Daniel Romero-Álvarez

• Doctor of Philosophy
• PhD at Universidad Internacional SEK

Climate change is an urgent global health challenge, with floods becoming increasingly frequent and exacerbating the spread of infectious diseases. With its diverse climates and recurring natural disasters, Latin America is particularly susceptible to outbreaks following floods. These events disrupt ecosystems and create ideal conditions for the sp...

We found Mycobacterium leprae, the most common etiologic agent of Hansen disease or leprosy, in tissues from 9 (18.75%) of 48 nine-banded armadillos (Dasypus novemcinctus) collected across continental Ecuador. Finding evidence of a wildlife reservoir is the first step to recognizing leprosy zoonotic transmission pathway in Ecuador or elsewhere.

Oropouche virus (OROV), which causes Oropouche fever (OROF), is an arthropod-borne virus (or arbovirus) that is maintained in a transmission cycle involving midges as the arthropod vector and multiple vertebrates as potential wildlife hosts. OROV was originally isolated in a village called Vega de Oropouche in Trinidad and Tobago and has since been...

The Black Sea basin has a strategic geographic location bridging Asia and Europe and depends on traditional livestock practices for their local economies. Anthrax, a zoonotic bacterial disease caused by Bacillus anthracis, poses a significant global threat impacting public health, food security, pastoralist communities, and national economies. The...

Background Collecting and sharing data in a timely manner is essential to responding effectively to phenomena that impact human well-being. In countries such as Ecuador, the collection and publication of this information may be insufficient. Objective To explore how publicly available health data are shared for policy implementation and decision-ma...

Background Understanding the population dynamics and geographic range of Aedes aegypti is of high importance for arbovirus vector surveillance and control. Little is known about the current distribution and seasonality of Ae. aegypti in Grand Lomé, Togo. Methods Mosquito oviposition traps (n = 70) were deployed in houses in the thirteen communes i...

Emerging infectious diseases are increasingly understood as a hallmark of the Anthropocene 1–3 . Most experts agree that anthropogenic ecosystem change and high-risk contact among people, livestock, and wildlife have contributed to the recent emergence of new zoonotic, vector-borne, and environmentally-transmitted pathogens 1,4–6 . However, the ext...

The states of Kansas and Oklahoma, in the central Great Plains, lie at the western periphery of the geographic distributions of several tick species. As the focus of most research on ticks and tick-borne diseases has been on Lyme disease which commonly occurs in areas to the north and east, the ticks of this region have seen little research attenti...

The Black Sea basin has a strategic geographical location bridging Asia and Europe and depends on traditional livestock practices. Anthrax, a zoonotic bacterial disease caused by Bacillus anthracis, poses a significant global threat impacting public health, food security, pastoralist communities, and national economies. The disease is endemic or sp...

Primary health care is at the core of health systems that aim to ensure equitable health outcomes. With an estimated 36% of rural population, Ecuador has a service year programme (created in 1970) for recently graduated doctors to provide primary care services in rural and remote communities. However, little has been done to monitor or evaluate the...

Background Vector-borne diseases (VBDs) are important contributors to the global burden of infectious diseases due to their epidemic potential, which can result in significant population and economic impacts. Oropouche fever, caused by Oropouche virus (OROV), is an understudied zoonotic VBD febrile illness reported in Central and South America. The...

Introduction: In Ecuador, poisonous snakebites are a public health problem. However, there is no recent hospital information from the Amazon. Objective: To retrospectively analyse the clinical-epidemiological characteristics of snakebites in patients admitted to a hospital in the Ecuadorian Amazon. Materials and methods: This is a cross-sectional s...

H ansen disease (leprosy) is an ancient pathology caused by 2 slow-growing intracellular bacilli, Mycobacterium leprae and M. lepromatosis (1). Both pathogens have the ability to damage peripheral nerves of hosts, producing a broad spectrum of clinical outcomes. Routes of disease transmission have been hypothesized for >100 years but are still acti...

Introduction Stroke is the second most common cause of death and disability-adjusted life years (DALYs) globally. However, the incidence and impact of stroke by ethnicity and gender is frequently distinct. This is particularly the case in Ecuador where geographic and economic marginalization are often correlated with ethnic marginalization and the...

The location of Ecuador-an equatorial nation-favors the multiplication and dispersal of the Leptospira genus both on the Pacific Coast and in the Amazon tropical ecoregions. Nevertheless, leptospirosis epidemiology has not been fully addressed, even though the disease has been recognized as a significant public health problem in the country. The pu...

