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PubMed1983

Does hyperimmunoglobulinemia-E protect tropical populations from allergic disease?

The Waorani Indians of eastern Ecuador have the highest blood concentration of IgE reported in a human population. Evidence obtained by medical history, physical examination, and immediate hypersensitivity skin tests suggests that pollen allergy and other atopic diseases are rare among the Waorani. A similar association between parasite-induced hyperimmunoglobulinemia-E and a low prevalence of conventional atopic disease has been reported in numerous other tropical populations. Saturation of mast cell IgE receptors with antibodies directed to the parasite and/or other antigens and competitive inhibition of passive binding of pollen allergen-specific IgE is one hypothetical cause of this association. We have tested this interesting conjecture by passively sensitizing the skin of Waorani Indians with serum containing pollen allergen-specific IgE antibodies. Waorani Indians with hyperimmunoglobulinemia-E can be adoptively sensitized with human ragweed or rye grass hyperimmune IgE antisera. This suggests that the cutaneous mast cells of healthy Waorani have active IgE receptors. The high circulating plasma concentrations of IgE in the Waorani do not prevent adoptive cutaneous sensitization with pollen-specific IgE antibodies.

Ecuador↗
PubMed1991

Onchocercacidal effects of amocarzine (CGP 6140) in Latin America.

An open clinical trial of amocarzine was carried out in onchocerciasis patients in Ecuador and Guatemala. Administration after food was more effective than that during fasting. The most effective and best tolerated regimen, 3 mg/kg twice daily after food for 3 days (in 312 patients), killed 73% of 1477 female worms at nodulectomy 4 months after treatment. The mean microfilarial skin count was greatly reduced within a week (6-11% Of day 0 value on day 8) and it remained low at least 6 months (14-18% on day 180). Follow-up of a higher dose 3 day regimen taken while fasting showed microfilaridermia of 7-9% of the day 0 value 2 years after treatment.

Adult↗
PubMed1983

Experience and expectation: conflict and change in traditional family health care among the Quichua of Saraguro.

Quichua Indian mothers have traditionally served as primary health caretakers for the families of Saraguro in highland Ecuador. A hospital has recently opened, providing biomedical health care and programs in preventive medicine for local indigenous commmunities. Opposition to the new facility has arisen, however, as families express dissatisfaction with hospital policies. Surveys and in-depth interviews, conducted with Saraguro families ad hospital staff between 1977 and 1982 have outlined problems encountered i the introduction and administration of biomedical care. The hospital is seen by some residents as a threat to Quichua women's authority as herbalists and family curers. More importantly, however, Saraguro families view the facility as a disappointment, as it provided services inconsistent with traditional health values, practices and felt needs, and it fails to fulfill residents' expectations of hospital care. Conflicts between traditional and hospital health care experiences and between expectations and reality, have bred hostility between the health facility and the community it serves. Inability to negotiate with hospital staff for greater flexibility in policies has intensified community frustration. The impact of cultural health values, expectations, and program flexibility are discussed with potential implications for planning and administration of biomedical delivery services.

Community Health Services↗
PubMed1984

A matter of life and death: health care change in an Andean community.

Saraguro Indians in Ecuador employ optimizing techniques to select from several available health care resources. Ideational needs, rather than physical access, appear to impose the greatest influence on therapeutic choice. The influence of felt needs on health care is particularly apparent at birth and death. The community's new hospital provided free health care, but doctors failed to consider indigenous attitudes toward birth and death. The ideational cost of hospital care has made it an unacceptable alternative for residents.

Attitude to Death↗
PubMed1989

In the shadow of biomedicine: self medication in two Ecuadorian pharmacies.

In Ecuador, as in most Third World nations, thousands of different prescription-only pharmaceuticals can be bought without a doctor's prescription. But how often does self medication actually occur? This study documents 619 prescription drug sales in two Ecuadorian pharmacies. In 51% of these sales, customers in fact present no prescription. Many of the drugs sold this way have serious side effects and must be used with care. Ecuadorian law greatly restricts information on drug packaging about side effects, indications, contraindications, schedule and dosage. Although the pharmacies differ with respect to self medication rates, drug choices, and clerk-customer interactions, both show the existence of a 'shadow system of biomedicine' in which prescription drugs are used without physician consultation. In view of the dominant role that transnational corporations play in Third World pharmaceuticals usage, this analysis incorporates a political economic perspective.

Cultural Characteristics↗
PubMed1979

Hallucinogenic plant use and related indigenous belief systems in the Ecuadorian Amazon.

