Sánchez Redrobán, José
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Sánchez Redrobán, José
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Quito
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Scopus Author ID
59772297900

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Time Series Analysis of Dengue, Zika, and Chikungunya in Ecuador: Emergence Patterns, Epidemiological Interactions, and Climate-Driven Dynamics (1988–2024)

2025 , Sánchez Redrobán, José , Carolina Álvarez Ramírez , Emilio Cevallos Carrillo , Juan Arias Salazar , César Barros Cevallos

Background: Ecuador presents a unique epidemiological laboratory for studying arboviral dynamics due to its diverse ecological zones and exposure to climatic variability. Methods: We conducted a comprehensive 36-year analysis (1988–2024) of dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV) using national surveillance data from Ecuador’s Ministry of Public Health. Statistical analyses included time series decomposition, change-point detection, correlation analysis, and climate association studies. Results: Ecuador reported 387,543 arboviral cases, with dengue comprising 91.3% (353,782 cases). Dengue exhibited endemic–epidemic cycles with major peaks during El Niño events (1994: 10,247 cases; 2000: 22,937 cases; 2015: 42,483 cases; 2024: 23,156 cases through week 26). CHIKV emerged explosively in 2015 (29,124 cases, incidence 181.10 per 100,000), followed by ZIKV in 2016 (2947 cases). Both showed rapid decline post-epidemic. Severe dengue cases paradoxically decreased from 2–4% of total cases in early 2000s to <0.1% post-2016, suggesting immunological modulation. Cross-correlation analysis revealed significant associations between climatic indices and epidemic timing (r=0.67, p<0.001), particularly for the El Niño-Southern Oscillation. Conclusions: Arboviral diseases in Ecuador function as an integrated epidemiological system with evidence of viral interactions, cross-protective immunity, and strong climate forcing. These findings emphasize the need for integrated surveillance and adaptive control strategies.

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A Narrative Review of Human Papillomavirus (HPV) Vaccination in Ecuador: A Crisis of Inequity and an Evidence-Based Roadmap for Elimination

2025 , Sánchez Redrobán, José , Loaiza Martinez, Daniela , Carlos Santillan

Background: Human Papillomavirus (HPV) remains the leading cause of cervical cancer in Ecuador, which suffers from systemic programmatic failures that undermine the global elimination strategy. Crisis: Ecuador’s HPV vaccination coverage (35.6% first dose; 17.3% complete) is the lowest in Latin America, starkly contrasting with the WHO’s 90% target for cervical cancer elimination (Pan American Health Organization 2025). Structural inequities, a profound genotypic mismatch with the circulating quadrivalent vaccine (HPV 58/31/52 prevalence), and fragmented implementation perpetuate this public health crisis (Jose Ortiz Segarra et al. Infectious Disease Reports, 15(3):267–278 2023). Key Findings: Our analysis reveals that the nation’s health-center-based model fails to reach vulnerable populations, a problem exacerbated by critical cold chain deficiencies in 30% of facilities. In contrast, regional successes, such as Peru’s school-based programs (94% coverage) and Colombia’s strategic adoption of the nonavalent vaccine, offer a clear roadmap for reform (Pan American Health Organization 2025, María Ines Sarmiento-Medina et al. PLOS ONE, 19(2):e0297579 2024). Recommendations: We propose an evidence-based 5-point plan to overhaul Ecuador’s strategy: a targeted nonavalent vaccine pilot, immediate adoption of a single-dose schedule, culturally adapted self-sampling programs, phased-in gender-neutral vaccination, and urgent investment in cold chain infrastructure

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