Las enfermedades cardiovasculares originan costos evitables de atención sanitaria, por ello el panel de expertos en Detección, Evaluación y Tratamiento del Colesterol Alto (ATPIII) ha establecido guías para su tratamiento. En el presente estudio explicativo, observacional y retrospectivo, se estudiaron 195 pacientes, tanto del sector público como el privado, mayores de 30 años, con dislipidemia confirmada mediante laboratorio y que han recibido atención médica por lo menos tres meses. A partir de la historia clínica del paciente, se recolectó edad, género, diagnóstico, valores de lípidos al inicio y 12 semanas, y tratamiento instaurado. Los sujetos estudiados presentaron riesgo cardiovascular alto y muy alto y mayoritariamente de sexo femenino. Al comparar los valores de lípidos iniciales con los posts tratamientos se observó que en el grupo de alto riesgo hubo una disminución no significativa en todos los valores de lípidos, mientras que en sujetos de muy alto riesgo existió una disminución significativa de triglicéridos (p=0.02) y colesterol LDL (p<0.0001). El nivel de cumplimiento de metas del ATP III fue tan solo el 20 % de los sujetos. Las estatinas fueron el tratamiento de elección en un 91 % de los casos.

Background: The nutritional traffic light label (NTLL) has become one of the most used Front of Package labels (FOP’s) around the world, for its simple and easy to understand graphical system. In Ecuador, this labelling system has recently been implemented; then, this research aims to evaluate the use and knowledge of NTLL and its effectiveness as a public health promotion strategy. Method: In a cross-sectional study at two different urban supermarkets in Quito-Ecuador, a survey was conducted in 73 participants to inquire about knowledge, perspectives and purchasing habits regarding the NTLL. Objective data obtained from pictures of the participants’purchase was compared with subjective data obtained from the survey. For categorical variables, Chi square or Fisher’s Exact test were used and variables with a statistical significance at α = 0.1 were included in multivariate logistic regression models. Results: 88.7% of participants knew about the NTTL. 27.4% reported using the NTLL, while 28.4% of participants were observed to really use it. Significant associations between self-knowledge of the NTLL and education level (p = 0.007) or knowledge level (p = 0.001) were found. A significant association was also found between the refered use of the NTLL and the shopping influencing factor (p = 0.02). In the multivariate analysis an association between knowledge of the NTLL and observed use was found only when adjusted for the supermarket (p = 0.038).

Introduction: Besides the well-known increased risk of developing HIV-related infectious comorbidities; compared with the general population, people living with HIV (PLHIV) may also have an increased risk of developing noninfectious comorbidities (NICMs). This is the first study intended to determine the NICMs rates affecting PLHIV who were under cART regimen in Ecuador. Methods: A total of 503 HIV-positive patients were evaluated during the period June 2015- November 2016 and included in a multicenter retrospective, cross-sectional study conducted in seven main government and nongovernment community-based hospitals in Ecuador. Results: The average age of the participants was 39.2±11.9 years old and the majority of them were male (67.2%). The average age at HIV diagnosis was 34.1 years old and cART in average was started 15.9 months after HIV-diagnosis. Recruited patients were receiving cART for an average of 59.2±40.2 months. Only 9.9% (n=50) of the patients did not show any NICMs. Diabetes and pre-diabetes were found in 6% (n=30) and 16.3% (n=82) patients, respectively; however, dyslipidemia and overweight/obesity was frequent, as they affected 41.4% (n=208) and 36.4% (n=183) patients, respectively. Sixty patients (11.9%) were diagnosed with depression and 28.2% (n=142) of the studied subjects were found to have other NICMs. Conclusion: Prevalence of NICMs among subjects under cART was greater than that reported among the Ecuadorian general population, therefore specific public health actions are required to make patients aware of and prevent NICMs among PLHIV in Ecuador.