This review article focuses on the on-going use of plant hallucinogens, especially various Banisteriopsis species, among contemporary aboriginal populations of Ecuador. It surveys the evidence of prehistoric ayahuasca use by interpretations of Ecuadorian archaeological remains, and surveys in detail the use and belief systems connected to major plant hallucinogenic use among the Jibaro Indians and other tribal groups. A secondary theme includes coastal and Inter-Adnean aboriginal drug use. The article stresses the interrelatedness of aboriginal belief systems, folk medicine and world view linked to plant hallucinogenic ingestion.

Ecuador↗
PubMedDate not supplied

Ritualistic use of the holly Ilex guayusa by Amazonian Jívaro Indians.

In Amazonian Peru and Ecuador leaf decoctions of the rainforest holly Ilex guayusa with high caffeine concentrations are used as a morning stimulant. After daily ingestion, ritualistic vomiting by male Achuar Indians, better known as Jívaros, reduces excessive caffeine intake, so that blood levels of caffeine and biotransformed dimethylxanthines do not cause undesirable CNS and other effects. Emesis is learned and apparently not due to emetic compounds.

Caffeine↗
PubMed1996

[Forestry Law and the conservation of natural areas and wildlife].

The Forest Law of Ecuador consists of 107 articles, whereas its regulations contain 269 articles. They are related to forestry resources, forestry patrimony protection, forests and vegetation, forest production and benefits, the control and mobilization of the forestry resources, research and capacitation, and the forestry industry protection; to natural areas, wild flora and fauna, their patrimony, conservation, and economic support; and to the violation of the law and its judgment.

Animals↗
PubMed2004

Skilled birth attendant competence: an initial assessment in four countries, and implications for the Safe Motherhood movement.

OBJECTIVES: Percentage of deliveries assisted by a skilled birth attendant (SBA) has become a proxy indicator for reducing maternal mortality in developing countries, but there is little data on SBA competence. Our objective was to evaluate the competence of health professionals who typically attend hospital and clinic-based births in Benin, Ecuador, Jamaica, and Rwanda. METHODS: We measured competence against World Health Organization's (WHO) Integrated Management of Pregnancy and Childbirth guidelines. To evaluate knowledge, we used a 49-question multiple-choice test covering seven clinical areas. To evaluate skill, we had participants perform five different procedures on anatomical models. The 166 participants came from facilities at all levels of care in their respective countries. RESULTS: On average, providers answered 55.8% of the knowledge questions correctly and performed 48.2% of the skills steps correctly. Scores differed somewhat by country, provider type, and subtopic. CONCLUSION: A wide gap exists between current evidence-based standards and current levels of provider competence.

Benin↗
PubMed2004

Factors associated with inadequate prenatal care in Ecuadorian women.

BACKGROUND: Although inadequate prenatal care has been associated with adverse perinatal outcomes, reports on the factors associated with poor prenatal care in developing Latin American countries are scarce. OBJECTIVE: To determine factors associated with inadequate prenatal care among women from low socioeconomic circumstances. METHOD: Women delivered after a pregnancy duration of more than 20 weeks at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador, were surveyed. The questionnaire collected sociodemographic data and reasons for having inadequate prenatal care. Adequacy of prenatal care was measured with the Kessner index and correlated to the sociodemographic data. RESULTS: During the study period, 1016 pregnant women were surveyed. Among them, there were adolescents (23.7%), primigravidas (30.8%), and women with a high-risk pregnancy (29.3%). According to the Kessner index, prenatal care was considered adequate or inadequate in 24.5% and 75.5% of cases, respectively. Knowledge regarding the importance of adequate prenatal care and the effects of poor prenatal care was lower among women who had received inadequate prenatal care. The women that were considered to have had adequate prenatal care had at least one visit, and they were more often cared for by a specialist than women who considered having inadequate prenatal care. The three most important reasons associated to inadequate prenatal care in this series (n=767), were economic difficulties having to care for a small child, and transportation difficulties. Logistic regression analysis determined that women with undesired pregnancies who resided in rural areas and were para 5 or higher had an increased risk of inadequate prenatal care. On the other hand, an adverse outcome to a prior pregnancy (abortion, intrauterine fetal demise, or ectopic pregnancy) decreased this risk. Marital status and educational level were confounding factors. CONCLUSIONS: Although prenatal care at our institution is free, adequacy was thought to be low. The main factors associated with poor prenatal care were mostly conditions related to poverty.

Confounding Factors, Epidemiologic↗
PubMed2004

First report of a trichomycete fungus (Zygomycota: Trichomycetes) inhabiting larvae of Simulium ochraceum sensu lato Walker (Diptera: Simuliidae) from the Galapagos Islands.

