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PubMed2003

Characteristics of clinical Helicobacter pylori strains from Ecuador.

In Ecuador, Helicobacter pylori infections are highly prevalent. A total of 42 H. pylori clinical isolates from 86 patients attending the outpatient clinic of the gastroenterology department of the university hospital of Guayaquil in Ecuador were characterized. Their susceptibility, and cagA and vacA status were determined. Resistance to metronidazole and clarithromycin was found in 80.9% and 9.5% of strains, respectively. Neither amoxicillin- nor tetracycline-resistant strains were found. The most prevalent genotype was the cagA(+), vacA s1b,m1 type. This genotype was associated with gastric cancer and peptic ulcer. Typing by random amplified polymorphic DNA showed no genetic relationship among the strains.

Drug Resistance, Bacterial↗

PubMed1997

Outcome of pediatric intensive care at six centers in Mexico and Ecuador.

OBJECTIVE: To improve understanding of the causes of morbidity and mortality among critically ill children in the countries studied. DESIGN: Survey of hospital records between 1992 and 1994. SETTING: Six pediatric intensive care units (ICUs) (four ICUs in Mexico City and two ICUs in Ecuador). PATIENTS: Consecutive patients (n = 1,061) admitted to the units studied. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The mortality rate for low-risk patients (pediatric Risk of Mortality [PRISM] score of < or = 10, n = 701) was more than four times the rate predicted by the PRISM score (8.1% vs. 1.8%, p < .001), with an additional 11.3% of this group incurring major morbidity. The mortality rate for moderate-risk patients (PRISM scores of 11 to 20, n = 232) was more than twice predicted (28% vs. 12%, p < .001). For low-risk patients, death was significantly associated with tracheal intubation, central venous cannulation, pneumonia, age of < 2 months, use of more than two antibiotics, and nonsurgical diagnosis (after controlling for PRISM score). Central venous cannulation and tracheal intubation in the lower-risk groups were performed more commonly in units in Mexico than in one comparison unit in the United States (p < .001). CONCLUSIONS: For six pediatric ICUs in Mexico and Ecuador, mortality was significantly higher than predicted among lower-risk patients. Tracheal intubation, central catheters, pneumonia, sepsis, and nonsurgical status were associated with poor outcome for low-risk groups. We speculate that reducing the use of invasive central catheters and endotracheal intubation for lower-risk patients, coupled with improved infection control, could lower mortality rates in the population studied.

Child, Preschool↗

PubMed1984

Planning for rural community health nursing needs: the experience of Ecuador.

One of the most prevalent and enduring health care delivery problems in the Third World and less developed countries is the lack of skilled medical personnel. This is particularly true in Ecuador where there are serious deficiencies at the community health level. This paper describes the health problems which have resulted from this situation. A planning model is then presented which Ecuador is beginning to follow for improving its rural community health nursing capabilities. Other countries or developing regions with similar problems might consider the model and its implementation in resolving their own community health problems.

Community Health Nursing↗

PubMed2006

Genetic and other diseases in the pottery of Tumaco-La Tolita culture in Colombia-Ecuador.

The people of Tumaco-La Tolita culture inhabited the borders of present-day Colombia and Ecuador. Already extinct by the time of the Spaniards arrival, they left a huge collection of pottery artifacts depicting everyday life; among these, disease representations were frequently crafted. In this article, we present the results of the personal examination of the largest collections of Tumaco-La Tolita pottery in Colombia and Ecuador; cases of Down syndrome, achondroplasia, mucopolysaccharidosis I H, mucopolysaccharidosis IV, a tumor of the face and a benign tumor in an old woman were found. We believe these to be among the earliest artistic representations of disease.

Colombia↗

PubMed1994

Frontier migration as a multi-stage phenomenon reflecting the interplay of macroforces and local conditions: the Ecuador Amazon.

"This paper considers frontier migration to the Ecuador Amazon as a multistage phenomenon, examining the entire migration stream from its origins in highland and coastal locales of Ecuador, to intermediate stops outside and within the Amazon, to final Amazon destinations. The approach is one where models pertaining to regional development, migration, and pioneer activity are treated as complementary to one another and meshed with a qualitative knowledge of place. It is shown that frontier settlement patterns reflect the composite of these models, a maturing space-economy, and the interaction of local characteristics with exogenous circumstances representing national and international contexts."

