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    Achieving high immunogenicity against poliovirus with fractional doses of inactivated poliovirus vaccine in Ecuador-results from a cross-sectional serological survey
    (Elsevier BV, 2022-07)
    Gabriel Trueba
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    Vishali Jeyaseelan
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    Lazaro Lopez
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    Bernardo A. Mainou
    ;
    Yiting Zhang
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    Item type:Publication,
    COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population
    (MDPI AG, 2021-01-27)
    Daniel Garzon-Chavez
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    Jackson Rivas-Condo
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    Adriana Echeverria
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    Jhoanna Mozo
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    <jats:p>The Bacillus Calmette–Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has a potential role in the pandemic, through the presence of homologous amino acid sequences. To identify a possible link between BCG vaccination coverage and COVID-19 cases, we used official epidemic data and Ecuadorian Ministry of Health and Pan American Health Organization vaccination information. BCG information before 1979 was available only at a national level. Therefore, projections based on the last 20 years were performed, to compare by specific geographic units. We used a Mann–Kendall test to identify BCG coverage variations, and mapping was conducted with a free geographic information system (QGIS). Nine provinces where BCG vaccine coverage was lower than 74.25% show a significant statistical association (χ2 Pearson’s = 4.800, df = 1, p = 0.028), with a higher prevalence of cases for people aged 50 to 64 years than in younger people aged 20 to 49 years. Despite the availability of BCG vaccination data and the mathematical models needed to compare these data with COVID-19 cases, our results show that, in geographic areas where BCG coverage was low, 50% presented a high prevalence of COVID-19 cases that were young; thus, low-coverage years were more affected.</jats:p>
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    Item type:Publication,
    Distribution of malignant neoplasms of the oral cavity in Ecuador: an epidemiological study from 2015 to 2019
    (Medwave Estudios Limitada, 2025-04-01)
    Karina Lalangui
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    PARISE VASCO, JUAN MARCOS
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    REYTOR GONZÁLEZ, CLAUDIA MARÍA
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    Evelyn Frías-Toral
    Introduction Malignant neoplasms of the oral cavity represent a public health problem worldwide with an increasing incidence, especially in young populations. In Ecuador, the epidemiology of these conditions has been little studied, limiting timely diagnosis and management. The study aims to identify the distribution of hospitalizations and deaths from oral cavity malignant neoplasms in Ecuador during the pre-pandemic years, from 2015 to 2019, describing spatiotemporal patterns by province, gender, and age. Methods An observational and descriptive study was conducted using the database of hospitalizations and deaths of the National Institute of Statistics and Census of Ecuador. Variables such as age, gender, province, and location of the neoplasms were analyzed, and frequencies, proportions, and crude rates were calculated. Results Between 2015 and 2019, 4444 hospitalizations and 726 deaths were reported, with a notable increase in 2019. Males predominated in all the studied years. Malignant neoplasms of unspecified sites and other sites of the tongue had the highest frequency of cases and deaths. Geographically, the provinces of Loja, El Oro, Cañar, Carchi, and Bolivar had the highest rates. Conclusions The study shows an increase in hospitalizations and deaths due to malignant neoplasms of the oral cavity between 2015 and 2019, highlighting the urgency of implementing public health strategies aimed at prevention, early detection, and timely treatment of this disease.
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    Spatial Variation in Excess Mortality in Mexico during the First 2 Years of the COVID‐19 Pandemic
    (Wiley, 2024-01)
    Christian Sánchez-Carrillo
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    Giovanna Santana Castañeda
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    Marcela Virginia Santana Juárez
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    Teerachai Amnuaylojaroen
    Background. Excess mortality from all causes is a reliable indicator of the direct or indirect effect of the COVID-19 pandemic. This study aimed to estimate excess deaths in Mexico during the first 2 years of the COVID-19 pandemic and to examine the spatial and temporal variations in relative excess mortality at the subnational level. Materials and Methods. This ecological study was based on publicly available governmental data and compared 2020–2021 total deaths with the average number of deaths in 5 previous years. The relative excess mortality was then analyzed as a function of time (waves) and space (distribution maps). Results. Between January 1, 2020 and December 31, 2021, Mexico recorded 2,136,611 deaths out of 1,385,240 expected deaths, representing 751,371 excess deaths (95% CI: 709,948.267–792,793.732). During this period, we identified three waves of excess deaths, the second being the most severe, with 109,846 more deaths than expected. When examining each wave, spatial variation in relative excess mortality was identified, with all 32 states experiencing more deaths than expected (values > 0%). However, in Mexico City, Tlaxcala and Queretaro recorded values greater than 100% at different times. Conclusions. During the first 2 years of the COVID-19 pandemic (2020–2021), the number of deaths increased excessively in the 32 states. The spatial variation in relative excess mortality in each observed wave demonstrated that the response to the effects of the pandemic in Mexico differed due to various factors, such as prevention measures against COVID-19, the beginning of the vaccination campaign, and pandemic fatigue which caused a certain relaxation and therefore a return of tourism, mainly in coastal areas. Therefore, it is necessary to implement equitable policies for the care of particularly affected areas.