A collection of the larval black fly Simulium ochraceum sensu lato Walker was made at six lotic habitats on San Cristobal Island, Galapagos Islands, Ecuador, during May 2003. Sixty-eight larvae were assayed for the presence of gut fungi (Zygomycota: Trichomycetes). A trichomycete, designated as Smittium sp. was found inhabiting the hindgut of 17.6% of S. ochraceum s.l. larvae. Implications of this finding with respect to both host and trichomycete biogeography are discussed.

Animals↗
PubMed2005

Measuring climacteric symptoms in an Ecuadorian population with the Greene Climacteric Scale.

OBJECTIVE: Measure climacteric symptoms in a low socio-economic Ecuadorian population with the Greene Climacteric Scale and determine factors involved with higher scorings. METHODS: Women aged 40--65, non hormone therapy (HT) users, with intact uterus and ovaries, attending the Gynecologic Outpatient Service of the Enrique C. Sotomayor Obstetrics and Gynecology Hospital Guayaquil-Ecuador, were selected and asked to fill out the Greene Climacteric Scale. RESULTS: During the study period, 385 women met inclusion criteria and filled out the climacteric scale. Mean age of this sample was 47.6 +/- 5.5 years and 36.6% were aged >or=50 years. Women were classified as: premenopausal 38.9%, perimenopausal 28.8% and postmenopausal 32.3%. The total Greene Climacteric score for postmenopausal was found to be higher than premenopausal total score (18.78 +/- 8.11 versus 16.31 +/- 7.62, p < 0.05). Total, clusters and subclusters scorings maintained an increasing trend from one menopausal status to the next. The most frequently and intensive presenting symptoms of the 21 symptoms composing the scale were: difficulty in concentrating, feeling unhappy or distressed, headaches, and hot flashes (n=385: 87, 82, 83.9 and 82%, anxiety and depression subclusters, and somatic and vasomotor clusters, respectively). Univariate analysis determined that age >or=47 years, parity >or=4 and schooling <12 years were associated to the risk for having a total Greene scoring of >or=18 (OR: [95% CI], 2.5[1.6-3.8]; 1.8[1.1-3]; 1.6[1-2.7], respectively, p < 0.05). Age >or=47 years was associated to increased rates of higher scorings in all clusters except for loss of sexual interest, which was contrarily increased together with vasomotor scoring in women with higher parity (p < 0.05). Women with educational level <12 years were related to higher somatic scorings. Logistic regression analysis confirmed all these associations except for parity, which was excluded as a risk factor for higher vasomotor scorings. CONCLUSION: In this specific population, climacteric symptoms presenting in all menopausal groups, as measured with the Greene Climacteric Scale, resulted to be higher than previously reported standards and age, parity and educational level were independent risk factors.

Adult↗
PubMed2006

Quality of life among postmenopausal Ecuadorian women participating in a metabolic syndrome screening program.

BACKGROUND: Quality of life decreases after the menopause as it has been assessed by several designed tools. Despite this, few studies have reported correlations between quality of life and the metabolic syndrome and its determinants. OBJECTIVE: Evaluate quality of life and determine factors related to its impairment among postmenopausal Ecuadorian women. METHODS: Postmenopausal women that participated in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador were interviewed using the Menopause-Specific Quality of Life Questionnaire (MENQOL). Mean domain scores as well as factors associated to higher scores within each of the domains of the questionnaire (vasomotor, psycho-social, physical and sexual) were determined. RESULTS: Three hundred twenty-five postmenopausal women (n=325) were surveyed. Mean age of participants was 55.9+/-8.1 years (median: 54 years). Women presented metabolic syndrome, hypertension, hyperglycemia, hypertriglyceridemia and abdominal obesity in 41.5%, 38.8%, 16.6%, 56.9% and 54.2% respectively. Mean scores obtained for each domain were: vasomotor: 3.5+/-2.5 (median 3); psycho-social: 3.7+/-1.5 (median 3.6); physical: 3.8+/-1.2 (median 3.8); sexual: 4.9+/-2.3 (median 5.3). More than 50% of women had scores above the median for each domain of the questionnaire. Logistic regression determined that vasomotor score decreased with age. Abdominal obesity increased the risk of having vasomotor, psycho-social and physical scores above the median. Hypertension and hyperglycemia increased the risk for higher scores within the psycho-social and sexual domain respectively. CONCLUSION: In this postmenopausal Ecuadorian population, impairment of quality of life was found to be associated to age and related conditions such as abdominal obesity, hypertension and hyperglycemia.

Adult↗
PubMed2006

Diverse tulasnelloid fungi form mycorrhizas with epiphytic orchids in an Andean cloud forest.