Americas↗

PubMed1995

Yaws in Ecuador: impact of control measures on the disease in the Province of Esmeraldas.

OBJECTIVES: To determine the impact of a community-based programme of yaws control in Esmeraldas province in Ecuador. METHODS: Community health workers provided mass treatment and subsequent surveillance for the detection and treatment of new cases and their contacts over the period 1988 to 1993. Clinical and serological surveys were performed in the study area in 1988 and 1993. RESULTS: Over the 5 year observation period, the number of communities with active infections had decreased by 75%, from 20 communities in 1988 to 5 in 1993. In 1993, 4 communities were found free of clinical infections as well as latent infections. There was a corresponding decrease of 94.6% in the prevalence of dermal lesions (from 11.2% to 0.6%), and a reduction of 97.3% in latent infections (from 93.6% to 2.5%). CONCLUSIONS: The control of yaws using existing community-based health workers has proved very effective in Ecuador.

Adolescent↗

PubMed2001

Diversity in the rhizobia associated with Phaseolus vulgaris L. in Ecuador, and comparisons with Mexican bean rhizobia.

Common beans (Phaseolus vulgaris L.) have centers of origin in both Mesoamerica and Andean South America, and have been domesticated in each region for perhaps 5000 years. A third major gene pool may exist in Ecuador and Northern Peru. The diversity of the rhizobia associated with beans has also been studied, but to date with an emphasis on the Mesoamerican center of origin. In this study we compared bean rhizobia from Mexico and Andean South America using both phenotypic and phylogenetic approaches. When differences between the rhizobia of these two regions were shown, we then examined the influence of bean cultivar on the most probable number (MPN) count and biodiversity of rhizobia recovered from different soils. Three clusters of bean rhizobia were distinguished using phenotypic analysis and principal-component analysis of Box AIR-PCR banding patterns. They corresponded principally to isolates from Mexico, and the northern and southern Andean regions, with isolates from southern Ecuador exhibiting significant genetic diversity. Rhizobia from Dalea spp., which are infective and effective on beans, may have contributed to the apparent diversity of rhizobia recovered from the Mesoamerican region, while the rhizobia of wild Phaseolus aborigineus from Argentina showed only limited similarity to the other bean rhizobia tested. Use of P. vulgaris cultivars from the Mesoamerican and Andean Phaseolus gene pools as trap hosts did not significantly affect MPN counts of bean rhizobia from the soils of each region, but did influence the diversity of the rhizobia recovered. Such differences in compatibility of host and Rhizobium could be a factor in the poor reputation for nodulation and N2 fixation in this crop.

Colony Count, Microbial↗

PubMed2006

Leishmania isoenzyme polymorphisms in Ecuador: relationships with geographic distribution and clinical presentation.

BACKGROUND: Determinants of the clinical presentation of the leishmaniases are poorly understood but Leishmania species and strain differences are important. To examine the relationship between clinical presentation, species and isoenzyme polymorphisms, 56 Leishmania isolates from distinct presentations of American tegumentary leishmaniasis (ATL) from Ecuador were analyzed. METHODS: Isolates were characterized by multilocus enzyme electrophoresis for polymorphisms of 11 isoenzymes. Patients were infected in four different ecologic regions: highland and lowland jungle of the Pacific coast, Amazonian lowlands and Andean highlands. RESULTS: Six Leishmania species constituting 21 zymodemes were identified: L. (Viannia) panamensis (21 isolates, 7 zymodemes), L. (V.) guyanensis (7 isolates, 4 zymodemes), L. (V.) braziliensis (5 isolates, 3 zymodemes), L. (Leishmania) mexicana (11 isolates, 4 zymodemes), L. (L.) amazonensis (10 isolates, 2 zymodemes) and L. (L.) major (2 isolates, 1 zymodeme). L. panamensis was the species most frequently identified in the Pacific region and was associated with several clinical variants of cutaneous disease (CL); eight cases of leishmaniasis recidiva cutis (LRC) found in the Pacific highlands were associated with 3 zymodemes of this species. Mucocutaneous leishmaniasis found only in the Amazonian focus was associated with 3 zymodemes of L. braziliensis. The papular variant of CL, Uta, found in the Andean highlands was related predominantly with a single zymodeme of L. mexicana. CONCLUSION: Our data show a high degree of phenotypic variation within species, and some evidence for associations between specific variants of ATL (i.e. Uta and LRC) and specific Leishmania zymodemes. This study further defines the geographic distribution of Leishmania species and clinical variants of ATL in Ecuador.

