Infectious Disease in Ecuador

The republic of Ecuador, which has a population of 10 million, is one of the smallest of the Andean countries in South America. Although it covers only an area of 110,000 square miles, it yields an extraordinary diversity of infectious diseases. Public health problems reflect socioeconomic realities and uniquely diverse climates, cultures, and geography. Equador extends from the Galapagos Islands 600 miles to the west, to inhabited Andean highlands with altitudes over 15,000 feet, and to both the coastal and Amazonian rain forests. Health statistics in Ecuador are widely variable by western standards. Life expectancy is 64-68 years, and infant mortality rates are up to 60 per 1000. The physical and geographic barriers to health care facilities are highly variable in different provinces. This was evidenced dramatically by recent death rates from cholera in 1991-92, which ranged from 0% in Guayaquil to over 50% in isolated highland villages or in the Oriente (eastern provinces). Major cities, provincial borders, and selected topographic features are illustrated in the accompanying map of Ecuador (Fig. 1.) This review reports data on some of the major infectious diseases existent in Ecuador. Emphasis is on the viral, bacterial, protozoal, or helminthic diseases, which are uncommon elsewhere in the world, but which are prevalent, or especially important to public health officials in Ecuador. Table 1 lists reportable disease categories in Ecuador, 1986-1993. Recognition of the diversity of infectious agents endemic to Ecuador may prove useful for diagnosis, treatment, and prevention of infectious diseases in international travelers.