Ecoepidemiology of Ancylostoma spp. in Urban-Marginal and Rural Sectors of the Ecuadorian Coast and Prevalence of Cutaneous Larvae Migrans.

BACKGROUND Ancylostoma spp., including A. duodenale, A. braziliense, A. caninum, and A. ceylanicum, are hookworms that are transmitted from infected soil and by contact with domestic animals and rodent hosts, and can cause systemic disease and cutaneous larva migrans. The objective of this study was to describe the ecoepidemiology of Ancylostoma caninum and Ancylostoma spp. in urban-marginal sectors and in rural sectors located in Ecuador. MATERIAL AND METHODS Through addressed sampling, a total of 498 domestic dogs and 40 synanthropic rodents were analyzed via the following coproparasitic methods: direct, flotation, sedimentation with centrifugation using saline (egg identification), modified Baermann (larval identification), and morphometric methods (confirmation). A total of 236 people were surveyed, and a clinical analysis was performed via physical examination. The environmental variables were obtained through reports from the INAMHI of Ecuador and the use of online environmental programs. Through surveys, data related to social determinants were obtained. Epidemiological indicators (prevalence, morbidity, and mortality) were obtained through microbial analysis and surveys. RESULTS A total of 250 domestic dogs were diagnosed with Ancylostoma caninum (50, 20%), and 41 were diagnosed with Ancylostoma spp. (8.23%). One synanthropic rodent (2.5%) was positive for A. caninum. In the clinical analysis, 3 patients were identified as positive (1.27%) for cutaneous larva migrans (CLM). Likewise, environmental variables and social determinants influence the transmission, prevalence, and nature of parasitism by hookworm. CONCLUSIONS People, domestic dogs, and rodents were infected with these parasites. Consequently, there is a risk of ancylostomiasis and cutaneous larvae migrans spreading.

A Case of Urbanorum spp. in a Woman from an Urban-Marginal Sector of Ecuador.

BACKGROUND Worldwide, there are few cases of Urbanorum spp. in humans; however, it is associated with gastrointestinal pathologies, where humans probably acquire the disease by fecal-oral transmission, by ingesting food or water with infective cysts. The main symptoms of the patients who have this presumed parasite are fever, vomiting, colic, dyspepsia, and watery diarrhea. Since the first case of Urbanorum spp. was reported in 1994 in Colombia, cases have subsequently been reported in Peru, Ecuador, Colombia, Brazil, and Mexico. In Ecuador, a prevalence of 1.16% has been reported, and the objective of this study was to record another case of Urbanorum spp. infection in Ecuador. CASE REPORT A female patient (mixed race; 40 years old; and thin, weighing 57 to 62 kg) requested help from the FCI Project approved and financed by the University of Guayaquil (Ecuador). She underwent routine tests, such as direct parasitology and sedimentation with centrifugation using saline solution. Samples were observed under an optical microscope with 10x and 40x objectives and stained with and without Lugol's solution. We detected a rounded structure with several filaments similar to light yellow pseudopods. CONCLUSIONS Herein, a case of Urbanorum spp. infection in Ecuador, where current environmental and sanitary conditions have contributed to new cases, is reported, indicating that the community was exposed to this probable parasite with importance in public health. Further studies are recommended to confirm its etiology, life cycle, and epidemiology, in order to create a national registry, in case it is defined as a protozoan.