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PubMed1988

Obligatory Social Security Law, 15 March 1988.

This Law sets forth the Obligatory Social Security Scheme in Ecuador. Among other things, it provides that an insured woman has the right during pregnancy and delivery and after birth to necessary obstetrical assistance and a monetary subsidy. Further provisions set forth other benefits under the scheme, define beneficiaries, and describe resources for the scheme. The Law also stipulates that the employer is responsible for paying for the first three days of maternity benefits.

Americas↗
PubMed1998

Demographic and socioeconomic determinants of variation in food and nutrient intake in an Andean community.

Understanding the sources of variation in a community's diet is vital for development work, as well as being a source of anthropological and cultural insights. Previous surveys in the South American Andes suggest that nutrient deficiencies may be widespread; however, such interpretations have remained tentative since variance in Andean populations' diet has not been thoroughly examined. In this paper we consider the variation in diet due to variation in age, sex, and socioeconomic status and variation attributed to inter- and intraindividual variation in the diet. One to six days of dietary data (mean = 3.1) were collected via 24 h recalls from 221 residents of a small, rural community in highland Ecuador. The contribution of various food groups to the diet varied with land holdings and age but not sex. For example, animal-derived foods contribute more and tubers contribute less to the diet of the households with > or = 5 Ha, and sweets contribute more to the diet of children. The interindividual variation in energy and nutrient intake was low and the intraindividual variation high relative to developed countries. The consequence are twofold. First, because interindividual variability is low, group mean intake can be estimated relatively easily, facilitating group comparisons. Second, because intraindividual variation is high, individual nutrient intake cannot be easily estimated, which will decrease the ability to detect associations between nutrient intake and health measures. This knowledge of the sources of dietary variation can lead to better study and survey designs in the rural Andes and elsewhere in the developing world.

Adolescent↗
PubMed1999

Genetic population structure of two African-Ecuadorian communities of Esmeraldas.

The genetic structure of two African-Ecuadorian communities, Rio Cayapas and Viche (Esmeraldas province, northwest Ecuador), was studied on the basis of ACP1, ADA, AK1, CA2, ESD, GLO1, G6PD, PGD, and PGM1 subtypes and thermostability, PGM2, HBbeta, F13A, F13B, ORM1, AHSG, C6, C7, and APOC2 gene frequency, and migration data on 255 individuals. The fixation index of Wright (F(ST)), correspondence, and genetic distance analysis were applied to compare the genetic relationships between these communities and other American populations of African ancestry. F(ST) values from the migration data and surname origins suggest that Rio Cayapas is genetically more isolated and shows less mobility and admixture than does Viche. The genetic admixture estimates indicate a large contribution of African genes to the gene pool of both communities (74.3% to 58.4%), whereas the proportion of the Amerindian component differs significantly (14.5% in Rio Cayapas to 27.6% in Viche).

Africa↗
PubMed2005

Interpopulation differences in exudate feeding of pygmy marmosets in Ecuadorian Amazonia.

Local variations in fruit- and leaf-eating have been reported for some primate species; however, similar variations in exudate-feeding of pygmy marmosets, one of the most specialized neotropical primate species, have not been studied. In our 3-year study of four populations of pygmy marmosets in northeastern Ecuador, we characterized their exudate-feeding behavior by describing the use of exudate sources. We tested whether the use of exudate species was related to ecological factors such as the availability of exudate species in an area. We estimated the daily activity budgets of the groups with 1-hr scan samples and found significant interpopulation differences in the time spent on exudate feeding. We recorded a total of 18 exudate species used in the four populations; however, the populations differed in the total number of species used and in the preferred species. The most commonly used plant species were Sterculia apetala at San Pablo, Cedrela odorata at Sacha, Inga marginata at Amazoonico, and Parkia balslevii at Zancudo. We recorded the presence and abundance of the 18 exudate species in 90-m transects in the home range of each group and in one additional control area that contained no marmosets, for each population. Differences in the most-used exudate species among populations did not appear to be related to the availability of these species in each population, i.e., the marmosets did not use at random the exudate species available within their range, nor did they use more often the exudate species that were more abundant in their home ranges. One implication of our results for conservation is that protecting exudate resources based on data from only one area will not be sufficient to preserve pygmy marmosets in all populations.

