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PubMed2002

Molecular Epidemiology of HIV Type 1 in Ecuador, Peru, Bolivia, Uruguay, and Argentina.

Surveillance for HIV infection among people at increased risk was conducted in five countries in South America. Seroprevalence studies were conducted in more than 36,000 people in Ecuador, Peru, Boliva, Uruguay, and Argentina, along with genetic analysis of the HIV-1 strains. In all countries, the prevalence of HIV-1 among men who have sex with men (MSM) was high (3-30%), whereas the prevalence among female commercial sex workers (FCSMs) was low (0.3-6%). By envelope heteroduplex mobility assay, subtype B predominated in MSM communities and in FCSWs in Ecuador, Bolivia, and Peru. A new genetic screening assay, the multiregion hybridization assay for subtypes B and F (MHA-bf), was developed to improve large-scale genetic screening in South America. MHA-bf can screen four regions of the genome for subtype B or subtype F, and thus can detect most recombinants. The sensitivity of MHA-bf when applied to a panel of pure subtypes and CRF12_BF was 100%, and 88% of unique recombinants were also detected as recombinant. Using MHA-bf, more than 80% of samples from Ecuador, Peru, and Bolivia were classified as pure subtype B, whereas in Uruguay and Argentina this proportion was only 30 to 40%. BF recombinants were the most prevalent form of HIV-1 in Uruguay and Argentina. Subtype B is the most common subtype in countries lacking injecting drug use (IDU) epidemics, whereas BF recombinants are more common in countries where extensive IDU epidemics have been documented, suggesting the ontogeny of recombinant strains in particular risk groups in South America.

DNA, Viral↗

PubMed1997

Unacceptable "occupational" exposure to toxic agents among children in Ecuador.

To document the problem of child labor as a health issue, we report here three case-studies in Ecuador: exposure to mercury among gold washers, exposure to organophosphates and carbamates in the fruit-growing industry, and exposure to solvents among shoe cleaners. We measured the relevant biological indicators of exposure (mercury in urine, urinary levels of phenols, and acetylcholine esterase in erythrocytes) among selected samples of 10 children for each working place. In all the case studies, the values of the biological indicators showed elevated exposure to well-known toxicants, which are now rare in developed countries, even among adult workers. The findings meld with a previously reported case study of intoxication from inorganic lead among children employed in the manufacture of roof tiles in Ecuador. This study highlights the need to properly evaluate and control the potential health effects due to exposure to toxic substances among children employed in different occupations in several parts of the world.

Acetylcholinesterase↗

PubMed2003

Snakebites in the rainforests of Ecuador.

Epidemiologic information about snakebites in Ecuador is scarce. Snakebites are more common in the lowlands east of the Andes, in the Amazon basin. In the present study, a retrospective review of all ( n = 142) snakebite admissions to Hospital Pio XII, a regional health center/hospital in the canton of Sucúa, Morona Santiago, Ecuador was carried out between the years of 1996 and 2000. Bites occurred more frequently during the months of March to May. The largest group of patients were in the 15- to 49-year-old range (52.5%), and agricultural workers were the most affected of all patients by occupation (> 40%). In most cases of snakebite, patients could not identify the type of snake that had bitten them. A small number of patients ( n = 60, 42.3%) received some type of treatment prior to arrival at the hospital. Bites occurred most frequently on the left lower extremity (31.7%). Typical symptoms included pain and local edema at the snakebite site; generalized symptoms such as fever, nausea, and vomiting were less frequent. Most patients (almost 90%) received antivenin during hospitalization in addition to supportive care. The mean hospital stay was 4.3 days. More than 90% of all 142 patients recovered, about 8% with local abscesses. Mortality was 2.9% and occurred as a result of complications, including renal failure, respiratory failure, and disseminated intravascular coagulation.

Adolescent↗

PubMed1985

Studies on the biology of Simuliidae (Diptera) at the Santiago onchocerciasis focus in Ecuador, with special reference to the vectors and disease transmission.

A survey showed the presence of seven simuliid species in the onchocerciasis focus in Ecuador Simulium exiguum and S. quadrivittatum were the two most common anthropophilic species and were shown to be both experimental and natural vectors of Onchocerca volvulus. S. antillarum only occasionally bit man. Observations were made on the biology of the two vector species and it was evident that S. exiguum was the primary vector of onchocerciasis in the rainy season. The relevance of these findings to the epidemiology and control of onchocerciasis in Ecuador are discussed.

