Hemoglobinopatías en comunidades de raza negra de los ríos Cayapas y Onzoles, cantón Eloy Alfaro, provincia de Esmeraldas, Ecuador

Blood samples from 1,364 individuals of Black race, inhabitants of the area bordering the Cayapas and Onzoles rivers, located in the northwest corner of the Esmeraldas' province, were analysed for haemoglobinopathies by means of haemoglobin electrophoresis using cellulose acetate and citrate agar plates. Of the studied population, 75.7% (1,032) were found to have normal haemoglobin and 24.3% (332) had some homoglobin variant. The rnost frequent variant was Hb.AS with 84.9% (282), followed by Hb.AF 9.6% (32), Hb.SS 2.7% (9), Hb.FS 2.4% (8) and Hb.FF 0.3% (1). The highest prevalence of haemoglobinopathies (31.8%) was detected in young people, 0-9 years of age, and in those aged 10-1 9 (25.8%). A higher prevalence was found in males than females throughout the two river areas studied. On the Cayapas river, cetiain geographical areas were found to have a high prevalence of haemoglobinopathies such as in Trinidad (45.5%) and Santa María (37.9%), while on the Onzoles river the prevalence was more uniform. These findings are discussed, particularly the prevalence of the genotype Hb .SS (2.7%) and the one case (0.3%) with Hb.FF electrophoretic characteristics which requires more detailed study.Se analizaron muestras de sangre de 1.364 individuos de raza negra pura, habitantes de la ribera de los ríos Cayapas y Onzoles, norte de la provincia de Esmeraldas, para hernoglobinopatías mediante electrofóresis de hemoglobina sobre acetato de celulosa y agar de citrato. El 75,7% (1.032) de la población estudiada presenta hemoglobina normal y 24,3% (332) tienevariantes de hemoglobina. La variante más frecuente fue Hb.AS con 84,9% (282), seguida de Hb.AF 9,6% (32), Hb.SS 2,7% (9), Hb.FS 2,4% (8) y Hb.FF 0,3% (1). La prevalencia más elevada se detectó en los grupos de edad jóvenes, 0-9 años (31,8%) y 10-19 años (25,8%). Los hombres presentaron mayor prevalencia que las mujeres en los dos ríos estudiados y existen áreas geográficas características con alta prevalencia en el río Cayapas, Trinidad (45,5%) y Santa María (37,9%), mientras que en el río Onzoles la prevalencia es más uniforme. Se discuten los hallazgos encontrados, principalmente, la prevalencia del genotipo Hb.SS (2,7%) y de un caso (0,3%) con características de Hb.FF que merecen ser estudiados con más detalle

Leptospirosis in Ecuador: Current Status and Future Prospects

The location of Ecuador—an equatorial nation—favors the multiplication and dispersal of the Leptospira genus both on the Pacific Coast and in the Amazon tropical ecoregions. Nevertheless, leptospirosis epidemiology has not been fully addressed, even though the disease has been recognized as a significant public health problem in the country. The purpose of this literature review is to update knowledge on the epidemiology and geographical distribution of Leptospira spp. and leptospirosis in Ecuador to target future research and develop a national control strategy. A retrospective literature search using five international, regional, and national databases on Leptospira and leptospirosis including humans, animals, and environmental isolations of the bacteria and the disease incidence in Ecuador published between 1919 and 2022 (103 years) with no restriction on language or publication date was performed. We found and analyzed 47 publications including 22 of humans, 19 of animals, and two of the environments; three of these covered more than one of these topics, and one covered all three (i.e., One Health). Most (60%) of the studies were conducted in the Coastal ecoregion. Twenty-four (51%) were published in international journals, and 27 (57%) were in Spanish. A total of 7342 human and 6314 other animal cases were studied. Leptospirosis was a frequent cause of acute undifferentiated febrile illness in the Coast and Amazon and was associated with rainfall. All three major clusters of Leptospira—pathogenic, intermediate, and saprophytic—were identified from both healthy and febrile humans, the environment, and animals; moreover, nine species and 29 serovars were recorded over the three Ecuadorian ecoregions. Leptospira infections were diagnosed in livestock, companion, and wild animals from the Amazon and the Coast regions along with sea lions from the Galápagos Islands. Microscopic-agglutination test was the diagnostic tool most widely used. Three reviews covering national data on outpatients and inpatients determined the varied annual incidence and mortality rate, with males being more commonly affected. No human cases have been reported in the Galápagos Islands. Genomic sequences of three pathogenic Leptospira were reported. No studies on clinical ground, antibiotic resistance, or treatment were reported, nor were control programs or clinical-practice guidelines found. The published literature demonstrated that leptospirosis was and still is an endemic disease with active transmission in the four geoclimatic regions of Ecuador including the Galápagos Islands. Animal infections, distributed in mainland and insular Ecuador, pose a significant health risk for humans. Nationwide epidemiological surveys—encouraging more research on the fauna and environment with appropriate sampling design on risk factors for human and animal leptospirosis, Leptospira genotyping, increased laboratory capability, and readily available official data—are required to improve our understanding of transmission patterns and to develop effective national intervention strategies with the intention of applying One Health approaches

