A review of national and international publications on paragonimiasis in Ecuador,
epidemiological records from the Ministry of Public Health and unpublished research
data was conducted to summarise the current status of the parasite/disease. The
purpose of the review is to educate physicians, policy-makers and health providers on
the status of the disease and to stimulate scientific investigators to conduct
further research. Paragonimiasis was first diagnosed in Ecuador 94 years ago and it
is endemic to both tropical and subtropical regions in 19 of 24 provinces in the
Pacific Coast and Amazon regions. Paragonimus mexicanus is the only
known species in the country, with the mollusc Aroapyrgus colombiensis
and the crabs Moreirocarcinus emarginatus,
Hypolobocera chilensis and Hypolobocera aequatorialis
being the primary and secondary intermediate hosts, respectively. Recent
studies found P. mexicanus metacercariae in Trichodactylus
faxoni crabs of the northern Amazon. Chronic pulmonary paragonimiasis is
commonly misdiagnosed and treated as tuberculosis and although studies have
demonstrated the efficacy of praziquantel and triclabendazole for the treatment of
human infections, neither drug is available in Ecuador. Official data recorded from
1978-2007 indicate an annual incidence of 85.5 cases throughout the 19 provinces,
with an estimated 17.2% of the population at risk of infection. There are no current
data on the incidence/prevalence of infection, nor is there a national control
programme.