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    Adapting for the COVID-19 pandemic in Ecuador, a characterization of hospital strategies and patients
    (Public Library of Science (PLoS), 2021-05-17)
    Daniel Garzon-Chavez
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    Daniel Romero-Alvarez
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    Marco Bonifaz
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    Juan Gaviria
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    Daniel Mero
    <jats:p>The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score &gt;70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics.</jats:p>
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    Increasing transmission of dengue virus across ecologically diverse regions of Ecuador and associated risk factors
    (Public Library of Science (PLoS), 2024-01-31)
    Leah C. Katzelnick
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    Savannah Colston
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    Thien-An Ha
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    Paulina Andrade
    The distribution and intensity of viral diseases transmitted by <jats:italic>Aedes aegypti mosquitoes, including dengue, have rapidly increased over the last century. Here, we study dengue virus (DENV) transmission across the ecologically and demographically distinct regions or Ecuador. We analyzed province-level age-stratified dengue incidence data from 2000–2019 using catalytic models to estimate the force of infection of DENV over eight decades. We found that provinces established endemic DENV transmission at different time periods. Coastal provinces with the largest and most connected cities had the earliest and highest increase in DENV transmission, starting around 1980 and continuing to the present. In contrast, remote and rural areas with reduced access, like the northern coast and the Amazon regions, experienced a rise in DENV transmission and endemicity only in the last 10 to 20 years. The newly introduced chikungunya and Zika viruses have age-specific distributions of hospital-seeking cases consistent with recent emergence across all provinces. To evaluate factors associated with geographic differences in DENV transmission potential, we modeled DENV vector risk using 11,693 Aedes aegypti presence points to the resolution of 1 hectare. In total, 56% of the population of Ecuador, including in provinces identified as having increasing DENV transmission in our models, live in areas with high risk of Aedes aegypti, with population size, trash collection, elevation, and access to water as important determinants. Our investigation serves as a case study of the changes driving the expansion of DENV and other arboviruses globally and suggest that control efforts should be expanded to semi-urban and rural areas and to historically isolated regions to counteract increasing dengue outbreaks.
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    Spatial Modeling of the Potential Distribution of Dengue in the City of Manta, Ecuador
    (MDPI AG, 2025-10-04) ; ;
    Marco Sánchez-Murillo
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    Max Cotera-Mantilla
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    Luis Loor
    In Ecuador, the transmission of dengue has steadily increased in recent decades, particularly in coastal cities like Manta, where the conditions are favorable for the proliferation of the Aedes aegypti mosquito. The objective of this study was to model the spatial distribution of dengue transmission risk in Manta, a coastal city in Ecuador with consistently high incidence rates. A total of 148 georeferenced dengue cases from 2018 to 2021 were collected, and environmental and socioeconomic variables were incorporated into a maximum entropy model (MaxEnt). Additionally, climate and social zoning were performed using a multi-criteria model in TerrSet. The MaxEnt model demonstrated excellent predictive ability (training AUC = 0.916; test AUC = 0.876) and identified population density, sewer system access, and distance to rivers as the primary predictors. Three high-risk clusters were identified in the southern, northwestern, and northeastern parts of the city, while the coastal strip showed lower suitability due to low rainfall and vegetation. These findings reveal the strong spatial heterogeneity of dengue risk at the neighborhood level and provide operational information for targeted interventions. This approach can support more efficient surveillance, resource allocation, and community action in coastal urban areas affected by vector-borne diseases.
