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PubMed2025

Genomic evidence of active circulation of Orthobunyavirus in Ecuador.

BACKGROUND: Between 2023 and 2025, the largest Oropouche fever epidemic recorded in history unfolded across Brazil seeding cases throughout Latin America. In 2024, three cases of Oropouche fever were reported in Ecuador. METHODS: An Oropouche fever case detected in Bolívar Province in June 2024 was preliminarily diagnosed as Oropouche virus (OROV) through RT-qPCR and was further processed using next-generation sequencing. RESULTS: Segments L and S of this virus forms a monophyly with another sequence circulating in Ecuador in April 2024 (i.e. PQ863772.1 isolate Ecuador traveler), with an uncertain province origin. Both sequences differ from previous OROV Ecuadorian sequences detected in 2016 and from the OROV strain driving the 2023-2025 epidemic in Brazil. CONCLUSIONS: Orthobunyavirus oropoucheense has an endemic circulation in Ecuador. Genomic surveillance of Orthobunyavirus in Ecuador and other regions should be actively pursued-independent of epidemics-to anticipate potential zoonotic outbreaks.

Adult↗

PubMed1992

The cholera epidemic in Ecuador: towards an endemic in Latin America.

We present an epidemiological study of the first wave of cholera in Ecuador in 1991. One month after the 7th cholera pandemic hit the Pacific coast of Peru, the disease reached the coast of Ecuador and spread to the rest of the country within a few weeks. One year later, 46,320 cases have been notified, giving an incidence of 481 cases per 100,000 inhabitants. The overall mortality rate has been low (697 deaths, i.e. 1.50%), although there have been large differences between the various provinces: in the Andes (Sierra), for example, rates above 8% have been recorded. The first wave peaked about eight weeks after the first case, with 3400 new cases per week throughout the country. This was followed by a gradual decrease towards a baseline of 250-500 new cases per week. A resurgence was observed in most coastal and Andean provinces from November 1991 onwards. The kinetics of the epidemic are compatible with an endemic implantation of the disease in Ecuador, as is probably the case in the entire intertropical Pacific coast region of Latin America. From the data presented, the latin-american episode of the 7th pandemic starting on the Pacific coast, is characterized by a very high attack rate and a low mortality rate as compared to Africa, and the unexpected involvement of populations living on the high Andean plateaux. It is probable from the results collected in Ecuador that cholera will become endemic in Latin America.

Cholera↗

PubMed1991

Primary health services in Ecuador: comparative costs, quality, and equity of care in Ministry of Health and rural social security facilities.

This study of costs, quality and financial equity of primary health services in Ecuador, based on 1985 data, examines three assumptions, common in international health, concerning Ministry of Health (MOH) and Social Security (SS) programs. The assumptions are that MOH services are less costly than SS services, that they are of lower quality than SS services, and that MOH programs are more equitable in terms of the distribution of funds available for PHC among different population groups. Full costs of a range of primary health services were estimated by standard accounting techniques for 15 typical health care establishments, 8 operated by the MOH and 7 by the rural SS program (RSSP), serving rural and peri-urban populations in the two major geographical regions of Ecuador. Consistent with the conventional premise, MOH average costs were much lower than RSSP costs for several important types of services, especially those provided by physicians. Little difference was found for dental care. The lower MOH physician service costs appeared to be attributable primarily to lower personnel compensation (only partially offset by lesser productivity) and to greater economies of scope. Several measures of the quality of care were applied, with varying results. Based on staff differences and patterns of expenditures on resource inputs, notably drugs, RSSP quality appeared higher, as assumed. However, contrary to expectation, a questionnaire assessment of staff knowledge and procedures favored the MOH for quality. Program equity was judged in terms of per capita budgeted expenditures (additional measures, such as the likelihood of receiving necessary care, would have required household survey data beyond the scope of this program-based study). The results support the assumption of greater MOH financial equity, as its program reveals less variation in budgeted expenditures between different population groups covered. Additional evidence of equity, using other indicators, would be helpful in future research. The paper's findings have policy implications not only for Ecuador's health sector but also for policy-makers in other countries at similar levels of socioeconomic development. These implications are spelled out in order to guide officials wrestling with issues of efficiency, quality, and equity as they search for the best use of scarce resources to promote health.

Costs and Cost Analysis↗

PubMed2026

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

Extended-spectrum β-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 β-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↗

PubMed1991

[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↗

PubMed1991

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↗

PubMed1991

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↗

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↗

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↗

PubMed1991

Abdominal sparganosis in Ecuador: a case report.