Adult↗

PubMed2003

Identification of endotrypanum species from a sloth, a squirrel and Lutzomyia sandflies in ecuador by PCR amplification and sequencing of the mini-exon gene.

PCR amplification and nucleotide sequencing of the mini-exon gene revealed that four strains isolated from a sloth (Choloepus hoffmanni), a squirrel (Sciurus granatensis) and two sandflies (Lutzomyia hartmanni) in Ecuador were indistinguishable from Endotrypanum monterogeii. Another strain isolated from Lu. hartmanni showed the high sequence similarity to E. schaudinni. Since three of these strains have been previously identified as Leishmania (Viannia) equatorensis, the results demonstrate that L. (V.) equatorensis is genetically closely related to the genus Endotrypanum. The present study also indicates that Endotrypanum species are distributed in arboreal animals and sandflies in Ecuador, and that mini-exon gene amplification is useful for epidemiological studies of Leishmania and Endotrypanum in the New World.

Animals↗

PubMed1998

Science, nature, and tradition: the mass-marketing of natural medicine in urban Ecuador.

In the past 15 years, "natural" medicine has become increasingly popular in the southern Ecuadoran city of Cuenca. Natural medicine products, which are distinct from traditional herbal remedies, are commercially packaged and processed and sold in a number of retail outlets in the central shopping district. This article discusses the results of field research to determine the client base of natural medicine and the reasons for its growing popularity among the poorer classes in Ecuador. Using an interpretative framework that posits that medical products carry symbolic messages, I discuss the ways in which important themes of modern life in Ecuador are played out in the packaging and marketing of these products. This research supports the growing body of literature that argues against a medical-systems approach to analyzing medical plurality by highlighting the multiple ideologies found in Ecuadoran beliefs about commercial natural medicine.

Commerce↗

PubMed2004

Satellite change detection analysis of deforestation rates and patterns along the Colombia-Ecuador border.

This study uses Landsat satellite data to document the rates and patterns of land-cover change along a portion of the Colombia-Ecuador border during a 23-yr period (1973-1996). Human colonization has resulted in extensive deforestation in both countries. Satellite change detection analysis showed that the annual rates of deforestation were considerably higher for the Colombian side of the border. In addition, loss of forest cover on the Colombian side for the study period was almost 43%, while only 22% on the Ecuadorian side. The study found that there is no single factor driving deforestation on either side of the border, but concluded that the higher rates on the Colombian side may be due to higher colonization pressures and intensification of illegal coca cultivation. On the Ecuador side of the border the satellite images documented patterns of deforestation that reflected road networks associated with oil exploration and development.

Agriculture↗

PubMedDate not supplied

Cytological and isoenzyme analysis of the Bucay and Quevedo cytotypes of the Onchocerciasis vector Simulium exiguum (Diptera: Simuliidae) in Ecuador.

Four cytotypes of Simulium exiguum occur in Ecuador, where this morphospecies is the primary vector of onchocerciasis. In this paper, we give the first full description of the banding pattern of the larval polytene chromosomes of the Quevedo cytotype and assess its degree of genetic separation from the Bucay cytotype. Both cytotypes differ from the chromosomal standard sequence (of the Cayapa cytotype) by the fixed inversions IIL-5 and IIL-6. The Quevedo cytotype additionally differs from the standard and Bucay cytotypes by possessing a differentiated X chromosome, which is indicated by the inversion IIS-A. As the degree of reproductive isolation between the Bucay and Quevedo cytotypes has not yet been established, they must be regarded as intraspecific variants of the same species. In fact, isoenzyme characterizations showed that the Bucay and Quevedo cytotypes are differentiated only to the extent expected of incipient species or geographical populations. Moreover, the sibling species status previously given to the Bucay cytotype needs be reassessed, there being inadequate analysis from areas in Ecuador where Bucay occurs in sympatry with the standard Cayapa cytotype. No isoenzyme electromorphs were discovered that identified all or most adult females of any one (cytotypepure) collection.

