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Aim The aim of this paper is to analyze the epidemiological pattern, the occupational background and the public health problems of acute pesticide poisoning in Ecuador. This is the first report of its kind. Subjects and methods This was an observational and retrospective study performed with data from 2001 to 2007 from the National Register of Hospital Admissions/Discharges from the Instituto Nacional de Estadísticas y Censos, and also with data from the Ministry of Public Health. Ecuador does not have an official public medical poisoning registry or disease-specific registries. Results The complete register reported 44,931 cases of poisoning with an average of 6,418 cases per year and a global progressive increase of 2,123 cases in the entire period. It reported 14,145 cases of pesticide poisoning. Of these, 10,100 cases were due to the effects of the insecticides organophospate and carbamate. The number of cases by gender was 7,102 (50.21%) males and 7,043 (49.79%) females. The major age group affected was adolescents and young adults. Conclusion In Ecuador, pesticide poisoning occurs in individuals of both sexes who are between 15 to 25 years old and work in adverse conditions as agricultural farmers. The poisoning especially occurs in flower and banana plantation workers throughout the country. Seventy-one percent of the cases are due to organophosphate and carbamate poisonings, which cause death in 4% of the cases; 57% die in the first 48 h, possibly because of the acute action of AChE inhibitors. The long-term effects of pesticides are still unclear and need further research.

The typical case was an adolescent woman between 16 and 19 years with self-harm around Christmas. There was no specific treatment, but early attendance was associated with improved prognosis. Further studies are necessary to establish an adequate protocol of treatment.

Ecuador has a heterogeneous population of almost 14 million people and a complex health care system provided through provincial and national health programs by government and private hospitals. There are public health facilities at regional and territorial level. Ecuador has a small cadre of genetic professionals that provide clinical genetic services in a few private medical centers in the main cities. Prenatal screening is offered exclusively in a few individual hospitals, with variable uptake as part of prenatal care. Surveillance of the effect of prenatal screening and diagnosis on the birth prevalence of congenital anomalies is limited by gaps and variations in surveillance systems. Newborn screening programs are almost inexistent. There is broad variation in optional participation in laboratory quality assurance schemes, and there are no regulatory frameworks that are directly pertinent to genetic testing services or population genetics. Health technology assessment in Ecuador is conducted by a diverse collection of organizations, several of which have produced reports related to genetics.

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Aim The aim of this study was to analyze the epidemiological issues related to suicide in Ecuadorians. Subject and methods This is an observational, descriptive, and epidemiological study. The data used in this study arise from the National Institute of Statistics and Censuses register. The study analyzed gender, sex, and method used in suicide and undefined cases.Results Every year in Ecuador 801 individuals die by suicide, with a prevalence rate (PR) of 60.55 deaths per million population (pmp). Suicide is the cause of 1.4% of all deaths in Ecuador. By gender, men account for 70.96% (PR=42.49 pmp), while the percentage in women is only 29.04% (PR=17.58 pmp). The male to female ratio is~2:1; 76.79% of all the cases involved individuals between 15 and 50 years of age. The most common method of suicide is hanging, strangulation, or suffocation (44.35%), followed by unspecified chemicals (20.37%) and pesticide poisoning (20.07%). Every year in Ecuador 352.6 individuals die by unspecified events or undetermined intents. These events could be a source of hidden suicides. By gender, men account for 76.39% (PR=20.35 ppm). The male to female ratio is~3:1. Conclusion Suicide in Ecuador has increased in a constant and progressive way, even though there is major underreporting of these cases. The main method to commit suicide was hanging followed by pesticide poisoning. Suicide prevalence rates were similar to neighboring countries in South America, with the exception of Uruguay. Unspecified events or undetermined intents could be a source of hidden suicides, a fact that needs further analysis.

Aim: This study sets out (a) to estimate the prevalence of admissions by birth defects, using the official database of hospitals of Ecuador; and (b) to set the basis for a new National Register of Birth Defects in Ecuador that works as a program for the clinical and epidemiological investigation of risk factors in the etiology of congenital anomalies in Ecuadorian hospitals, using a case-control methodological approach. This is the first report in their class. Methods:The data used in this study are derived from the National Register of Hospital Admission/Discharges of the Instituto Nacional de Estadísticas y Censos; data of the Ministry of Public Health were also used. Ecuador does not have an official Medical Birth Registry or a Congenital Malformations Registry. Results: A total of 51,375 discharges by congenital malformations were registered in a 7-year period. Of these, 16,679 admissions were of children aged less than 1 year of age, with a birth prevalence rate (BPR) of 72.33/10,000 births. 77% of the congenital defects registered comprise the 50 most common birth defects observed in this age group. Cleft lip was the most prevalent birth defect in children less than 1 year of age and the second most common defect in children 1 to 5 years of age. Unilateral cleft lip shows a BPR of 4.57/10,000 births; cardiac birth defects as a group have a BPR of 4.2; hydrocephalus a BPR of 3.77; and Down's syndrome a BPR of 3.70. Undescended testicle was the most prevalent birth defect in children between 1 to 5 years. 9384 children under 1 year of age were male (55.9%) and 7053 were female (42.1%). BPR in males was 40.45 and in females 30.40. Conclusion: This report documents the prevalence estimates for birth defects reported in the hospital discharge data. These estimates are important to 1) plan for health-care and education needs of the Ecuadorian population, 2) identify increased occurrences of birth defects in specific geographic regions, 3) serve as a reference point for assessment of provincial surveillance systems, 4) evaluate national public health interventions, 5) compare Ecuador prevalence estimates with those of other countries, and 6) help determine the appropriate allocation of resources for basic and public health research. There is an urgent need to establish a National Registry of Birth Defects involving different sources of information such as prenatal medical records, birth records and medical records during the first year of life at an early stage, and surveys on cytogenetic prenatal diagnostic surveys and cytogenetics of therapeutic abortions.

There was a higher predisposition for inherited cases (26%) versus controls (9.85%), p < 0.05, for the occurrence of preeclampsia. The frequency of the recessive gene for Mendelian inheritance model mother-fetus homozygous (aa/aa), in agreement with the Hardy-Weinberg Law, was 0.41 for the sample.