Animals↗
PubMed1985

Markers of genetic variation among the Waorani Indians of the Ecuadorian Amazon headwaters.

Until recently, the Waorani Indians of Ecuador's Amazon headwaters maintained a fierce resistance to all intruders into their territory, and as a result of their actions and reputations a population of 600 people controlled a very large territory (about 8,000 square miles). The isolation of the Waorani has resulted in a large linguistic and genetic distance from their neighbors. Our survey of red cell enzymes, immunoglobulin allotypes, and dermatoglyphics demonstrates that the Waorani are a highly inbred and homogeneous population. Of 18 red cell enzymes studied, the Waorani have a limited polymorphism for only 6. Only two Gm haplotypes (Gm1,2,17,21, Gm1,17,21) were found and 60% of those tested were homozygous for the Gm1,17,21 haplotype. All individuals were A2m (1) and 95% of these were homozygous. The Waorani's dermatoglyphic traits fell within the wide range found among other South American Indians with close affinity to the Ecuadorian Jivaro group. Despite the limitations of these genetic systems, they demonstrate that the Waorani share limited genetic traits with the neighboring Jivaro Indians and are isolated from other tribal populations in South America.

Dermatoglyphics↗
PubMed1996

The gene for the Ellis-van Creveld syndrome is located on chromosome 4p16.

Ellis-van Creveld syndrome (EVC) is an autosomal recessive disorder characterized by disproportionate dwarfism, polydactyly, and congenital heart disease. This rare disorder is found with increased frequency among the Old Order Amish community in Lancaster County, Pennsylvania. We have used linkage analysis to localize the gene responsible for the EVC phenotype in nine interrelated Amish pedigrees and three unrelated families from Mexico, Ecuador, and Brazil. We now report the linkage for the Ellis-van Creveld syndrome gene to markers on the distal short arm of human chromosome 4, with Zmax = 6.91 at theta = 0.02 for marker HOX7, in a region proximal to the FGFR3 gene responsible for the achondroplasia phenotype.

Brazil↗
PubMed1984

Pena in the Ecuadorian Sierra: a psychoanthropological analysis of sadness.

In highland Ecuador, pena refers to a state of mind characterized by a mixture of sadness and anxiety as well as to an illness state resembling depression. This paper attempts to illustrate, through an analysis of the discourse on pena, how the ideology in which it is embedded serves to interpret a bodily problem at the same time as it reflects a more global attitude toward life. In essence, the folk theory states that the physical complaints caused by suffering are the result of a disturbance of the heart, the central organ of man, and of the emotional life which it controls. Because this suffering is often attributed to the immediate family group of the victim, the community at large often formulates accusations against one of its members. Though the therapy is limited to a cure of the symptoms through herbal remedies, a formal request can be made to a perceived wrongdoer to amend his behavior. The pena is also a state which can lead to colerin, a dangerous and sometimes lethal illness which is characterized by a sudden explosion of anger or madness and which will follow an unattended state of pena.

Adjustment Disorders↗
PubMed1990

Urbanization, roads, and rural population change in the Ecuadorian Andes.

"Like many developing countries Ecuador has experienced extensive ubanization in the past twenty-five years as well as a shift in the pattern of rural population change between the 1960s and 1970s. Rural places with difficult access to cities (without roads and located far from cities) gained population during the 1960s but lost population during the 1970s. Rural places with easy access to cities (i.e., located near cities or on all-weather roads) continued to gain population during the 1970s. The explanation for the differential ability of rural places to retain their population during the 1970s focuses on increases in labor circulation by peasants and growth in the numbers of small, urban-oriented manufacturing and agricultural enterprises in accessible rural areas. The article concludes with a discussion on the implications of these findings for policies to reduce rates of rural-urban migration."

Americas↗
PubMed1997

Antibiotic prophylaxis for pit viper envenomation: prospective, controlled trial.