Animals↗

PubMedDate not supplied

Tropical pyomyositis in eastern Ecuador.

In the ten year period 1980-1989, 97 patients were treated for tropical pyomyositis at Hospital Vozandes Oriente in eastern Ecuador, accounting for 2.2% of surgical admissions. Operation records from an affiliated hospital in Quito showed that, high on the Andean plateau, pyomyositis accounted for only 0.1% of surgical admissions. Among the patient population of Ecuador's eastern tropical rain forest, persons who were members of an indigenous ethnic group were affected with pyomyositis twice as often as would be expected from their representation in the general population.

Abscess↗

PubMed2005

Survey on porcine trichinellosis in Ecuador.

A survey on porcine trichinellosis was organised in Ecuador between 2000 and 2003. Blood samples were taken in slaughterhouses (study 1, n=2000; study 2, n=331) and in a remote village where pigs are free roaming (study 3, n=646) and examined by ELISA using excretory/secretory (E/S) antigens. Seven samples (0.35%) in study 1 and none of the samples of study 2 were serologically positive. Thirty-seven (5.72%) village pigs tested positive by E/S ELISA in study 3. Sero-positive results by the E/S ELISA in study 1 were confirmed by ELISA using beta-tyvelose antigen, and by immunoblot. Muscle samples taken from pigs slaughtered in the abattoir (study 2) and from animals that showed a positive serology in study 3 were examined by trichinoscopy and artificial digestion. These techniques failed to demonstrate the presence of muscle larvae. The results of this survey need confirmation, but suggest that Trichinella is present in Ecuador; however, prevalence and parasite burdens are likely to be very low. The likelihood of detecting trichinellosis are higher in traditional settings than in pigs raised on improved farms.

Animals↗

PubMed2026

Genome-wide SNP data support species boundaries in sympatric Polylepis Ruiz & Pav. (Rosaceae) species from Bolivia and Ecuador.

Species delimitation in the South American genus Polylepis is notoriously challenging due to high morphological similarity and phenotypic plasticity, likely driven by hybridization and gene flow. Previous phylogenetic studies suggested that genetic structure aligns more strongly with geography than with taxonomy, questioning existing species concepts and hampering conservation efforts. We used double-digest RAD sequencing (ddRADseq) to generate genome-wide SNP data for 11 Polylepis species sampled across multiple localities in Bolivia and Ecuador. Population genetic analyses, phylogenetic inference, and network approaches were combined to assess whether genetic structure aligns more closely with taxonomy or geography. Morphologically defined species formed largely cohesive genetic lineages across regions, with species identity explaining substantially more genetic variation than locality. While localized admixture and reticulation were detected among closely related taxa, widespread species showed strong genetic cohesion and clear separation from congeners. Our results indicate that the sampled Polylepis species from Bolivia and Ecuador maintain distinct genetic identities despite localized signals consistent with gene flow. This genome-wide support for current taxonomy highlights Polylepis as a valuable model for studying speciation under gene flow and indicates that multiple geographic sampling will be essential in reconstructing a robust phylogeny of the genus, with important implications for conservation planning in Andean montane forests.

Bolivia↗

PubMedDate not supplied

Trypanosoma cruzi isoenzyme variability in Ecuador: first observation of zymodeme III genotypes in chronic chagasic patients.

We have analysed by multilocus enzyme electrophoresis (MLEE) at 21 genetic loci 10 Trypanosoma cruzi stocks isolated from chronic chagasic patients and 3 stocks isolated from Triatoma dimidiata collected in human habitats from the coastal part of Ecuador (all stocks isolated in August-December 1998). Isoenzyme profiles were compared to those of 4 laboratory-cloned stocks representing the major phylogenetic subdivisions of T. cruzi. This parasite's genetic variability in Ecuador proved to be considerable, even in this limited sample, since all main isoenzyme genotypes were recorded. Four stocks from patients were identical at all loci to the reference stock MNcl2 ('major clonet #39'; T. cruzi II) isolated in Chile. The 3 stocks isolated from T. dimidiata were closely related to the formerly described zymodeme I (T. cruzi I). Finally, 3 stocks from chronic chagasic patients (one with an asymptomatic form, 2 with a cardiac-digestive form) were closely related to the formerly described zymodeme III (presently not classified in either T. cruzi I or T. cruzi II). This is the first observation of this category of T. cruzi genotypes in chronic chagasic patients. In the past it was recorded only in acute patients, wild mammals and wild triatomine bugs. The epidemiological implications of these results are discussed.