Sparganosis, infection with plerocercoids of the pseudophyllidean tapeworm Spirometra, rarely has been described in Ecuador. We report the details of a human case of sparganosis identified serendipitously in the course of an abdominal hernia repair. The parasite was found moving freely upon the external oblique fascia adjacent to the site of a direct abdominal hernia. The organism was recovered intact, photographed while alive and preserved for subsequent detailed morphological studies. The presumed route of entry into this patient was percutaneous, after application of a poultice of snake flesh to the site of a painful abdominal hernia. The literature on sparganosis in South America is reviewed. This is the second case of human sparganosis reported from Ecuador.

Abdominal Muscles↗

PubMed1991

[Primary health care in Ecuador: services provided by the Ministry of Health and Rural Social security Services].

The present study will examine three common premises in the field of international public health: that the primary care services offered by agencies of the Ministries of Health (MH) are less costly than those offered by Social Security institutions, that the former services are inferior to the latter, and that funds are distributed more equitably by the MH centers among their various recipient populations. The 1986 study compared the costs, quality, and equity of the services in 15 primary care centers in Ecuador--eight Ministry of Health centers and seven rural Social Security (RSS) centers--examining budgetary data from 1985 and obtaining information through a questionnaire and interviews with the personnel at those centers. Average costs were calculated by standardized accounting techniques, and it was confirmed that for several important services, especially medical consultations, these costs were much lower in the Ministry centers than in the Social Security centers. However, no differences in the cost of dental care were detected. The evaluation of quality, based on an analysis of the production structure and process, did not yield uniform results. On the one hand, the distribution of personnel and the allocation of funds for drugs and other supplies indicated that the RSS agencies provided better quality services. On the other hand, a questionnaire revealed that the MH health workers' knowledge of various principles of primary care was superior to that of the RSS workers. Upon comparing the per capita budget of the two types of entities, it was confirmed that the Ministry of Health had more equitable per capita coverage than rural Social Security. The implications of these findings for Ecuador and other developing countries are discussed and several recommendations made.

Costs and Cost Analysis↗

PubMed1989

Cost-effectiveness of routine and campaign vaccination strategies in Ecuador.

A national household coverage survey of 3697 Ecuadorean children, carried out in July 1986, provided an opportunity for a cost-effectiveness analysis of (1) routine vaccination services based in fixed facilities and (2) mass immunization campaigns. A major purpose of the campaigns was to complement the routine services and to accelerate immunization activities. Based on the coverage survey, the Program for Reduction of Maternal and Childhood Illness (PREMI) and earlier campaigns increased the proportion of children under 5 years who were fully vaccinated from 43% to 64%. In one year, the PREMI campaign was responsible for fully vaccinating 11% of children under one year, 21% of 1-2-year-old children, and 13% of all children under 5 years. The campaign also helped ensure that vaccinations were completed when children were still very young and at greatest risk. The average cost per vaccination dose (in 1985 US$ prices) was approximately $0.29 for fixed facilities and $0.83 for the PREMI campaign. Total national costs were $675,000 and $1,665,000 for routine and campaign services respectively. The cost per fully vaccinated child (FVC) was $4.39 for routine vaccination services and $8.60 for the campaign. The cost per death averted was about $1900 for routine vaccination services, $4200 for the PREMI campaign, and $3200 for the combined programme. Because of Ecuador's lower mortality rates, the costs per death averted in Ecuador from both vaccination strategies are not as low as those from studies of vaccinations in Africa. The campaigns, though less cost-effective than routine services, significantly improved the vaccination coverage of younger children who had been missed by the routine services. The costs per FVC of both the campaign and the routine services compare favourably with such programmes in other countries.

Child↗

PubMed1990

Clinical pattern and the genetics of the fetal iodine deficiency disorder (endemic cretinism): results of a field study in Highland Ecuador.

The clinical manifestations of various degrees of mental retardation, spastic diplegia, and deaf mutism are known as the neurologic type of endemic cretinism (EC), occurring in countries with high goiter endemicity. Maternal iodine deficiency has been established as the major cause in EC, whereas a genetic predisposition has not been well-documented. Genetic data on 70 families with EC from Highland Ecuador are reported. A segregation analysis of 49 fully classified families yielded an estimate of P = 0.245 (var [P] = 0.00167). Half-sibs were all unaffected and no significant birth order effect was observed among 101 probands. The data indicate an autosomal recessive predisposition as a major etiological factor. Because the neurologic type of EC represents a defined section of the spectrum of iodine deficiency disorders (IDD), the term fetal iodine deficiency disorder (FIDD) rather than cretinism is suggested. The clinical findings in 70 patients were used to delineate the minimal diagnostic criteria of FIDD.

