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dc.contributor.authorCalvopiña, Manuel
dc.contributor.authorVásconez, Eduardo
dc.contributor.authorCoral-Almeida, Marco
dc.contributor.authorRomero-Alvarez, Daniel
dc.contributor.authorGarcia-Bereguiain, Miguel Angel
dc.contributor.authorOrlando, Alberto
dc.date.accessioned2022-07-05T19:40:39Z
dc.date.available2022-07-05T19:40:39Z
dc.date.issued2022-05-12
dc.identifier.citationCalvopiña M, Va´sconez E, Coral-Almeida M, Romero-Alvarez D, Garcia-Bereguiain MA, Orlando A (2022) Leptospirosis: Morbidity, mortality, and spatial distribution of hospitalized cases in Ecuador. A nationwide study 2000-2020. PLoS Negl Trop Dis 16(5): e0010430. https://doi.org/10.1371/journal.pntd.0010430en_US
dc.identifier.urihttp://hdl.handle.net/1808/32800
dc.description.abstractBackground In Ecuador, leptospirosis surveillance involves a mandatory notification of all cases and a hospitalization for severe illness. Morbidity and mortality are, nevertheless, underestimated and contribute directly to the status of leptospirosis as a neglected disease. Leptospira spp. is zoonotic in Ecuador with established endemic transmission in the Tropics. Here, we review retrospective national data within the country to aid in control strategies.

Methodology/Principal findings In a population-based nationwide study, we analysed morbidity, mortality, and spatial distribution on confirmed hospital-discharged leptospirosis cases from 2000–2020 from a publicly accesible National Database, including males and females of all ages. We computed data for the 24 provinces across the four-geoclimatic regions of Ecuador based on seasonal and monthly variations and calculated rates according to age and sex. The spatial distribution was estimated at the level of ecoregions, provinces, and cantons. A total of 2,584 hospitalizations were recorded over all three continental regions in 22 provinces, except Carchi province and the Galapagos Islands. The annual incidence varied from 0.27 to 2.45 cases per 100,000 inhabitants with ages ranging from 1 to 98 years-old and an overall male/female ratio of 1.92:1. Most hospitalizations and deaths occurred in males ages 25–34 years. We registered 79 fatalities (3.06%); the highest mortality rate was 0.05 per 100,000 inhabitants. More cases clustered in the tropical cantons of central and north of the Coast and in the southern Amazon when compared to the Andes.

Conclusions and significance Our findings evidence leptospirosis endemicity and pinpoint the highest incidence within resource-poor tropical settings. The highest incidence occurred in males of adult age, with those also exhibiting the highest mortality. The national incidence rate was stable, but peaks occurred intermittently during the rainy seasons. Thus, strategies aimed at leptospirosis monitoring and control involving the application of preventive measures should consider this season and the aforementioned high-risk groups.
en_US
dc.publisherPublic Library of Scienceen_US
dc.rights© 2022 Calvopiña et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.titleLeptospirosis: Morbidity, mortality, and spatial distribution of hospitalized cases in Ecuador. A nationwide study 2000-2020en_US
dc.typeArticleen_US
kusw.kuauthorRomero-Alvarez, Daniel
kusw.kudepartmentBiodiversity Instituteen_US
kusw.kudepartmentEcology & Evolutionary Biologyen_US
dc.identifier.doi10.1371/journal.pntd.0010430en_US
dc.identifier.orcidhttps://orcid.org/ 0000-0002-0286-0747en_US
kusw.oaversionScholarly/refereed, publisher versionen_US
kusw.oapolicyThis item meets KU Open Access policy criteria.en_US
dc.identifier.pmidPMC35551530en_US
dc.rights.accessrightsopenAccessen_US


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© 2022 Calvopiña et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Except where otherwise noted, this item's license is described as: © 2022 Calvopiña et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.