[Tuberculosis mortality in Ecuador].
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BACKGROUND: Driven by accelerating transformation of land use in the Amazon, studies addressing the impacts of deforestation and mercury (Hg) leaching on the geophysical, biological, social, health, economic and political systems of Amazonian countries are crucial to evaluate the population health risks of these rapid changes. METHODS: We used an ecosystem approach, integrating Hg measurements with socio-cultural and politico-economic elements, to provide an integral analysis and comprehensive solutions. RESULTS: Our interdisciplinary research in the Ecuadorian Andean Amazon has shown that comestible fish and riparian communities which rely on fish as a major protein source have mercury levels that could potentially cause subtle but deleterious population health alterations. A parallel study identified deforestation and soil erosion as a significant source of mercury to the aquatic ecosystem. INTERPRETATION: The analysis of these results in conjunction with the prevailing socio-cultural and politico-economic context allowed us to identify economic trends, and especially petroleum exploitation, as pivotal in the deforestation/mercury-exposure dynamic. In collaboration with public health authorities, we shared our results with local health stakeholders, including public health care staff, federal government agencies, researchers and local communities, in such a way as to promote sustainable land use practices and the nutritional benefits of fish eating while reducing toxic exposures.
The surveillance of prevalent Leishmania and sand fly species in endemic areas is important for prediction of the risk and expansion of leishmaniasis. In this study, we developed a polymerase chain reaction (PCR)-based method for detection of Leishmania minicircle DNA within individual sand flies. Using this method, we detected minicircle DNA in 6 (3.3%) of 183 sand flies, while 5 (3.5%) of 143 were positive for Leishmania promastigotes in the same areas by microscopic examination. The species were identified as Leishmania (Leishmania) mexicana by nucleotide sequencing of the cytochrome b gene. Additionally, all the Leishmania-positive sand flies were identified as Lutzomyia ayacuchensis by the restriction enzyme digestion of the PCR-amplified 18S ribosomal RNA gene fragments. Since this combined method is relatively easy and can process a large number of samples, it will be a powerful tool for the rapid identification of prevalent sand fly and Leishmania species as well as monitoring the infection rate in sand fly populations in endemic areas.
Allele frequency data for the STR systems CSFaPO, TPOX, TH01, D13S317, D16S539, D5S818, and D7S820 were determined in a population sample of unrelated, healthy Amerindian Kichwa individuals. All loci met Hardy-Weinberg expectations, and there was no evidence for association of alleles among the seven loci.
Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.
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Previous studies in developing countries have demonstrated post-disaster stress disorders in a substantial share of the people living through a natural calamity, but questions have remained as to the severity of these mental health problems. This article reports information derived from a 1987 study of Ecuadorian earthquake victims that shows many of the victims had diagnosable psychiatric disorders and provides insight into the nature of those disorders.
Mini mental state tests (MMS) were administered to 227 adults over the age of 40 years living in an Ecuadorian urban Andean community known to be an endemic zone for Taenia solium taeniasis and cysticercosis. The overall prevalence of cognitive impairment was 8.4% (19/227). The prevalence of cognitive impairment was 23.5% (8 cases) in adults over 75 years (n=34). The Hachinski ischemic score for vascular dementia was abnormal in 4 of the 19 adults (21%) exhibiting cognitive impairment. This survey highlighted a high prevalence of dementia in comparison with industrialised countries. Parasitic encephalopathy that was present in one out of five persons in this Andean community could play a part in early damage of cognitive function.
Wound botulism results from colonization of a contaminated wound by Clostridium botulinum and the anaerobic in situ production of a potent neurotoxin. Between 1943, when wound botulism was first recognized, and 1990, 47 laboratory-confirmed cases, mostly trauma-associated, were reported in the United States. Since 1990, wound botulism associated with injection drug use emerged as the leading cause of wound botulism in the United States; 210 of 217 cases reported to the Centers for Disease Control and Prevention between 1990 and 2002 were associated with drug injection. Despite the worldwide distribution of Clostridium botulinum spores, wound botulism has been reported only twice outside the United States, Europe, and Australia. However, wound botulism may go undiagnosed and untreated in many countries. We report two cases, both with type A toxin, from the Ecuadorian rain forest. Prompt clinical recognition, supportive care, and administration of trivalent equine botulinum antitoxin were life-saving.
A clinical and serological epidemiological study done on a yaws focus in the Santiago Basin area, province of Esmeraldas, showed a prevalence of 11.3% for active clinical lesions and a seropositivity of 94.9%. The Rio Santiago was hyperendemic for yaws (prevalence, 17.9%; seropositivity, 98.0%) while Rio Zapallito was found to be mesoendemic and the Rio Cayapas and Rio Onzoles hypoendemic. Active and latent evidence of yaws was found only in the black race. Children, ages 5-12 year, were found to have the highest incidence (55.8%) of clinical lesions, with the majority found on the legs (64.2%). Papilloma was the most prevalent lesion (55.4%). Mass treatment of the basin using benzathine penicillin G was done according to WHO recommendation.
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