Adult↗

PubMed2003

Treatment and control of arterial hypertension in a rural community in Ecuador.

Cardiovascular diseases are widespread in developing countries, but little is known about cardiovascular risk profiles in rural communities. To assess the importance of arterial hypertension in a rural district of Ecuador, we screened 4284 of the 8876 adults who lived in the area. 1542 (36%) individuals had hypertension, only four (0.3%) of whom were well controlled by treatment. We monitored all deaths for 2.5 years, and noted that cardiovascular diseases were the primary cause of death in the adult population. Furthermore, of the individuals who died of a cardiovascular disease, four out of five had a history of hypertension. Our findings indicate that in this rural area of Ecuador the high prevalence of uncontrolled hypertension is a major cause of total mortality.

Adult↗

PubMed2003

[Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador].

OBJECTIVE: To determine the duration of the outpatient diagnostic process for lung cancer in comparison to that of other solid organ tumors/all tumors at the National Oncology Institute-Society to Fight Cancer (ION-SOLCA) of Ecuador. PATIENTS AND METHODS: All patients with non-small cell lung cancer (NSCLC) seen between January 1 and December 31, 1995 at the ION-SOLCA, a specialized tertiary care hospital in Guayaquil, Ecuador, were studied. The duration of the patients' diagnostic process was compared to that of other patients with solid organ tumors (1 control per NSCLC patient). DESIGN: Retrospective study of health care services to measure the duration of each stage of the diagnostic process for cancer patients at the ION-SOLCA. MEASURES: The main variable was the duration of the diagnostic process. The duration of each phase of the process was also recorded. RESULTS: Results are given as means ( standard deviations, with standard errors between parentheses). The overall duration of the diagnostic process for all solid organ tumors (lung and others) at the ION-SOLCA was 54.5 days 62.3 (7.6). No differences were detected between the duration of diagnosis for lung and other tumors. The durations of the different phases of diagnosis were as follows: from the first pre-admission contact with the hospital until a visit with a specialist, 12.5 days 11.4 (1.4); from the visit with a specialist until a diagnostic procedure, 33.3 days 57 (7); and from the diagnostic procedure until the pathological diagnosis, 8.7 days 6.9 (0.8). CONCLUSIONS: Outpatient evaluation is an inefficient, slow and potentially dangerous process in cases in which the probability of a cancer diagnosis is high. A more interventionist process involving hospital admission may accelerate diagnosis in such cases.

Cancer Care Facilities↗

PubMed2000

Assessing survey measures of infant birth weight and birth size in Ecuador.

The purpose of this study was to assess the utility of using maternal assessments of infant birth size as proxy measures for birth weight in Ecuador, a country in which a sizeable proportion of births take place at home, where birth weight is typically not recorded. Four thousand and seventy-eight women who experienced a live singleton birth between January 1992 and August 1994 were interviewed in the Ecuador Demographic and Maternal-Child Health Survey. All women were asked if their child was weighed at birth, his/her weight, and what they considered to be his/her birth size relative to other newborns. The consistency between birth size and birth weight measures was assessed, and the differences between infants with and without reported birth weights were explored. The authors conclude that maternal assessments of birth size are poor proxy indicators of birth weight. Estimates of low birth weight based on maternal assessments of birth size as very small should be recognized as underestimates of the actual prevalence of low birth weight. Moreover, infants for whom birth weights are missing should not be considered similar to those for whom weight was reported. Those without reported birth weights are more likely to be low birth weight. Thus, relying solely on reports of numeric birth weight will underestimate the prevalence of low birth weight.

Adult↗

PubMed1998

Use of family planning at first sexual intercourse among young adults in Ecuador.

