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Epileptic seizures in an Andean region of Ecuador. Incidence and prevalence and regional variation.
A large-scale neuro-epidemiological study was carried out in a population of 72,121 inhabitants of a region of Northern Ecuadorian Andean Sierra, to identify prevalence and incidence rates of epileptic seizures and to identify demographic and geographic variations in these rates. Calculations were made using three datasets. First, rates were calculated from all cases identified in the field (raw dataset); secondly, lower rates were calculated based on a further diagnostic and reclassification procedure (minimum estimated dataset); thirdly, higher rates were derived by calculating false negative rates from the screening procedures, and adding these to the cases actually identified (maximum estimated dataset). Lifetime point-prevalence rates between 12.2/1000 and 19.5/1000 were recorded (minimum and maximum estimated rates), and the prevalence of active epileptic seizures was between 6.7/1000 and 8.0/1000 (minimum estimated and raw datasets). Incidence rate ranging between 122/100,000/year and 190/100,000/year were found (minimum, estimated and raw datasets). A marked difference in prevalence rates was found in two subregions of the survey area, and also in urban and rural areas. The reasons for these differences were not identified.
Longevity and age exaggeration in Vilcabamba, Ecuador.
Systematic age exaggeration was found after age 70 in an Equadorian population noted for extreme longevity. Extreme ages (over 100 years) were either incorrect or unsubstantiated. There was no evidence of increased longevity in the Vilcabamba population.
Migration, relocation, and intergenerational relations: Jews of Quito, Ecuador.
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The impact of price changes on demand for family planning and reproductive health services in Ecuador.
Donor funding for family planning and reproductive health (FP/RH) has declined in Latin America over the past decade, obliging providers to consider other financing mechanisms, including cost recovery through user fees. Pricing decisions are often difficult for providers, who fear that increased fees will cripple demand and create barriers to access for poor clients. Providers need information on how changes in price can affect utilization of services, and how to resolve trade-offs between generating income and serving poor clients. This paper reports on an experiment that measured the impact of higher client fees on utilization, revenue and client socioeconomic characteristics at 15 clinics operated by CEMOPLAF, an Ecuadoran not-for-profit FP/RH agency. The study improves on previous research by comparing effects of different price levels on demand for services. We conclude that demand was inelastic for three of CEMOPLAF's four main FP/RH services, and we found no evidence that the price increases had a disproportionate impact on utilization by poorer clients. The study therefore provided CEMOPLAF managers with knowledge that price increases at the levels tested would help to achieve sustainability goals (by increasing locally generated income) without undermining CEMOPLAF's social mission.
Fatal heat-related illness in naval cadets in Ecuador.
On 13 April 1982, after a 6 to 7 km training run on an extremely hot and humid day, 20 of 216 cadets at the Ecuadorian Naval Academy in Guayaquil became ill with symptoms of heat-related illness. Four of them suffered heat stroke, and three died. Illness was most highly associated with the amount of exercise performed that day but was significantly more common in first-year cadets than in older cadets. There were no differences in the anthropometric measurements of ill and well subjects. We conclude that heat-related illness can affect conditioned military personnel during routine training in severe weather and make recommendations for prevention.
Geographical differences in cancer incidence in the Amazon basin of Ecuador in relation to residence near oil fields.
BACKGROUND: Since 1972, oil companies have extracted more than 2 billion barrels of crude oil from the Ecuadorian Amazon, releasing billions of gallons of untreated wastes and oil directly into the environment. This study aimed to determine if there was any difference in overall and specific cancer incidence rates between populations living in proximity to oil fields and those who live in areas free from oil exploitation. METHODS: Cancer cases from the provinces of Sucumbios, Orellana, Napo and Pastaza during the period 1985-1998 were included in the study. The exposed population was defined as those living in a county (n = 4) where oil exploitation had been ongoing for a minimum of 20 years up to the date of the study. Non-exposed counties were identified as those (n = 11) without oil development activities. Relative risks (RR) along with 95% CI were calculated for men and women as ratios of the age-adjusted incidence rates in the exposed versus non-exposed group. RESULTS: The RR of all cancer sites combined was significantly elevated in both men and women in exposed counties. Significantly elevated RR were observed for cancers of the stomach, rectum, skin melanoma, soft tissue and kidney in men and for cancers of the cervix and lymph nodes in women. An increase in haematopoietic cancers was also observed in the population under 10 years in the exposed counties in both males and females. CONCLUSION: Study results are compatible with a relationship between cancer incidence and living in proximity to oil fields. An environmental monitoring and cancer surveillance system in the area is recommended.
Epidemiology vs epidemiology: the case of oil exploitation in the Amazon basin of Ecuador.
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The road to institutionalizing quality assurance in Ecuador in an environment of health sector reform.
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HIV-1, HIV-2 and HTLV-I seroprevalence surveys in continental Ecuador and Galapagos.
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West Indian punctate keratopathy in Ecuador.