The efficacy of prophylactic antibiotics for preventing infectious complications at the site of pit viper envenomation has not been well studied. We undertook a prospective, controlled trial of antibiotic treatment versus no antibiotic treatment among 114 victims of crotalid envenomation in Ecuador's Amazon rain forest. A group of 59 patients received intravenous gentamicin and chloramphenicol, and 55 patients did not. All other aspects of care were identical. There were no statistically significant differences between antibiotic-treated and untreated patients with regard to demographics, delay in treatment, clinical and laboratory evidence of severity of envenomation, or use of antivenin. Nine abscesses occurred, six in the antibiotic-treated group and three in the untreated group. The results of this study did not show any statistically significant differences in outcome in terms of the number of abscesses that occurred between antibiotic-treated and untreated patients. Based on this lack of differences, routine use of prophylactic antibiotics for prevention of infectious complications of crotalid envenomation cannot be recommended.

Abscess↗
PubMed2001

Molecular polymorphism of O alleles in five populations of different ethnic origins.

Sequences of exons 6 and 7 of the O allele of the ABO gene were studied in 317 individuals of the O phenotype from five different ethnic groups (Basques, Berbers, Akans from the Ivory Coast, and Amerindians: Cayapas from Ecuador and Aymaras from Bolivia). Twenty-one O alleles were characterized, among which 9 differed from all O alleles reported to date. The nine alleles differed from either the O01 allele (four out of nine) or O02 allele (five out of nine) by one to three point mutations. The number of different O alleles in population samples varied greatly: the highest number (13) was observed in Akans, and the lowest (5) in Amerindians. Some rare alleles previously reported by others at low frequencies were found with high frequencies in the Akans. The results also revealed a decreasing frequency of Ov7 alleles from south to north (Akans, Berbers, Basques). Berbers and Basques share two rare alleles, Ov6 and O03, which were not encountered in the other populations studied here.

ABO Blood-Group System↗
PubMed2004

Analysis of HFE gene mutations (C282Y, H63D, and S65C) in the Ecuadorian population.

Type 1 hemochromatosis is a disorder of iron metabolism mostly related to the HFE gene mutations. In the present study, we performed a mutation analysis to determine the frequencies of the HFE gene mutations (C282Y, H63D, and S65C) in DNA samples of 100 healthy Ecuadorian individuals. We used the polymerase chain reaction (PCR) to amplify exons 2 and 4 of the HFE gene and then the restriction fragment length polymorphism (RFLP) method to detect the mutations. The results revealed that the mutations in the normal Ecuadorian population have frequencies of 0.0, 0.035, and 0.04 for C282Y, H63D, and S65C, respectively. We also searched for these mutations in 12 hemochromatosis patients, and the frequencies that we found were 0.0 for C282Y, 0.167 for H63D, and 0.042 for S65C. We found differences [using the chi-square (chi2) test] in the frequency of the H63D mutation between the control group and the group of hemochromatosis patients (p<0.01). This suggests that in Ecuador, type 1 hemochromatosis is more influenced by the H63D mutation than the other two mutations that we analyzed. Given that in a Caucasian population hereditary hemochromatosis is mostly related to the C282Y mutation, it is possible that the findings for the Ecuadorian population are due to geographical differences between the populations.

Case-Control Studies↗
PubMed2004

Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study.

OBJECTIVE: The purpose of this study was to determine obstetrical and neonatal outcome among early adolescent pregnancies (< or =15 years). METHOD: We compared obstetrical and neonatal outcome of early adolescent nulliparas with outcome of nulliparous women aged 20-30 years. RESULTS: Two hundred and one (201) early adolescent nulliparous patients of low socio-economic status were enrolled at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador, and matched for gestational age with 201 low socio-economic nulliparous controls aged 20-30. Mean maternal age of the adolescent group was 14.2+/-0.6 years. The incidence of cervicovaginal infections during current pregnancy was significantly higher among adolescents (trichomoniasis: 11.4% vs. 5% and candidiasis: 27.8% vs. 12.4%, p<0.05). The incidence of eclampsia was higher in adolescents (2.5% vs. 0%, p<0.05). The preterm rate in each group was 4.9%. There were no differences in labor characteristics and the rate of cesarean section, labor complications and abnormal puerperium between both studied groups. Nevertheless, mean neonatal weight was lower and the incidence of low birth weight infants (<2,500 g) and adverse neonatal outcome was significantly higher in the adolescent group (2,837.6+/-454 g vs. 3,017+/-547 g; 19.9% vs. 11.4% [OR=1.92, 95% CI: 1-3.5] and 9.5% vs. 3.5% [OR=2.9, 95% CI: 1.1-7.7] respectively, p<0.05). CONCLUSION: Pregnancy in young adolescents (< or =15 years) of low socio-economic status did not impose adverse obstetrical outcome, however it did increase the risk for low birth weight, adverse neonatal outcome and cervicovaginal infections.