The world is facing unprecedented global challenges that pose existential-level threats to the survival of humanity and the planet. Despite the enormity of these challenges, world leaders have failed to rise to the occasion. Instead, we have observed increasingly nationalistic, siloed responses that undermine much-needed approaches centred around g...

Melioidosis is an underreported human disease of tropical and sub-tropical regions caused by the saprophyte Burkholderia pseudomallei. Although most global melioidosis cases are reported from tropical regions in Southeast Asia and northern Australia, there are multiple occurrences from sub-tropical regions, including the United States (U.S.). Most...

The COVID-19 pandemic has caused over 500 million cases and over six million deaths globally. From these numbers, over 12 million cases and over 250 thousand deaths have occurred on the African continent as of May 2022. Prevention and surveillance remains the cornerstone of interventions to halt the further spread of COVID-19. Google Health Trends...

Background In Ecuador, leptospirosis surveillance involves a mandatory notification of all cases and a hospitalization for severe illness. Morbidity and mortality are, nevertheless, underestimated and contribute directly to the status of leptospirosis as a neglected disease. Leptospira spp. is zoonotic in Ecuador with established endemic transmissi...

Background The COVID-19 pandemic has caused more than 25 million cases and 800 thousand deaths worldwide to date. In early days of the pandemic, neither vaccines nor therapeutic drugs were available for this novel coronavirus. All measures to prevent the spread of COVID-19 are thus based on reducing contact between infected and susceptible individu...

Purpose Extended-spectrum beta-lactamase-producing (ESBL) Enterobacteriaceae, which includes Escherichia coli, has emerged as a global health threat. ESBL enzymes including CTX-M, TEM, and SHV are the most detected. Here, a systematic review was developed to assess the status of ESBLs in E. coli considering studies performed in the human, animal, f...

Background Estimates of the geographical distribution of Culex mosquitoes in the Americas have been limited to state and provincial levels in the United States and Canada and based on data from the 1980s. Since these estimates were made, there have been many more documented observations of mosquitoes and new methods have been developed for species...

Objectives We aim to assess the evidence on the usefulness of post-vaccination testing of Covid-19 antibodies. Study design We use a descriptive analytical approach. Methods We synthesize insights of studies on the immunological responses to SARS-CoV-2 after natural infection or vaccination and recommendations by regulatory institutions, such as...

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 Apri...

The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hosp...

Objectives: In the present manuscript we used Internet-derived data to assess whether Google Health Trends (GHT) search counts are able to track COVID-19 incidences in Africa. Methods: We collected COVID-19 case and death incidence for 54 African countries from February 2020 to January 2021. We used GHT to characterize COVID-19 incidence up to 24 J...

https://www.nature.com/articles/s41598-021-84805-6 Neanderthals have often been seen as populations that sought refuge in southern regions of Europe during ice ages and whose ultimate disappearance could be attributed to their inability to adapt to climate change. An international team of archaeologists, ecologists, and climate modelers refute thi...

Purpose: Discharge or follow up of confirmed coronavirus disease 2019 (COVID-19) cases depend on accurate interpretation of RT-PCR. Currently, positive/negative interpretations are based on amplification instead of quantification of cycle threshold (Ct) values, which could be used as proxies of patient infectiousness. Here, we measured Ct values i...

The French Middle Gravettian represents an interesting case study for attempting to identify mechanisms behind the typo-technological variability observed in the archaeological record. Associated with the relatively cold and dry environments of GS.5.2 and 5.1, this phase of the Gravettian is characterized by two lithic typo-technical entities (faci...

Cadaveric prosections are effective learning tools in anatomy education. They range from a fully dissected, sometimes plastinated, complete cadaver (in situ prosections), to a single, carefully dissected structure detached from a cadaver (ex situ prosections). While most research has focused on the advantages and disadvantages of dissection versus...

The COVID-19 pandemic has caused more than 25 million cases and 800 thousand deaths worldwide to date. Neither vaccines nor therapeutic drugs are currently available for this novel coronavirus. All measures to prevent the spread of COVID-19 are thus based on reducing contact between infected and susceptible individuals. Most of these measures such...

1 The COVID-19 pandemic has caused more than 25 million cases and 800 thousand 2 deaths worldwide to date. Neither vaccines nor therapeutic drugs are currently avail-3 able for this novel coronavirus. All measures to prevent the spread of COVID-19 are 4 thus based on reducing contact between infected and susceptible individuals. Most 5 of these mea...