The mycorrhizal state of epiphytic orchids has been controversially discussed, and the state and mycobionts of the pleurothallid orchids, occurring abundantly and with a high number of species on stems of trees in the Andean cloud forest, were unknown. Root samples of 77 adult individuals of the epiphytic orchids Stelis hallii, S. superbiens, S. concinna and Pleurothallis lilijae were collected in a tropical mountain rainforest of southern Ecuador. Ultrastructural evidence of symbiotic interaction was combined with molecular sequencing of fungi directly from the mycorrhizas and isolation of mycobionts. Ultrastructural analyses displayed vital orchid mycorrhizas formed by fungi with an imperforate parenthesome and cell wall slime bodies typical for the genus Tulasnella. Three different Tulasnella isolates were obtained in pure culture. Phylogenetic analysis of nuclear rDNA sequences from coding regions of the ribosomal large subunit (nucLSU) and the 5.8S subunit, including parts of the internal transcribed spacers, obtained directly from the roots and from the fungal isolates, yielded seven distinct Tulasnella clades. Tulasnella mycobionts in Stelis concinna were restricted to two Tulasnella sequence types while the other orchids were associated with up to six Tulasnella sequence types. All Tulasnella sequences are new to science and distinct from known sequences of mycobionts of terrestrial orchids. The results indicate that tulasnelloid fungi, adapted to the conditions on tree stems, might be important for orchid growth and maintenance in the Andean cloud forest.

Ecuador↗
PubMed2005

Prevalence and risk factors for protozoan and nematode infections among children in an Ecuadorian highland community.

In order to create a parasite prevention program for Santa Ana, Ecuador, we worked with local physicians to identify the prevalence and risk factors for intestinal parasitic infection among children. Two hundred households were randomly selected and asked to submit three stool samples from a selected child. Information from direct observation and questionnaires was used to determine environmental and behavioral risk factors for parasitic infection. Prevalence of any parasitic infection was 65.6% of the 189 children who submitted fecal samples. Parasitic infections included Entamoeba histolytica/E. dispar (46.6%), Giardia lamblia (18.5%) and Ascaris lumbricoides (20.1%). In a multivariate logistic model, risk factors (P<0.05) for E. histolytica/E. dispar included >1 month since antiparasitic treatment, not adding chlorine to drinking water, children not washing their hands before eating, and having a fewer number of electrical appliances in the home. The risk factor identified for G. lamblia was children not washing their hands before eating. Risk factors for A. lumbricoides included >6 months since antiparasitic treatment and having a fewer number of electrical appliances in the home. This study may have implications for other communities throughout the developing world.

Age Distribution↗
PubMed2004

Evolution of Galapagos Island Lava Lizards (Iguania: Tropiduridae: Microlophus).

Nucleotide sequences of mitochondrial genes (ND1, ND2, COI, and tRNAs) were determined for 38 samples representing 15 taxa of tropidurid lizards from the Galapagos Islands and mainland South America. Phylogenetically informative characters (759 of 1,956) were analyzed under Bayesian, maximum likelihood, and parsimony frameworks. This study supports the hypothesis that tropidurid lizards dispersed to the Galapagos on at least two separate occasions. One dispersal event involved an eastern Galapagos clade (Microlophus habelii and M. bivittatus, on Marchena and San Cristobal islands, respectively) the sister taxon of which is M. occipitalis from coastal Ecuador and Peru; the closest mainland relative of the western Galapagos clade was not unambiguously identified. The wide-ranging M. albemarlensis is revealed to be a complex of weakly divergent lineages that is paraphyletic with respect to the insular species M. duncanensis, M. grayii, and M. pacificus.

Animals↗
PubMed2006

Phylogeny of the túngara frog genus Engystomops (= Physalaemus pustulosus species group; Anura: Leptodactylidae).

We present a phylogeny of the Neotropical genus Engystomops (= Physalaemus pustulosus species group) based on sequences of approximately 2.4 kb of mtDNA, (12S rRNA, valine-tRNA, and 16S rRNA) and propose a phylogenetic nomenclature. The phylogeny includes all described taxa and two unnamed species. All analyses indicate that Engystomops is monophyletic and contains two basal allopatric clades. Clade I (Edentulus) includes E. pustulosus and the Amazonian E. petersi + E. cf. freibergi. Clade II (Duovox) includes all species distributed in W Ecuador and NW Peru. Brevivox, a clade of small-sized species is strongly supported within Duovox. Populations of Engystomops pustulosus fall into two well-supported clades, each of which occupies two disjunct portions of the species range. Overall, our phylogeny is congruent with most previous hypotheses. This study is among the few published species-level phylogenies of Neotropical amphibians derived from molecular datasets. A review of the proportion of new species detected by similar studies suggests that the increasing use of molecular techniques will lead to the discovery of a vast number of species of Neotropical amphibians.

Animals↗