Adolescent↗
PubMed1997

Extensive lead exposure in children living in an area with production of lead-glazed tiles in the Ecuadorian Andes.

We have determined the concentrations of lead (Pb), cadmium (Cd), and mercury (Hg) in the blood of children living in two Andean villages in Ecuador with many family-owned cottage-type industries using Pb from discarded car batteries and occasionally, utility batteries containing Cd and Hg for the production of glazed tiles. The battery metals are ground together with water to a suspension, which is applied manually onto the tiles and then fused at about 1,200 degrees C in sawdust-fired kilns. Children aged 4-15 years were recruited from the schools with the assistance of the school-teachers. Children from homes with and without tile-glazing activities were to be included. Blood metal concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS). The children had extremely high blood lead concentrations (B-Pb), which ranged between 100 and 1,100 micrograms/l (median 510 micrograms/l, n = 82). Children from families engaged in tile-glazing production had significantly higher B-Pb (median 600 micrograms/l) than those living in homes with no such activity (median 210 micrograms/l), although the B-Pb of the latter were nonetheless clearly elevated. B-Cd and B-Hg were low (medians 0.25 microgram Cd/l and 1.6 micrograms Hg/l, respectively), indicating that the exposure from utility batteries containing Cd and Hg was low. The blood hemoglobin concentrations decreased significantly with rising B-Pb, indicating an effect on the heme synthesis. This was supported by a marked increase in the blood concentration of protoporphyrins with increasing B-Pb. It can be concluded that children from families with cottage industries producing glazed tiles are at risk for severe health effects due to high lead exposure.

Adolescent↗
PubMed2003

Stable isotopes as indicators of altitudinal distributions and movements in an Ecuadorean hummingbird community.

Altitudinal migration and dispersal is an important component of the life history of several temperate and tropical birds but remains poorly understood due to the limited success of mark and recapture techniques. Stable isotopes of hydrogen (deltaD) in rainfall, and to a lesser extent, carbon (delta13C) in plants are known to change with altitude and hence may provide the basis of a technique for tracking the altitudinal movements in birds and other wildlife. We investigated the potential for this technique by measuring delta13C, deltaD, and delta15N values in tail feathers of eight species of hummingbirds ( Phaethornis malaris, P. syrmatophorus, P. guy, Adelomyia melanogenys, Coeligena torquata, C. lutetiae, Metallura baroni, M. williami) along an altitudinal gradient (300-3,290 m asl) in the Andes Mountains of Ecuador. Feather delta13C and deltaD values were correlated and each changed significantly with elevation above 400 m. In general, we found good agreement between feather deltaD values and those predicted from a generalized relationship of precipitation and surface water deltaD with altitude. Similarly, feather delta13C values showed an enrichment of approximately 1.5 per thousand per 1,000 m over the linear portion of the elevational response. Stable-nitrogen isotope values were variable, and so did not provide useful information on elevation in birds, apart from trophic effects. Overall there appears to be good potential for using the (deltaD, delta13C) stable isotope approach to track altitudinal movements and to elucidate previously unrecognized patterns of life history variation in both temperate and tropical species that migrate across elevational isotopic gradients.

Altitude↗
PubMed2006

God's laboratory: religious rationalities and modernity in Ecuadorian in vitro fertilization.