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on March 11th. In Ecuador, the first case of COVID-19 was recorded on February 29th. Despite efforts to control its spread, SARS-CoV-2 overrun the Ecuadorian public health system which became one of the most affected in Latin America with 22,719 cases...

Amphimerus sp. is a fluke that dwells in the biliary tracts of vertebrate definitive hosts including humans, domestic, and wild mammals in Latin America. Opisthorchiid liver infections are rarely studied in the Americas confirming its status as a neglected tropical disease. In Ecuador, small trematode eggs were reported in human cases from the prov...

Ecological niche modeling (ENM) and species distribution modeling (SDM) are sets of tools that allow the estimation of distributional areas on the basis of establishing relationships among known occurrences and environmental variables. These tools have a wide range of applications, particularly in biogeogra-phy, macroecology, and conservation biolo...

Background: Dengue fever is a mosquito-borne infection transmitted by Aedes aegypti and mainly found in tropical and subtropical regions worldwide. Since its re-introduction in 1986, Brazil has become a hotspot for dengue and has experienced yearly epidemics. As a notifiable infectious disease, Brazil uses a passive epidemiological surveillance sy...

The French Middle Gravettian represents an ideal case study for attempting to identify mechanisms behind the diversity observed in the archaeological record. Associated with the relatively cold and dry environments of GS-5.2 and 5.1, this sub-phase of the Gravettian is characterized by two lithic typo-technical facies: the Noaillian (defined by the...

Background Bacillus cereus biovar anthracis (Bcbva) is an emergent bacterium closely related to Bacillus anthracis, the etiological agent of anthrax. The latter has a worldwide distribution and usually causes infectious disease in mammals associated with savanna ecosystems. Bcbva was identified in humid tropical forests of Côte d’Ivoire in 2001. He...

Vector control strategies recommended by the World Health Organization are threatened by resistance of Anopheles mosquitoes to insecticides. Information on the distribution of resistant genotypes of malaria vectors is increasingly needed to address the problem. Ten years of published and unpublished data on malaria vector susceptibility/resistance...

Background Information on the distribution of malaria vector species and their susceptibility profiles is needed for development of an effective vector control program. This study therefore aimed to (1) provide information about susceptibility and resistance status of Anopheles gambiae sensu lato populations across Togo, (2) assess genetic resistan...

El conjunto de ideas, métodos y programas informáticos que se conoce como “Modelado de Nicho Ecológico” (MNE)—y el relacionado “Modelado de Distribución de Especies” (MDS)—han sido objeto de intensa exploración e investigación en las últimas décadas. A pesar de existir al menos cuatro síntesis publicadas, este campo ha crecido tanto en complejidad,...

Objectives To describe a clinical case of Acinetobacter baumannii sequence type (ST) 32 harbouring a New Delhi metallo-β-lactamase (NDM) in Ecuador. Methods We used multilocus sequence typing (MLST) to confirm the bacterial species and the sequence type of an A. baumannii isolate. We used synergy with the imipenem–EDTA disc method and the carbapen...

Often facilitated by human-mediated pathways, aquatic invasive species are a threat to the health and biodiversity of global ecosystems. We present a novel approach incorporating survey data of watercraft movement in a social network analysis to reconstruct potential pathways of aquatic invasive species spread between lakes. As an example, we use t...

Large-scale biodiversity databases have become crucial information sources in many analyses in biogeography, macroecology, and conservation biology, often involving development of empirical models of species’ ecological niches and predictions of their geographic distributions. These analyses, however, can be impaired by the presence of errors, part...

Background Recently, a high prevalence of infection by the liver fluke Amphimerus spp. has been documented in the Chachi Amerindians of Ecuador. For diagnosis, no studies exist that compare the sensitivity of different coproparasitological detection techniques. The present study compares the Kato-Katz technique with three other coproparasitological...

Present the structured collected data for age, gender, and positive or negative result for each of the four techniques employed for the 105 samples in this study. (XLSX)

Approximately 5 million people suffer from snakebites, around 95,000 die as a consequence of envenoming, and ~300,000 survive with some level of disability. The majority of victims are concentrated around the poorest areas of the world. In July 2017, the World Health Organization re-established snakebite envenoming into the category of neglected tr...