Animals↗

PubMed1999

Epidemiology of Chagas disease in Ecuador. A brief review.

Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i) persistence of Trypanosoma cruzi transmission in already known foci; (ii) a marked endemicity in some urban areas of Guayaquil; and (iii) the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus), but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai). Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa). High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions.

Animals↗

PubMed2000

Epidemiology of malaria in the Amazon basin of Ecuador.

Malaria is reemerging in most endemic countries of South America. In Ecuador, malaria is endemic on the Pacific coast, in the inter-Andean valleys, and in the Amazon River basin. In the Lower-Napo region of northeastern Ecuador, malaria was considered eliminated in the 1970s, but the disease has reemerged in recent years. Three organizations are involved in malaria-related work in the area, but they are not coordinating their efforts. This study was designed to describe the epidemiology of malaria incidence in the Lower-Napo region for the period of January 1992 through December 1995, and to determine the extent of seasonality in transmission in the area. To determine malaria incidence, data were collected for that 4-year period from the records of the three malaria-related organizations: the office of the National Center for Malaria Eradication (NCME) in the town of Coca, the district hospital in Nuevo Rocafuerte (DHNR), and an association of community health workers called Sandi Yura. Data on climatic conditions for the same period were collected from the Ecuadorian Air Force and civil aviation authorities. During the 1992-1995 period, NCME diagnosed a total of 773 malaria cases, DHNR diagnosed 485, and Sandi Yura clinically diagnosed 859. For the 4-year period, an annual parasite index of 40.4 was found with the DHNR data, 35.8 with the Sandi Yura data, and 6.2 with the NCME data. The predominant parasite in the area was Plasmodium vivax (92% of all the cases). Twenty-eight percent of the infected persons were under 10 years old. No discernible differences between the genders were found. There was also no seasonal variation among the cases. Further research is needed in order to confirm these findings and better understand malaria transmission in the region. The study highlights the need for a closer coordination among the area's malaria-control organizations so as to have an improved understanding of malaria epidemiology and to design and implement effective control strategies.

Adolescent↗

PubMed2001

[Health of women living near oil wells and oil production stations in the Amazon region of Ecuador].

OBJECTIVE: Investigate the environmental conditions in and the state of health of women who live in rural communities surrounded by oil wells and oil production stations in the Amazon region of Ecuador. METHOD: We used a comparative cross-sectional design, classifying exposure according to the location of the communities with respect to the oil wells and production stations. Water samples from the local rivers were analyzed to determine total petroleum hydrocarbons, and a structured questionnaire was used with the head of each family in the study. The study was performed in rural communities in northeastern Ecuador from November 1998 through April 1999. The study included 9 communities in the exposed area (368 participants) and 14 communities in the unexposed area (291 participants). RESULTS: The rivers of the exposed communities showed contamination levels much above the limits acceptable for human use. Statistically significant differences between the exposed communities and the unexposed communities were found for the prevalence of skin fungi for the two weeks prior to the study (odds ratio (OR) = 1.37; 95% confidence interval (CI) = 1.01-1.86) as well as for nasal irritation (OR = 2.18, 95% CI = 1.64-2.91) and for throat irritation (OR = 1.68, 95% CI = 1.02-2.75) in the preceding 12 months. Also associated with exposure in the two preceding weeks were fatigue and the category of "other symptoms"; similarly associated with exposure in the preceding 12 months were headaches, eye irritation, earaches, diarrhea, and gastritis. CONCLUSIONS: The symptoms found among the participants in the exposed communities match the toxicity symptoms caused by oil. There is an urgent need to establish an adequate environmental control and remediation program in order to prevent unnecessary and unacceptable health hazards for these populations.

Adolescent↗

PubMed2003

[Prevalence of anaemia in schoolchildren in the Amazon area of Ecuador].