Genotyped indigenous Kiwcha adults at high altitude are lighter and shorter than their low altitude counterparts

Background Anthropometric measures have been classically used to understand the impact of environmental factors on the living conditions of individuals and populations. Most reference studies on development and growth in which anthropometric measures were used were carried out in populations that are located at sea level, but there are few studies carried out in high altitude populations. Objective The objective of this study was to evaluate the anthropometric and body composition in autochthonous Kiwcha permanently living at low and high altitudes. Methodology A cross-sectional study of anthropometric and body composition between genetically matched lowland Kiwcha from Limoncocha (n = 117), 230 m in the Amazonian basin, and high-altitude Kiwcha from Oyacachi (n = 95), 3800 m in Andean highlands. Student's t-test was used to analyze the differences between continuous variables, and the chi-square test was performed to check the association or independence of categorical variables. Fisher's exact test or Spearman's test was used when the variable had evident asymmetries with histograms prior to the selection of the test. Results This study shows that high altitude men are shorter than their counterparts who live at low altitude, with p = 0.019. About body muscle percentage, women at high altitudes have less body muscle percentage (− 24.8%). In comparison, men at high altitudes have significantly more muscle body mass percentage (+ 13.5%) than their lowland counterparts. Body fat percentage was lower among low altitude women (− 15.5%), and no differences were found among men. Conclusions This is the first study to be performed in two genotyped controlled matching populations located at different altitudes to our best knowledge. The anthropometric differences vary according to sex, demonstrating that high altitude populations are, in general, lighter and shorter than their low altitude controls. Men at high altitude have more muscled bodies compared to their lowland counterparts, but their body age was older than their actual age

El pian en la provincia de Esmeraldas, Ecuador

A clinical and serological epidemiological study in a yaws focus in cantón Eloy Alfaro, in the Santiago basin area of the province of Esmeraldas, showed a prevalence of 11.3% for active skin lesions and seropositivity of 94.9%. The Santiago river was found to be hyperendemic for yaws (prevalence 17.9), while the Zapallito river was rnesoendemic and the Cayapas and Onzole rivers were hypoendemic. Active and latent evidence of yaws was found only in the black race. Children, aged 5-12, were found to have the highest incidence (55.8%) of clinical lesions, the majority being found on the legs (64.2%). The most prevalent lesions (55.4%) were papilloma. Mass treatment of all positive communities, using benzathine penicillin G, was carried out according to WHO recommendations.Se realizó un estudio epidemiológico, clínico y serológico del pian en la cuenca del río Santiago, cantón Eloy Alfaro, provincia de Esmeraldas, el cual demostró una prevalencia del 11,3% con lesiones dérmicas activas y una seropositividad del 94,9%. El área del río Santiago era hiperendémica para el pian (prevalencia 17,9%; seropositividad 98,0%), mientras que el río Zapallito era mesoendémico y los ríos Cayapas y Onzole, hipoendémicos. Se encontró evidencia del pian, activa y latente, solamente en la raza negra. La mayor incidencia de las lesiones clínicas (55,8%) se encontró en los niños de 5-12 años de edad, localizándose el porcentaje superior en las piernas (64,2%). Los papilomas fueron las lesiones más frecuentes (55,4%). Se administró tratamiento masivo con penicilina benzatínica, según las normas de OMS, en todas las comunidades positivas para esta enfermedad