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Kathy Beck. A ministry to moms in Ecuador.
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Epilepsy and neurocysticercosis in Atahualpa: a door-to-door survey in rural coastal Ecuador.
PURPOSE: To determine the prevalence of epilepsy and the role of neurocysticercosis in the occurrence of epilepsy in Atahualpa. METHODS: We used a door-to-door survey to detect subjects with epileptic seizures, to collect a blood sample for determination of anticysticercal antibodies, and to evaluate social characteristics of the population, including household pig ownership. Neurologists examined suspected cases and a sample of negative individuals. Then patients with epilepsy, as well as age- and sex-matched controls, underwent a head computed tomography (CT) and a scalp EEG. RESULTS: The questionnaire was answered by 2,415 of 2,548 residents of Atahualpa, and cysticercosis serology was performed in 1,687 consenting individuals. Cysticercosis seroprevalence was 145 (8.6%) per 1,686). Neurologic examination confirmed 24 patients with epilepsy (crude prevalence, 9.9 per 1,000 population, and 10.8 per 1,000 when adjusted to the United States population). After adjustment by age, sex, and pig raising, positive serology was strongly associated with epilepsy (odds ratio (OR), 4.16; 95% confidence interval (CI), 1.6-11.2). CT findings compatible with neurocysticercosis were found in five patients with epilepsy and also were more frequent than in controls, although this did not reach statistical significance (five of 19 vs. one of 19; p = 0.125, McNemar's test). Besides these five cases, three other patients with epilepsy had positive serology (one with a normal CT and two who did not have a CT). CONCLUSIONS: Neurocysticercosis is associated with one-third of cases of epilepsy in Atahualpa and may be a major contributory factor for the excess fraction of epilepsy seen in this population.
Distribution and taxonomic status of chromosomal forms of the onchocerciasis vector Simulium exiguum in central Ecuador.
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Field ecology of sylvatic Rhodnius populations (Heteroptera, Triatominae): risk factors for palm tree infestation in western Ecuador.
Most Rhodnius species (Triatominae) are primarily associated with palm trees. They maintain enzootic Trypanosoma cruzi transmission and are responsible for human infection (causing Chagas disease) through the Neotropics. Assessing whether individual palm traits (ecological and/or botanical) may increase the risk of palm infestation by triatomines is relevant in areas where bugs invade houses flying from peridomestic palms. We developed a novel fieldwork approach with that objective, and applied it to study infestation by sylvatic Rhodnius ecuadoriensis in 110 tagua palms (Phytelephas aequatorialis). Palm infestation (23% overall) was non-randomly distributed in our sample. Palms located in anthropic landscapes were frequently infested (>27%, n=92), whereas no bugs were collected from palms surveyed within forest remnants (n=18; P=0.01). The presence of abundant decaying vegetable matter (P=0.001) and (to a lesser extent) epiphytic plants (P=0.049) on palm crowns and stems increased the probability of infestation and was positively correlated with the apparent density of bug colonies (R2=0.68). A trend towards higher infestation rates in male palms (34% vs. 18%) could relate to female palm management (removal of infrutescences and vegetable debris) in areas where palm seeds are harvested. An outline of 'risk palm ecotopes' and environmental management-based strategies for the control of peridomestic, palm tree-living vector populations are proposed.
Sustainable livelihood development in the Andes: local institutions and regional resource use in Ecuador.
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The housing, geography, and mobility of Latin American urban poor: the prevailing model and the case of Quito, Ecuador.
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Russulaceae and Thelephoraceae form ectomycorrhizas with members of the Nyctaginaceae (Caryophyllales) in the tropical mountain rain forest of southern Ecuador.
* Three members of the Nyctaginaceae, two Neea species and one Guapira species, occurred scattered within a very species-rich neotropical mountain rain forest. The three species were found to form ectomycorrhizas of very distinctive characters, while all other tree species examined formed arbuscular mycorrhizas. * The ectomycorrhizas were structurally typified according to light and transmission electron microscope investigations. The internal transcribed spacer (ITS) rDNA and part of the nuclear large subunit (LSU, 28S) rDNA of the mycorrhiza forming fungi were amplified and sequenced. Phylogenetic analyses were carried out. * Neea species 1 was found to form typical ectomycorrhizas with five different fungal species, Russula puiggarii, Lactarius sp., two Tomentella or Thelephora species, and one ascomycete. Neea species 2 and the Guapira species were associated with only one fungus each, a Tomentella/Thelephora species clustering closely together in an ITS-neighbour-joining tree. The long and fine rootlets of the Guapira species showed proximally a hyphal mantle and a Hartig net, but distally intracellular fungal colonization of the epidermis and root hair development. The ectomycorrhizal segments of the long roots of Neea species 2 displayed a hyphal mantle and a Hartig net around alive root-hair-like outgrowths of the epidermal cells. * The distribution and the evolution of ectomycorrhizas in the predominantly neotropic Nyctaginaceae are discussed.