OBJECTIVE: To determine the prevalence of anemia in rural school-age children in the Amazon region of Ecuador. METHODS: We carried out a cross-sectional study during May to October 2000 in two cantons of the province of Orellana, in northeastern Ecuador, involving 626 children from 17 schools. Demographic and anthropometric data (weight and height) were collected, values for hemoglobin and for zinc erythrocyte protoporphyrin were determined, and feces samples were analyzed to check for infestation by parasites. RESULTS: The general prevalence of anemia was 16.6% among the schoolchildren; of the affected children, 75.5% of them had iron-deficiency anemia. The prevalence of moderate chronic undernutrition was 28.8% and that of serious chronic undernutrition was 9.3%. There was also a prevalence of moderate acute undernutrition of 8.4% and of severe acute undernutrition of 3.4%. Parasitic infections were very frequent (82.0%). The most common parasites were Entamoeba coli (30.3%) and Ascaris lumbricoides (25.0%). There were no relationships between the prevalence of either anemia or of iron-deficiency anemia and any of the indicators of nutrition or of parasitic infection. CONCLUSIONS: Anemia is not a serious public health problem in the population studied. Nevertheless, the high prevalence of chronic undernutrition among the children points to the need to improve their diets. The lack of association between the prevalence of undernutrition and anemia could be due to low iron bioavailability or absorption rather than insufficient intake. Studies are needed to evaluate the customary diet of this population.

Adolescent↗

PubMed2004

[Nutritional status of Naporuna children under five in the Amazon region of Ecuador].

OBJECTIVES: To assess the nutritional status of Naporuna children under five years of age from the Amazon region of Ecuador, and to identify risk factors for developing malnutrition in this population group. METHODS: A survey-based cross-sectional study was carried out in Orellana, a province in northeastern Ecuador, between June 2001 and February 2002. Household interviews were conducted in 30 communities chosen at random, and a questionnaire was used to record the following: the social and demographic characteristics and parity of mothers having children under five years of age, and the children's demographic and anthropometric characteristics, history of breastfeeding, and medical conditions suffered over the two-week period just prior to the survey. Each child was also subjected to a physical examination. Anemia was diagnosed clinically by conjunctival exam. The statistical association among variables was determined by means of the chi-square test, with use of Yates' correction and Fisher's exact test (two-tailed) when there were 5 observations or less. Risk factors for chronic malnutrition and underweight were determined by means of logistic regression. RESULTS: Overall, 189 mothers of 347 children under five were interviewed. Of these 347 children, 307 (88.5%) participated in the study. Chronic malnutrition was found in 22.8% of the children; 26.4% were underweight, and 9.8% had acute malnutrition. Moreover, 7.5% had severe chronic malnutrition; 4.9% were severely underweight, and 1.6% had severe acute malnutrition. A total of 5 children (1.6%) showed signs of both chronic and acute malnutrition. The largest prevalence of chronic malnutrition was found in the 12-23 month age group. Risk factors for chronic malnutrition that were statistically significant included living in an area without access to a road, the total number of children in the family (> or =7), and the presence of an acute respiratory infection or abdominal distension on the day the physical examination was performed. Abdominal distension and pale conjunctiva on physical examination were predictive for underweight. CONCLUSIONS: Among the Naporuna children under 5 years of age included in this study, the prevalences of acute malnutrition and underweight appeared to be higher than had been previously detected among other populations in the Amazon region. More studies on the prevalence of parasitic infections and anemia and on the feeding practices and dietary habits of indigenous communities are needed in order to better understand their nutritional intake. A program for monitoring the diet of indigenous peoples is necessary and should be established.

Child, Preschool↗

PubMed2000

Detection of dengue virus neutralizing antibodies in bats from Costa Rica and Ecuador.

Neutralizing antibodies for dengue virus serotypes 1 and 2 and serotypes 2 and 3 were detected in 1998 in 12 of 53 (22.6%) and 3 of 10 (30.0%) bats sampled in Costa Rica and Ecuador, respectively. Dengue is a consistent health problem in the two Costa Rican communities in which bats were sampled. The high percentage of bats with neutralizing antibodies to dengue virus in these two Costa Rican communities suggests that bats may become infected with dengue virus. This appears to be the case in Costa Rica and Ecuador.

Animals↗