LAMPhimerus: a novel LAMP assay for detecting Amphimerus sp. DNA in human stool samples

[EN]Amphimeriasis, a fish-borne zoonotic disease caused by the liver fluke Amphimerus spp., is a highly prevalent parasitic infection affecting an indigenous Amerindian group, the Chachi, living in rural and remote tropical areas along the RõÂo Cayapas and its tributaries in the north-western coastal rainforest of Ecuador. Very little is known about the clinical course and treatment of this disease, and the only method for diagnosing it is the parasitological microscopic detection of eggs from Amphimerus spp. in patients' stool samples. This method lacks sensitivity, and the morphology of the eggs may be confounded with other liver and intestinal flukes. New diagnostic tools that can improve the sensitivity and specificity for diagnosing Amphimerus spp. infection would be desirable. At present, LAMP technology shows all the characteristics required of a real-time assay with simple operation for potential use in the clinical diagnosis of infectious diseases, particularly in the field conditions in developing countries for most neglected tropical diseases. In this study, we developed and successfully evaluated a LAMP assay for detecting Amphimerus sp. in human stool samples. After further validation, our LAMP assay (LAMPhimerus) could be readily adapted for effective field diagnosis and disease surveillance in amphimeriasis- endemic areas

Hematological parameters, lipid profile and cardiovascular risk analysis among genotype-controlled indigenous Kichwa men and women living at low and high altitudes

Introduction: Human adaptation to high-altitude is due to characteristic adjustments at every physiological level. Differences in lipid profile and cardiovascular risk factors in altitude dwellers have been previously explored, nevertheless there are no reports available on genotype-controlled matches among different altitude adapted indigenous populations. Objective: To explore the possible differences in plasma lipid profile and cardiovascular risk among autochthonous Kiwcha people inhabitants of low and high-altitude locations. Methodology: A cross-sectional analysis of plasmatic lipid profiles and cardiovascular risk factors in lowland Kiwchas from Limoncocha (230 m) and high-altitude Kiwchas from Oyacachi (3,800 m). Results: In the low altitude group, 66% were women (n=78) and 34% (n=40) were men, while at high altitude, 59% (n=56) were women and 41% (n=41%) were men. We found the proportion of overweight and obese individuals to be higher among low altitude dwellers (p<0.05). Red blood cells (RBC), Hemoglobin concentration and SpO2% were higher among high altitude dwellers and erythrocyte's size was found to be smaller at high altitude .The group located at low altitude showed also lower levels of plasma cholesterol, LDL and HDL but most of these differences are not influenced by gender or elevation. Conclusions: Living at altitude elicits well-known adaptive physiological changes such as erythrocyte count, hemoglobin concentration, hematocrit, and serum glucose. We report also clinical differences in the plasma lipid profile, with higher levels of cholesterol and high density and low-density lipoproteins in Andes Mountain inhabitants versus their Amazonian basin peers. Despite we found altered underlying physiological pathways between the populations, this does not allow in a different cardiovascular risk

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Background: The reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization. Objective: The objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude. Methodology: A cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3,180 m) in Andean highlands. Chi-square method was used to analyze association or independence of categorical variables, while Student's t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn't meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups. Results: People from Oyacachi (high altitude) showed a higher predicted values than those from Limonocha (low altitude). The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001). The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants. Conclusion: Residents of Oyacachi had greater lung capacity than their peers from Limoncocha, a finding physiologically plausible according to published literature. When analyzing the spirometric patterns obtained in these populations, it was evident that no person had an obstructive pattern, while on the other hand, the restrictive pattern appeared in Limoncocha and Oyacachi populations in 12.9% although it is clear that there is a predominance of this in the individuals belonging to Limoncocha