The Joint United Nations Program on HIV/AIDS estimates that between 0.3% and 0.7% of adults aged 15 to 49 years were living with HIV in Ecuador in 2013. However, very little is known about the HIV prevalence rate among men who have sex with men (MSM) in that country. A cross-sectional survey was conducted to investigate the knowledge, attitudes, and practices regarding HIV/AIDS as well as to estimate the prevalence of HIV among MSM in one of the cities with high HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 307 adult MSM. An HIV prevalence of 10% was observed. Knowledge about HIV was high; 91% of participants could identify how HIV is transmitted. Although consistent condom use for anal sex was relatively high (89%) among participants who reported having pay-for-service clients, only 64% reported using a condom during oral sex with a client. Participants who had multiple male sexual partners (i.e., their stable male partners plus other partner[s]) had 3.7 times higher odds of testing positive for HIV compared with those who did not. They also had reduced odds of condom use. Participants who were forced to have anal receptive sex had 3 times higher odds of testing positive for HIV. Despite the finding that participants exhibited high knowledge about HIV/AIDS, a high prevalence rate of HIV was observed, which warrants targeted behavioral interventions. These data are consistent with MSM being one of the highest at-risk population groups for HIV in this region of Ecuador.

There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.

Abstract: Background: Globally, female sex workers (FSWs) constitute one of the most vulnerable populations for HIV/STI acquisition. However, very little is known about these infections and their risk factors among FSWs in Ecuador and Latin America. Objectives: To assess the level of knowledge, risk behaviors and factors associated with the prevalence of HIV, syphilis and self-reported STI among FSWs in a high HIV prevalence province in Ecuador. Methods: Data from 270 FSWs in Ecuador recruited by snowball sampling were analyzed. Structured questionnaires were administered through face-to-face interviews and blood samples were obtained and tested for HIV and syphilis. Results: The prevalence were 0.7% for HIV infection, 3.3% for syphilis and 26.4% for other self-reported STIs. Age of onset of sex work, knowledge of HIV transmission and condom use were significant risk factors for HIV/syphilis co-infection. The factors associated with self-reported STI were the age of onset of sex work, knowledge of any STI, marital status, and sex with other person(s) other than clients. Conclusions: In a high HIV prevalent region of Ecuador, among FSWs the prevalence of HIV and syphilis was low but self-reported STIs was high, and this study identified several risk factors that provide scientific evidences for health policy decisions like the strength of health promotion and education programs for FSWs, especially the among the youngest.

Background: The Adult Treatment Panel III (ATPIII) guidelines aim to reduce cardiovascular morbidity and mortality. In Ecuador, 20% of people have high LDL cholesterol levels, and 39% have high triglyceride levels. Objective: To analyze lipid-lowering regimens in Ecuadorian patients and determine the achievement rate of the ATPIII goals for lipid profile. Methods: Using a retrospective analysis, 385 subjects older than 30 years, who received pharmacological treatment for dyslipidemia for at least three months was randomly selected from institutions at two large cities in Ecuador. Data were collected from patients’ medical records and analyzed by chi-square test or paired t-test; p-values less than 0.05 were considered significant. Results: Baseline total cholesterol values were above 200 mg/dL in 75% of subjects, LDL-c values above 129 mg/dL in 83% of subjects and triglycerides values above 150 mg/dL in 79% of subjects. Most (n = 253, 95.8%) patients at very high cardiovascular risk were taking statins, 50% of them atorvastatin. Considering the ATPIII guidelines’ goals, only 24 subjects (19%) at high CV risk achieved an LDL-c < 100 mg/dl, while a significantly lower percentage (p = 0.04) of patients at very high risk reached an LDL-c < 70mg/dl (11%; n = 30). Conclusion: These data indicate a low rate of compliance with the ATPIII guidelines, independent of the medication used or duration of the treatment. This may be attributed to the prescription of low doses of medication and a therapy targeting isolated lipid fractions rather than a complete lipid profile. (Int J Cardiovasc Sci. 2020; 33(4):371-376)

Background: The nutrition transition continues to affect populations throughout the world. The added impact of market integration and urbanization exacerbates the impact of the nutrition transition upon Indigenous populations worldwide. Objectives: This study aims to explore the nutritional concerns of the urban Kichwas community residing in the Andes highlands of Ecuador. Study design: This is a qualitative study. Methods: Eight focus groups were conducted with Kichwas men and women in November 2015 in the Imbabura province of the Andes in Ecuador. Data analysis: Applied thematic analysis was used to analyze findings regarding nutrition. Results: The participants shared concerns regarding increased intake of fast food, poor meal timing, and a shift in the child's food preferences that rejects traditional foods. They attributed these concerns to urbanization resulting from an increase in dual-income households and a loss of cultural identity. Conclusions: Synergistic cultural factors are related to nutritional concerns voiced by the urban Kichwas community. Public health implications: Syndemic theory is a useful interpretive lens regarding nutritional trends within the Kichwas communities as they relate to the increased risk of chronic disease.