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Temporal Trends in Lower Respiratory Infection Mortality in Ecuador, 2012-2022.
Reena Krishna1, Luis Furuya-Kanamori2, Harriet L S Lawford2
1School of Public Health, The University of Queensland, Herston, QLD 4006, Australia.
Tropical Medicine and Infectious Disease
|January 27, 2026
Summary
Lower respiratory infections (LRIs) show a concerning trend shift in Ecuador, with decreasing mortality rates reversing to increasing trends in young children and the elderly. Sociodemographic factors significantly influenced LRI deaths, with notable changes observed post-2020.
Area of Science:
- Epidemiology
- Public Health
- Demography
Background:
- Lower respiratory infections (LRIs) represent a significant public health challenge in Ecuador, contributing to substantial morbidity and mortality.
- Limited evidence exists regarding effective prevention strategies for LRIs within the Ecuadorian context.
Purpose of the Study:
- To analyze age-specific trends, spatial distribution, and sociodemographic risk factors associated with LRI mortality in Ecuador from 2012 to 2022.
- To identify shifts in LRI mortality patterns before and after the COVID-19 pandemic.
Main Methods:
- Utilized national mortality data from the Ecuadorian National Institute for Statistics and Censuses (INEC) for the period 2012-2022.
- Employed Joinpoint regression for age-sex-specific trend analysis and multivariable logistic regression to assess risk factors.
- Mapped LRI age-standardized mortality rates (ASMRs) by province and calculated percentage changes.
Main Results:
- A reversal from decreasing to increasing trends in LRI mortality was observed for both genders in children aged 0-4 and 5-15 years.
- Significant increasing mortality trends were identified for males (2014-2019) and females (2016-2019) aged 70 years and above.
- Guayas province exhibited the highest average LRI ASMR (30.90 deaths/100,000), while Orellana showed the largest percentage increase (419.54%) between 2012-2019.
- Pre-2020, LRI mortality was significantly associated with sex, age, education, ethnicity, place of death, and climate region, with substantial changes noted post-COVID-19.
Conclusions:
- Ecuador has experienced a concerning shift in LRI mortality trends, particularly impacting young children and the elderly.
- Spatial and sociodemographic disparities in LRI mortality are evident, necessitating targeted public health interventions.
- The COVID-19 pandemic appears to have influenced risk factors and mortality patterns associated with LRIs in Ecuador.
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