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.

Zoonotic Transmission of Hepatic Hydatid Cyst from Domestic Dogs: A Case Report from an Urban-Marginal Area in Ecuador

BACKGROUND Hepatic hydatidosis, or echinococcosis, is a zoonosis with worldwide prevalence and is potentially lethal in humans. This report presents a case of hydatidosis in a 40-year-old woman that was associated with a zoonotic transmission of Echinococcus granulosus from domestic dogs in an urban-marginal area of the city of Guayaquil, Ecuador. This report shows how early diagnosis and awareness favored the correct treatment of the disease. CASE REPORT A 40-year-old woman from the aforementioned sector presented the following symptoms: malaise, pain in the upper right hypochondrium, palpable mass, jaundice, and fever. Next, the patient's fecal samples were analyzed by direct coproparasitic methods, flotation, and sedimentation with centrifugation using saline solution, whereby the presence of Entamoeba histolytica eggs was determined. Likewise, she underwent an ultrasound, in which hepatic hydatid cysts were observed. Subsequently, the cysts were treated and surgically removed, and parasitic forms of E. granulosus were identified. Later, coproparasitic analysis of her 2 domestic dogs for coproantigen ELISA were performed, by which the presence of this cestode was also identified and confirmed. CONCLUSIONS Hydatidosis is a zoonosis that can affect the population, especially in endemic areas of developed and underdeveloped countries. In this case, hepatic hydatidosis was identified in a 40-year-old woman. Additionally, the presence of E. granulosus eggs was determined in the fecal matter of her dogs, which indicated that the patient's relatives and other people around them were exposed to this zoonosis.

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.

Hymenolepiasis Caused by Hymenolepis nana in Humans and Natural Infection in Rodents in a Marginal Urban Sector of Guayaquil, Ecuador

BACKGROUND Hymenolepiasis is a globally prevalent zoonosis of the monoxenic cycle. Humans acquire the disease through fecal-oral transmission by ingesting food or water with infective eggs from infected rodents. This report presents 3 cases of hymenolepiasis in children, due to zoonotic transmission from rodents and presumably associated with the consumption of powdered milk contaminated with infective eggs of Hymenolepis nana, and shows that awareness and early diagnosis contributed to timely treatment of the disease. CASE REPORT Three children, aged 9, 12, and 13 years, living in a marginal urban area of Guayaquil, Guayas province, Ecuador, presented symptoms of diarrhea, low body weight, abdominal discomfort, anorexia, paleness, and anal itching. Subsequently, their fecal samples were analyzed by direct coproparasitic methods, flotation and sedimentation with centrifugation using saline solution; the presence of H. nana eggs was determined. Blood biometry was performed. Further, 10 rodents were captured and necropsied to obtain intestinal contents. The powdered milk consumed by the children was analyzed, the same powder that contained rodent feces. Subsequently, these were studied with the above-mentioned coproparasitic methods. H. nana eggs were identified in the 6 trapped rodents, the powdered milk, and the feces of rodents found in the milk powder. CONCLUSIONS Hymenolepiasis can affect populations of endemic areas. In this case, the disease was identified in 3 children, who were diagnosed with eosinophilia and anemia. Additionally, the presence of H. nana eggs in captured rodents and in powdered milk was determined, indicating that the community was exposed to this zoonotic disease.