QUENTIN, EMMANUELLE

Preferred name

QUENTIN, EMMANUELLE

Main Affiliation

Facultad de Ciencias de la Salud Eugenio Espejo

CISPEC - Centro de Investigación en Salud Pública y Epidemiología Clínica

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ORCID

0000-0001-5600-2361

Scopus Author ID

6701484398

Now showing 1 - 10 of 14

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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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QUENTIN, EMMANUELLE
<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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Disparidades rural-urbanas en la mortalidad materna en Ecuador: Un análisis desde una perspectiva de género (2019–2021)
(2025)
SÁNCHEZ VERDUGA, SAMI GABRIELA
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IZURIETA GUEVARA, MÓNICA GIOCONDA
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LALANGUI VIVANCO, KARINA DEL ROCÍO
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QUENTIN, EMMANUELLE
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NÚÑEZ VÁSQUEZ, CRISTINA ELIZABETH
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.
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The spatiotemporal evolution of homicides in Ecuador from 2015 to 2022
(Universidad de Alicante Servicio de Publicaciones, 2025-07-23)
LALANGUI VIVANCO, KARINA DEL ROCÍO
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Christian Sánchez-Carrillo
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QUENTIN, EMMANUELLE
In recent years, the homicide rate in Ecuador has displayed a particularly worrying increase. Therefore, this study seeks to identify the spatial and temporal patterns of homicides in Ecuador from 2015 to 2022. Using official data and combining spatial analysis techniques, the aim is to gain a better understanding of the extent of the phenomenon. On a regional level, Ecuador has relatively high homicide rates and excess risk compared to other countries. Within the country, 74% of homicides occur in the coastal region and 21% in the highlands. The 20-29 age group is most affected (34%), 88% of whom are men. Furthermore, the homicide rate has increased dramatically, from around 6 to 8 per 100,000 inhabitants per year to 25 per 100,000 inhabitants in 2022. Spatiotemporal analysis on a more local administrative level (cantons) makes it possible to focus on the most critical municipalities. The problem of deteriorating socio-economic conditions and increasing violence is widespread in Latin America and seriously affects public health indicators, so it is important to understand the dynamics of homicides on a local, regional and global level.
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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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QUENTIN, EMMANUELLE
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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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QUENTIN, EMMANUELLE
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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 >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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QUENTIN, EMMANUELLE
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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)
LALANGUI VIVANCO, KARINA DEL ROCÍO
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QUENTIN, EMMANUELLE
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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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Space–time distribution of intestinal infectious diseases and their association with socioeconomic variables in Ecuador
(Frontiers Media SA, 2024-07-10)
LALANGUI VIVANCO, KARINA DEL ROCÍO
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Max Cotera-Mantilla
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Marco Sánchez-Murillo
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Alex Carrera-Alvarez
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Mónica Duque-Cuasapaz
Intestinal infectious diseases are a global concern in terms of morbidity, and they are closely linked to socioeconomic variables such as quality of life, weather and access to healthcare services. Despite progress in spatial analysis tools and geographic information systems in epidemiology, studies in Ecuador that evaluate temporal trends, specific geographic groups, and their correlation with socioeconomic variables are lacking. The absence of such information makes it challenging to formulate public health policies. This study sought to identify the spatial and temporal patterns of these diseases in Ecuador, along with their correlation with socioeconomic variables. In Ecuador, the study was carried out in a continental territory, focusing on data related to intestinal infectious diseases collected from the National Institute of Statistics and Census (Instituto Nacional de Estadística y Censos) during the period from 2014 to 2019. This study involved spatial and temporal analyses using tools such as the global Moran’s index and Local Indicators of Spatial Association to identify spatial clustering patterns and autocorrelation. Additionally, correlations between morbidity rates and socioeconomic variables were examined. During the investigated period, Ecuador registered 209,668 cases of these diseases. Notable variations in case numbers were identified, with a 9.2% increase in 2019 compared to the previous year. The most impacted group was children under 5 years old, and the highest rates were centered in the southern and southwestern regions of the country, with Limón Indanza and Chunchi being the cantons with the highest rates, notably showing a significant increase in Limón Indanza. Additionally, there were significant correlations between morbidity rates and socioeconomic variables, school dropout rates, low birth weight, and access to water services. This study emphasizes the importance of considering socioeconomic variables when addressing these diseases in Ecuador. Understanding these correlations and geospatial trends can guide the development of health policies and specific intervention programs to reduce the incidence in identified high-risk areas. More specific research is needed to understand the underlying causes of variability in morbidity and develop effective prevention strategies.
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Space-time dynamics of COVID-19 mortality in Mexico from 2020 to 2022; Dinámica espaciotemporal de la mortalidad por COVID-19 en México de 2020 a 2022
(Instituto de Geografia, UNAM, 2025-03-27)
Christian Ivan Sánchez Carrillo
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Giovanna Santana Castañeda
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QUENTIN, EMMANUELLE
Este estudio analiza la dinámica espaciotemporal de la mortalidad por COVID-19 en México entre marzo de 2020 y diciembre de 2022, mediante el cálculo de la serie temporal de muertes mensuales y la estimación de las tasas crudas de mortalidad por COVID-19 de 2020, 2021 y 2022 a nivel de municipio. Además, se emplea la estadística de exploración espaciotemporal para identificar conglomerados de alta mortalidad. Se identificaron cinco olas de mortalidad por COVID-19. La segunda ola, ocurrida entre noviembre de 2020 y junio de 2021, fue la más severa, alcanzando su pico máximo en enero de 2021 con 39 151 decesos. La distribución espacial de las tasas en 2020 y 2021 resultó heterogénea, mientras que en 2022 el 87.05% de los municipios (2139) registraron las tasas más bajas (≤ 33 por cada 100 000 habitantes). La estadística de exploración detectó 19 conglomerados espaciotemporales de muertes por COVID-19, el más probable se agrupó al norte de la Ciudad de México, que registró 9400 más muertes de las esperadas y el riesgo relativo más alto (RR=3.61). Los hallazgos revelan la localización de poblaciones en riesgo durante el periodo crítico de la pandemia en México, y proporcionan información útil para priorizar la asignación de recursos. Además, permiten prever el desarrollo de bases de datos y herramientas de análisis con el fin de mejorar la prevención y las intervenciones destinadas al control y la vigilancia de futuros brotes de enfermedades infecciosas y pandemias.

QUENTIN, EMMANUELLE

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