6379ef8e7507344cb1634ae15d3300d3 337098.pdf 833e5a0e18837b106755b730e66a0a76c1800b75 337098.pdf 62f85f937a8f98dc8dcfb4de8c2ddc111cfc435f81397ffead0170ad364007ff 337098.pdf Title: Morbidity and Mortality Profile of Leishmaniasis in an Andean Region of Ecuador in the Context of Climate Change Subject: Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are associated with humid, low-altitude rural areas, our study uncovered an unexpected trend: confirmed cases occurring in traditionally cold Andean regions. To investigate this issue, we conducted a cross-sectional ecological study using official morbidity and mortality records from the Ecuadorian Health Care Registration Platform, focusing on the cantons of Alausí and Chunchi in Chimborazo Province from 2013 to 2022. Chimborazo Province, in the Andes, is characterized by higher altitudes (2740 m above sea level) and a cold climate (averaging 13 C throughout the year). Among a population of 44,089 residents in Alausí, we reported a total of 40 confirmed cases, with 97.5% classified as cutaneous and 2.5% as mucocutaneous, predominantly affecting children and males. No mortality cases were recorded during the study period. To further explore environmental influences, we examined the Alausí region, where climate change has led to rising average temperatures, deforestation, and changes in humidity levels. Leishmaniasis cases in Alausí showed seasonal peaks, particularly in 2018 and 2019, correlating with warmer and more humid conditions. Environmental factors such as temperature and humidity were strongly associated with the prevalence of the disease, suggesting that climate change may be increasing transmission risks. These findings point to the value of incorporating environmental monitoring into public health strategies for vector-borne diseases that affect vulnerable populations in the Andes. Keywords: leishmaniasis; climate change; Andean slope; morbidity; Ecuador Author: Enma Veronica Páez-Espinosa, Delia Maria Sosa-Guzmán, Luis René Buitrón-Andrade, Nicole Dávila-Jumbo, Martín Israel Cáceres-Ruiz, Vinicio Francisco Robalino-Flores and Eugènia Mato-Matute Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Thu Sep 4 08:29:59 2025 CEST ModDate: Thu Sep 4 08:38:31 2025 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2508921 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- FZXENW+URWPalladioL-Ital Type 1 Custom yes yes yes 165 0 CSWBLV+URWPalladioL-Bold Type 1 Custom yes yes yes 166 0 WYEKQU+VnURWPalladioL-Bold Type 1 Custom yes yes yes 167 0 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ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-10-09 11:21:35 CEST Size: 2508921 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 718 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Ethics Statement Item: Title: Study Design Item: Title: Overview of the Geographical Area Under Investigation Item: Title: Sample and Setting Item: Title: Data Analysis Item: Title: Results Children: Item: Title: Annual Distribution of Leishmaniasis Cases in the Cantons of Alausi and Chunchi and Their Respective Parishes from 2013 to 2022 Item: Title: Monthly Distribution of Leishmaniasis Cases in the Cantons of Alausi and Chunchi Item: Title: Spatial Distribution of Leishmaniasis in the Province of Chimborazo Item: Title: Spatial Distribution of Leishmaniasis Cases in the Valley of Alausi and Chunchi and Its Parishes Item: Title: Type of Leishmaniasis Item: Title: Demographic Characterization of Reported Cases of Leishmaniasis Children: Item: Title: Distribution of Leishmaniasis Cases by Sex Item: Title: Distribution of Leishmaniasis Cases by Marital Status Item: Title: Distribution of Leishmaniasis Cases by Age Item: Title: Number and Distribution of Leishmaniasis Lesions Item: Title: Environmental Correlation Analysis of Leishmaniasis Prevalence in Alausí (2018–2019) Item: Title: Discussion Children: Item: Title: Environmental Shifts and Epidemiological Patterns Item: Title: Leishmaniasis in Andean Regions: A Shifting Paradigm Under Climate Change Item: Title: Implications of Geographical and Demographic Distribution in a Climate Change Context Item: Title: Clinical and Epidemiological Characterization Item: Title: Comparison with Global and Regional Trends and Contemporary Studies Item: Title: Limitations and Future Research Directions: Building Resilience in the Face of Climate Change Item: Title: Conclusions Item: Title: References Info: Title: Morbidity and Mortality Profile of Leishmaniasis in an Andean Region of Ecuador in the Context of Climate Change Author: Enma Veronica Páez-Espinosa, Delia Maria Sosa-Guzmán, Luis René Buitrón-Andrade, Nicole Dávila-Jumbo, Martín Israel Cáceres-Ruiz, Vinicio Francisco Robalino-Flores and Eugènia Mato-Matute Subject: Leishmaniasis is a parasitic disease transmitted by female sandflies of the genus Lutzomyia. Ecuador is divided into three distinct natural regions: the Andes, the Coast, and Amazonia, each characterized by significant variations in altitude and climate. While most reported cases of leishmaniasis are associated with humid, low-altitude rural areas, our study uncovered an unexpected trend: confirmed cases occurring in traditionally cold Andean regions. To investigate this issue, we conducted a cross-sectional ecological study using official morbidity and mortality records from the Ecuadorian Health Care Registration Platform, focusing on the cantons of Alausí and Chunchi in Chimborazo Province from 2013 to 2022. Chimborazo Province, in the Andes, is characterized by higher altitudes (2740 m above sea level) and a cold climate (averaging 13 C throughout the year). Among a population of 44,089 residents in Alausí, we reported a total of 40 confirmed cases, with 97.5% classified as cutaneous and 2.5% as mucocutaneous, predominantly affecting children and males. No mortality cases were recorded during the study period. To further explore environmental influences, we examined the Alausí region, where climate change has led to rising average temperatures, deforestation, and changes in humidity levels. Leishmaniasis cases in Alausí showed seasonal peaks, particularly in 2018 and 2019, correlating with warmer and more humid conditions. Environmental factors such as temperature and humidity were strongly associated with the prevalence of the disease, suggesting that climate change may be increasing transmission risks. These findings point to the value of incorporating environmental monitoring into public health strategies for vector-borne diseases that affect vulnerable populations in the Andes. 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