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    The spatio-temporal dynamics of infant mortality in Ecuador from 2010 to 2019
    (Springer Science and Business Media LLC, 2022-10-01)
    Karina Lalangui
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    Karina Rivadeneira Maya
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    Christian Sánchez-Carrillo
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    Gersain Sosa Cortéz
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    <jats:title>Abstract</jats:title><jats:p>The infant mortality rate (IMR) is still a key indicator in a middle-income country such as Ecuador where a slightly increase up to 11.75 deaths per thousand life births has been observed in 2019. The purpose of this study is to propose and apply a prioritization method that combines clusters detection (Local Indicators of Spatial Association, LISA) and a monotonic statistic depicting time trend over 10 years (Mann–Kendall) at municipal level. Annual national databases (2010 to 2019) of live births and general deaths are downloaded from National Institute of Statistics and Censuses (INEC). The results allow identifying a slight increase in the IMR at the national level from 9.85‰ in 2014 to 11.75‰ in 2019, neonatal mortality accounted for 60% of the IMR in the last year. The LISA analysis allowed observing that the high-high clusters are mainly concentrated in the central highlands. At the local level, Piñas, Cuenca, Ibarra and Babahoyo registered the highest growth trends (0.7,1). The combination of techniques made it possible to identify eight priority counties, half of them pertaining to the highlands region, two to the coastal region and two to the Amazon region. To keep infant mortality at a low level is necessary to prioritize critical areas where public allocation of funds should be concentrated and formulation of policies.</jats:p>
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    Spatiotemporal trends in hospitalizations and mortality due to mental disorders in Ecuador 2014–2023. A national epidemiological study
    (Springer Science and Business Media LLC, 2025-11-24) ; ; ;
    Yekaterina Altuna
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    Daniel Simancas-Racines
    Background: Mental disorders constitute a growing public health concern, accounting for a substantial share of global morbidity and mortality. In Ecuador, despite increasing policy attention, the availability of epidemiological evidence remains limited. This study examines hospitalizations and mortality due to mental disorders (ICD-10 F00–F99) from 2014 to 2023, aiming to generate robust evidence to support informed decision-making and strengthen mental health planning within the national health system. Methods: This study analyzed data from national public-access registries. Descriptive statistics were calculated by sex, age, year, region, and province, and crude rates per 100,000 inhabitants were estimated. Spatiotemporal patterns were examined using k-means clustering and visualized through thematic maps. Results: Between 2014 and 2023, Ecuador recorded 93,680 hospitalizations and 2,281 deaths due to mental disorders, with the highest hospitalization burden observed among individuals aged 20–29 years and a notable increase among females aged 10–19. Substance use disorders predominated in men, whereas mood disorders were more frequent in women. Spatial clustering revealed distinct regional patterns, with the Sierra region, home to approximately 43% of the population, exhibiting the highest hospitalization and mortality rates, whereas the Galápagos province showed extreme temporal variability. Conclusion: Over the past decade, Ecuador has experienced a steady increase in hospitalizations and deaths associated with mental disorders. The results underscore the urgent need to strengthen community-based mental health systems, update national care models, and develop evidence-based promotion and prevention strategies.
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    Disparidades rural-urbanas en la mortalidad materna en Ecuador: Un análisis desde una perspectiva de género (2019–2021)
    La mortalidad materna es un indicador sensible de desigualdad en los sistemas de salud. En Ecuador persisten marcadas brechas sociales entre zonas rurales y urbanas, acentuadas por factores estructurales como el territorio, la etnicidad y el género. Este estudio analiza las disparidades rural-urbanas en la mortalidad materna entre 2019 y 2021 desde un enfoque interseccional y de derechos humanos. Se utilizaron datos oficiales del Ministerio de Salud Pública e INEC, así como herramientas de análisis estadístico y georreferenciación. Los hallazgos evidencian razones de mortalidad materna más elevadas en el área rural, provincias fronterizas y especialmente entre mujeres racializadas y de edades avanzadas. Se concluye que los sistemas de salud deben contemplar recursos e inversión en estas áreas y grupos, así como las operaciones logísticas y de comunicación necesarias para una oportuna atención prenatal.