Abnormalities, Multiple↗

PubMed1977

Genetic studies in Ecuador: acetylator phenotypes, red cell enzyme and serum protein polymorphisms of Shuara Indians.

Population genetic studies of Shuara Indians in Ecuador are performed for GPT, AP, PGM1, Ak, EsD, 6-PGD, Hp, Gc, C3, Bg, ChE, Tf, Pi, Bf phenotypes, IgG, IgA, IgM, C3, C3-proactivator, C4 levels and acetylator phenotypes. Some systems having a polymorphism in many other populations showed a lack of some of those alleles in the population under study (C3, ChE, Tf, AK and almost absent 6-PGD, Bg, Bf).

Acetylation↗

PubMed1979

Skeletal evidence for kneeling in prehistoric Ecuador.

Bony changes on the superior distal surface of the metatarsals and the superior proximal surface of the first proximal foot phalanx are described in a prehistoric skeletal sample from Coastal Ecuador. The location and morphology of the alterations, as well as their association with femoral "squatting facets" strongly suggests they were produced by prolonged hyperdorsiflexion of the toes, probably resulting from habitual kneeling posture. Comparative data are presented from five other New World skeletal samples.

Anthropology, Physical↗

PubMed2026

A cross-sectional study of genomic knowledge comfort, attitudes, ethical and educational perspectives on precision medicine among medical students in Ecuador.

BACKGROUND: Precision medicine is increasingly transforming clinical practice, yet its effective implementation depends on adequately trained healthcare professionals. OBJECTIVE: This study assessed genomic knowledge comfort, attitudes, ethical perceptions, and educational perspectives regarding precision medicine among medical students in Samborondón, Greater Guayaquil, Ecuador. METHODS: A cross-sectional survey was conducted between August and November 2025 using a structured questionnaire. A total of 340 students participated. Descriptive and inferential statistical analyses, including non-parametric tests and Spearman correlation, were performed. RESULTS: Participants demonstrated relatively high but uneven genomic knowledge comfort (median 81.3%) and positive attitudes toward precision medicine (65.6%), alongside moderate ethical (62.5%) and educational perception scores (68.8%). While students strongly recognized the importance of precision medicine, perceived preparedness remained limited. Lower confidence was observed in advanced topics such as pharmacogenomics and next-generation sequencing. Ethical concerns were more pronounced at the societal level, particularly regarding health inequities, rather than individual risks. Correlation analyses revealed generally weak associations across domains, with only a moderate relationship between ethical and educational perceptions. CONCLUSION: These outcomes highlight a gap between acceptance and readiness, suggesting fragmented competency development. Strengthening curricula through integrated, applied, and context-specific training is essential to support effective implementation of precision medicine in low- and middle-income settings.

Attitudes↗

PubMed1989

Agricultural pesticide accidents and prevention in Ecuador.

Accidents due to the misuse and abuse of agricultural pesticides is a worldwide problem. Although data gaps exist, there is an ever-growing body of information on the incidence and nature of pesticide-caused poisonings in the developing countries of the world. The information gathered in a field study in Ecuador, South America, among rural-based users of pesticides contributes to the understanding of the problem. Factors that contribute to accidental poisonings are detailed and described and are related to accident prevention efforts.

Accidents, Occupational↗

PubMedDate not supplied

Onchocerciasis in Ecuador: infection in children in the Santiago Basin focus, province of Esmeraldas.

The prevalence of onchocerciasis infection in children aged 1-12 in the Santiago Basin focus, province of Esmeraldas, Ecuador, was determined to see if active transmission of the disease had occurred in the past 6 years. An infection rate of 45.0% was found. Compared to that found in 1980 (14.5%), the infection rate had increased by 210.1%. The increase was greater on the Rio Santiago (340.5%) than on the Rio Cayapas (195.5%). An increase of 286% was seen in the skin microfilarial density in the 1-4 year age group, with a 56.8% increase in the 5-12 year age group. The prevalence of infection in children aged 0-4 years (those born since the first enquiry in 1980) was 64.3%, with an average skin microfilarial density of 12.2 microfilariae (mf)/mg and with 20% presenting nodules, of which 92.1% occurred in the head region. Of the 34 children examined aged less than one year, 25 (73.5%) were positive for microfilariae with an average microfilarial skin density of 9.6 mf/mg. These data suggest that there is active transmission of the disease in the Santiago Basin onchocercal foci.

Age Factors↗