The purpose of this study was to assess factors associated with the use of family planning at first sexual intercourse among young adults aged 15 to 24 in urban Ecuador. The study population consisted of 1443 young adults (494 females and 949 males) in the cities of Quito and Guayaquil, interviewed by the 1988 Ecuador Young Adult Reproductive Health Survey, who reported having experienced consensual sexual intercourse. Approximately 11% of females and 15% of males reported using contraception at first intercourse. Binary logistic regression was performed to assess jointly the effect of multiple factors on contraceptive use at first intercourse. The regression model was first run on the entire study population and then separately for males and females. In the overall population, the following variables were significantly related to using family planning at first sex: being male; being from Guayaquil; older age; father's completion of secondary school. Having lost one's virginity to a prostitute was significantly associated with non-use of family planning. Males were 3.6 times more likely than females to use family planning during their first sexual intercourse. For each year older a young adult was at first sex, his or her odds of using family planning was multiplied by a factor of 1.3. Twenty-eight per cent of males in this study experienced their first sexual intercourse with a prostitute, and these young men were highly unlikely to use family planning. A male who experienced first intercourse with his girlfriend was more than five times as likely to use contraception than a male who lost his virginity to a prostitute.

Adolescent↗

PubMed2004

Assessment of areas at increased risk for poliovirus circulation in Ecuador.

To assess areas at risk for poliovirus circulation in Ecuador, we first selected provinces at highest risk based on low immunization coverage with three doses of oral poliovirus vaccine, and a low number of reported cases of acute flaccid paralysis (AFP). Subsequently, we reviewed discharge data for the period 1996--2000 for diagnoses compatible with AFP in the only two national referral hospitals in Quito, and at least two main hospitals in each of the six selected provinces. Environmental samples from one or two cities/towns in each selected province were tested for poliovirus. Of the 14 identified AFP-compatible cases, 8 (57%) had been previously reported and investigated. We visited four out of the six unreported cases; none of those four had sequelae compatible with poliomyelitis. From the 14 environmental samples taken, we identified Sabin viruses in six of the samples; no vaccine-derived polioviruses were isolated. Using this methodology, we found no evidence of undetected poliovirus circulation in Ecuador.

Disease Outbreaks↗

PubMed2005

High infection rates of Triatoma dimidiata are associated with low levels of Trypanosoma cruzi seroprevalence in Pedro Carbo, Ecuador. Use of a tc24 gene-based PCR approach.

In control programs for vectorial transmission of Chagas' disease, conventional microscopic procedures are generally performed to determine baseline levels of infectivity of vectors. Reported here are data using Polymerase Chain Reaction in the detection of Trypanosoma cruzi in Triatoma dimidiata, one of the principal vectors of Chagas' disease in Ecuador. The microscopy and PCR techniques showed a high percentage of vector infection in Pedro Carbo, province of Guayas (Ecuador), with 44.16% and 46.13% positive insects, respectively. This contrasted with the very low Chagas seropositivity recorded (0.5%). Since T. dimidiata was the only vector of the Chagas' disease found in Pedro Carbo and looking at the vector behavior, our data suggest that despite the high T. dimidiata infection, the low Chagas seropositivity detected is closely associated with the epidemiological and ecological context of T. dimidiata in Pedro Carbo.

Animals↗

PubMed2001

Emergency medicine in Ecuador.

Emergency medical care in Ecuador is limited by geographic, economic, political, and infrastructural barriers. Afflictions of the developing world (eg, tropical infections and natural disasters) combine with ailments of the developed world (eg, trauma and cardiovascular disease) to mandate improved emergency medical systems. The nation has recently initiated FASBASE, a program dedicated to the enhancement of both prehospital and emergency department (ED) services. Furthermore, a dedicated residency program in Emergency and Disaster Medicine recently graduated its first class. Although more programs and funding are necessary to sustain the effort, Ecuador has begun to develop a modern emergency medical system.

Disasters↗

PubMed2004

Cytochrome P4501B1 mutations cause only part of primary congenital glaucoma in Ecuador.

PURPOSE: To determine the role of cytochrome P450IBI (CYP1B1) mutations in causing primary congenital glaucoma (PCG) in a cohort of Native Americans from Quito, Ecuador. MATERIALS AND METHODS: Seventeen patients with PCG from 15 Native American families were recruited from the Ophthalmology Clinic at Hospital Metropolitano, Quito, Ecuador. Experienced ophthalmologists examined all affected study subjects. Purified DNA was prepared from peripheral blood samples and CYP1B1 coding exons (exons 2 and 3) were amplified and sequenced. Southern blot was performed only on those affected patients who showed no mutations in the CYP1B1 coding exons. RESULTS: The molecular basis of PCG in two families was determined: two novel mutations (a deletion and a point mutation) and one novel polymorphism in CYP1B1 were identified in addition to a previously described single amino acid substitution. Southern blot analyses on whole genomic DNA from affected individuals in whom no mutations were identified by the direct PCR/sequencing approach did not detect any large rearrangements or mutations outside the coding region. CONCLUSION: These findings suggest that mutations in CYPIBI are not a major cause of PCG in this population and that at least one additional locus for this condition is responsible for most cases. Further, the PCG phenotype did not correlate readily with the molecular basis of the disorder, suggesting that careful clinical analysis of the phenotype cannot predict the molecular basis of the disease with accuracy.