Catholicism is the only major world religion that unequivocally bans the use of in vitro fertilization (IVF). Nevertheless, in Ecuador, Catholic IVF practitioners declare God's dominion over their IVF laboratories and clinics in explaining pregnancy outcomes. My analysis of this routine combination of spiritual and material causal models in Ecuadorian IVF contributes to two ongoing discussions about (1) the tensions between "institutional" and popular forms of Catholic religiosity and (2) the proper boundaries of science in modernity. The Catholic Church's historical and contemporary struggle to determine control of the miraculous has usually been characterized as a conflict between educated clergy and humble peasants. In the case of Ecuadorian IVF, we find, instead, educated elites and middle classes participating in this same contestation with the Church, proclaiming their direct ability to harness the power of God to effect material change on earth. This spiritual power to affect clinical outcomes does not take place just anywhere, but in clinic and lab, disrupting another set of presumptions about modern scientific practice and subjectivity. Like other Ecuadorian elites and middle classes, IVF practitioners are heirs to Enlightenment thought, and experience themselves as modern in their participation in these high-tech endeavors. But their spiritual approach to laboratory rationality does not trouble these IVF practitioners' experience of themselves as moderns, prompting a reevaluation of the narratives of scientific modernity that limit their scope to Europe and North America.

Attitude to Health↗
PubMed1993

A multicenter comparative trial of triphasic and monophasic, low-dose combined oral contraceptives.

A comparative multicenter clinical trial of two combined oral contraceptives (OCs) was conducted at clinics located in the Sudan, Sri Lanka, Chile, the Dominican Republic and Ecuador. The trial was designed to determine if there were differences in efficacy, safety and acceptability between a triphasic and a low-dose monophasic OC. This report includes analysis of 1088 women. At each center, subjects were randomly allocated to one of the two OCs. Follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. There were two accidental pregnancies attributed to user failure reported during the study period; one in the triphasic group and one in the monophasic group. Adverse experiences were mainly minor with headaches and dizziness being the most common complaints; frequency of reports was similar in both groups. Cycle control was good in both groups with women in the triphasic group reporting fewer complaints of intermenstrual bleeding. Both OCs were safe and effective.

Adolescent↗
PubMed1990

The clinical utility of the roll-over test in predicting pregnancy-induced hypertension in a high-risk Andean population.

The utility of the roll-over test (ROT) as a prognostic tool for predicting pregnancy-induced hypertension (PIH) was examined in primiparas in Quito, Ecuador. In Study I, 14 of 16 subjects with a +ROT developed PIH (positive predictive value (PPV) = 88%); only 2 of 27 subjects with a -ROT developed PIH (negative predictive value (NPV) = 92.5%). In Study II (n = 66), the PPV and NPV were 71.4% and 78.6%, respectively. Data from these and previous studies indicate that although the ROT is not a perfect predictor, its advantages recommend usage in populations with high PIH-associated maternal and perinatal mortality.

Adolescent↗
PubMed1996

The effect of chronic intestinal parasitic infection on maternal and perinatal outcome.

OBJECTIVE: The main objective of this prospective cohort study was to investigate the prevalence, risk factors and maternal-perinatal consequences of chronic asymptomatic intestinal parasitic infection during pregnancy. METHODS: Prenatal patients (n=91) attending a public clinic in Quito, Ecuador, were followed during the third trimester. Intestinal parasitic, nutritional status, sociodemographic/sanitation indicators and fetal outcome data were collected and analyzed using multivariate ANOVA and regression techniques. RESULTS: Most subjects (93%) were infected with at least one species of pathogenic intestinal parasite: 88% with Entamoeba histolytica. Greater parasite burdens were associated with poorer maternal iron status and reduced fetal growth. In particular, a high E. histolytica load was associated with decreased maternal serum hemoglobin (P=0.002) and hematocrit levels (P=0.01), iron deficiency anemia (P=0.026), and indicators of diminished intrauterine growth including a decreased ponderal index (P=0.04), mid-arm circumference (P=0.01), and mid-arm/head circumference ratio (P=0.003). CONCLUSION: Asymptomatic intestinal parasitic infection represents a hidden risk factor for maternal iron deficiency anemia and fetal growth retardation.

Adult↗