputum samples from 241 persons were examined for presence of acid-fast rods with a direct Ziehl-Neelsen (ZN) stain and a ZN stain after concentration of the sputum. If ZN stain was negative, the sputum was cultured on Löwenstein-Jensen medium or on Coletsos medium. The Löwenstein-Jensen medium was past the expiration date. RESULTS: Bacteriological examination of the sputum samples from 241 patients and controls brought to light 65 (26.9%) individuals with acid-fast rods in the sputum. Forty per cent of the affected patients were between the ages of 20 and 34. Investigation of 82 contact persons revealed 19 (23.2%) positive cases. The results of culturing of the sputum samples were disappointing: only 6 of 152 (3.9%) samples showed growth of acid-fast rods. CONCLUSIONS: The frequency of pulmonary tuberculosis (as defined by the presence of acid fast rods in sputum) is high in the community investigated, much higher than the official data on the prevalence of tuberculosis indicate. It is important to investigate contacts of patients with pulmonary tuberculosis to trace a source and to trace new cases.

Adolescent↗

Intermediate hosts of Paragonimus in the eastern Amazonic region of Ecuador.

A study was done to determine the intermediate hosts of Paragonimus mexicanus (P. peruvianus, P. ecuadoriensis) in the northeastern amazonic region of Ecuador. The first intermediate host belongs to the molluscan family Hydrobiidae, similar to the findings reported in other parts of Latin America. One of 2350 specimens of the hydrobiid snail Aroapyrgus colombiensis examined was found to be naturally infected with rediae containing microcercous cercariae of Paragonimus, this being the first naturally infected first intermediate host reported in Ecuador. The crustacean family, Trichodactylidae, was found as the second intermediate host of paragonimiasis, this being the first time reported in Ecuador. The freshwater crab Zilchiopsis ecuadoriensis was found to be heavily parasitized by Paragonimus metacercariae.

Animals↗

A review of leishmaniasis in Ecuador.

This article briefly reviews current knowledge about leishmaniasis in Ecuador--proceeding from 1920, when the first human case was described, to the present. Regarding basic conditions, it appears that 14 of Ecuador's 20 provinces have endemic leishmaniasis. Nationally, over 4,000 cases were registered in the 1983-1986 period. Of 260 cases cited in the literature from 1920 through 1987, 240 (92.3%) were said to involve cutaneous forms of the disease and 18 (6.9%) mucocutaneous ones. Only one case each of visceral and diffuse cutaneous leishmaniasis was reported in 1920-1987, and neither of these has been confirmed. Various Leishmania strains isolated by the authors from wild animals and man are currently being studied. To date, tests employing isoenzyme electrophoresis and monoclonal antibodies have identified some of the isolated strains as L. amazonensis and L. panamensis. At present it seems evident that a detailed study of leishmaniasis transmission in Ecuador is needed in order to develop a plan for future control of the disease. Survey work directed at identifying the particular Leishmania varieties prevalent in the country's different endemic areas is also needed, as is research on the sandfly vectors and animal reservoirs of the disease.

Animals↗