Aryl Hydrocarbon Hydroxylases↗

PubMedDate not supplied

COL1A2 (type I collagen) polymorphisms in the Colorado Indians of Ecuador.

BACKGROUND: EcoRI, MspI and RsaI restriction fragment length polymorphisms (RFLPs) of the COL1A2 (type I collagen) gene are proving to be extremely informative markers for describing human populations; therefore they hold considerable potential for anthropogenetic research. AIM: The objective of this study was to characterize at the DNA level the Colorado Indians from Ecuador, for whom only blood group frequency information is available, and to investigate their relationships with the Cayapa-another Ecuadoran Native American group belonging to the same linguistic affiliation-and other world populations. SUBJECTS AND METHODS: Colorado Indians (n = 80) were analysed for the three anthropologically informative RFLPs of the COL1A2 gene. To better define the genetic relationship between this group and other populations, principal component analysis (PCA) was performed and genetic distances were estimated. Population genetic structure was tested through analysis of molecular variance (AMOVA) by comparing haplotype frequencies. RESULTS: COL1A2 allele and haplotype frequencies showed a certain degree of heterogeneity between the two Chibchan populations of Ecuador. The AMOVA test detected a significant level of differentiation (Fst = 0.034, p = 0.0049) between Colorado and Cayapa Indians. PC and genetic distance analyses showed a clear-cut separation between African and non-African populations; within the latter, the two Native American groups were differentiated from each other. CONCLUSIONS: The present findings suggest the presence of a low level of genetic relatedness between the Colorado and the Cayapa, despite their supposed common ethnogenesis. This confirms what has been inferred from other genetic data about the high degree of heterogeneity among Native Americans, even within the same linguistic branch, thus supporting the existence of genetic sub-structure within the central and southern American populations.

Alleles↗

PubMed2006

The metabolic syndrome among postmenopausal women in Ecuador.

BACKGROUND: The prevalence of the metabolic syndrome increases with age and after the onset of menopause, and may explain in part the apparent acceleration of cardiovascular disease in postmenopausal women. OBJECTIVE: To determine the prevalence of metabolic syndrome and related risk determinants among postmenopausal women in Ecuador. METHODS: Postmenopausal women >or=40 years of age, non-users of hormone therapy and with an intact uterus, were asked to participate in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador. Sociodemographic data, waist circumference and blood pressure measurements were recorded, and a fasting blood sample obtained for serum glucose and lipid profile determinations. Woman were counseled and managed according to the results. Metabolic syndrome was defined in accordance with the criteria of the Third Adult Treatment Panel (ATP III). RESULTS: Three hundred and twenty-five postmenopausal women entered the program. Mean (+/-standard deviation) age was 55.9 +/- 8.1 years, 53.5% of them were aged >or=54 years (median). The prevalence of metabolic syndrome, according to ATP III criteria, was 41.5%. Using the same criteria, 38.8%, 16.6%, 56.9% and 54.2% of the women presented with hypertension, diabetes, hypertriglyceridemia and abdominal obesity, respectively. More than 40% of women determined to have hypertension or diabetes lacked knowing so. Logistic regression analysis determined that age increased the risk of presenting hypertension and diabetes (odds ratio (95% confidence interval): 2.0 (1.2-3.2) and 1.6 (0.9-3.0), respectively, p < 0.05), entities which in turn duplicated the risk of having high triglyceride levels. Sedentary women with <5 years since menopause onset were at higher risk of having abdominal obesity, which was directly related to diabetes and hypertension. CONCLUSIONS: In this postmenopausal Ecuadorian population the prevalence of the metabolic syndrome was high and its determinant factors related to age, time since menopause onset and sedentary habits. Because of the implications for cardiovascular risk, counseling programs directed toward high-risk populations should be encouraged.

Adult↗