Background Hantavirus pulmonary syndrome (HPS) is an infection endemic in Chile and Argentina, caused by Andes hantavirus (ANDV). The rodent Oligoryzomys longicaudatus is suggested as the main reservoir, although several other species of Sigmodontinae are known hosts of ANDV. Here, we explore potential ANDV transmission risk to humans in southern S...

To determine that Paragonimus sp. is actively transmitted in a tropical area of the Pacific region of Ecuador where human cases of pulmonary paragonimiasis have recently been documented, a total of 75 freshwater crabs were collected from 2 different streams in the Pedernales area of Manabí Province, Ecuador. All collected crabs were identified as H...

Oropouche virus is the aetiological agent of Oropouche fever, a zoonotic disease mainly transmitted by midges of the species Culicoides paraensis. Although the virus was discovered in 1955, more attention has been given recently to both the virus and the disease due to outbreaks of Oropouche fever in different areas of Brazil and Peru. Serological...

Objectives: To describe a clinical case of Klebsiella pneumoniae harboring New Delhi metallo-β-lactamase (NDM) plasmid in Ecuador and to present a map of reports of NDM isolates in South America. Methods: We used the Modified Hodge Test, Carbapenem Inactivation Method, the synergy with imipenem-EDTA disk method, and Rapidec Carba NP for identificat...

Traditional epidemiological studies of disease in animal populations often focus on directly transmitted pathogens. One reason pathogens with complex lifecycles are understudied could be due to challenges associated with detection in vectors and the environment. Ecological niche modeling (ENM) is a methodological approach that overcomes some of the...

Scorpion envenoming by species in the genus Tityus is hereby reported from rural locations in the Amazonian province of Morona Santiago, southeastern Ecuador. Twenty envenoming cases (18 patients under 15 years of age) including one death (a 4-year-old male) were recorded at the Macas General Hospital, Morona Santiago, between January 2015 and Dece...

Starry stonewort (Nitellopsis obtusa) is an alga that has emerged as an aquatic invasive species of concern in the United States. Where established, starry stonewort can interfere with recreational uses of water bodies and potentially have ecological impacts. Incipient invasion of starry stonewort in Minnesota provides an opportunity to predict fut...

Table A. Correlation matrix of environmental variables. Table B. Summary of model evaluations. (DOCX)

This manuscript presents the concept of "surveillance fatigue" (fatigatio vigilantiae), to describe an epidemiological scenario of an evident underreporting of cases during overwhelming epidemics. We revised past epidemics and found that surveillance fatigue is a common pattern, thus, it may be a useful concept in modern epidemiology.

BACKGROUND Oropouche virus causes Oropouche fever, an arboviral disease transmitted mainly by midges of the genus Culicoides and Culex mosquitoes. Clinical presentation of Oropouche fever in humans includes fever, headache, rash, myalgia, and in rare cases spontaneous bleeding and aseptic meningitis. Landscape change has been proposed as a driver o...

More than half of the world population is at risk of vector-borne diseases including dengue fever, chikungunya, zika, yellow fever, leishmaniasis, chagas disease, and malaria, with highest incidences in tropical regions. In Ecuador, vector-borne diseases are present from coastal and Amazonian regions to the Andes Mountains; however, a detailed char...

A 30-year-old male, from a subtropical region of Ecuador, was hospitalized with a 5-year history of persistent cough with rusty brown sputum, chest pain, and progressive dyspnea. The patient underwent thoracic surgery 3 years ago for pleural effusion and subsequently received a 9-month regimen treatment of tuberculosis. However, there was no clinic...

Author In Ecuador, leishmaniasis is a major public health concern reported in 21 of 24 provinces of the country, and eight Leishmania species, Leishmania (Leishmania) mexicana, L. (L.) amazonensis, L. (L.) major-like, L. (Viannia) guyanensis, L. (V.) panamensis, L. (V.) braziliensis, L. (V.) naiffi, and L. (V.) lainsoni, have been identified as ca...

Phylogenetic tree of cyt b gene sequences among species. Leishmanial cyt b genes were amplified and sequenced from patients with cutaneous leishmaniasis, and a phylogenetic analysis of cyt b gene sequences was performed by the neighbor-joining method together with sequences from 12 Leishmania species. The scale bar represents 0.01% divergence. Boot...

Sample collection sites in Ecuador. The dark gray areas show the Andean plateau (>1,000 m altitude), and the light gray areas show highland jungle or Andean slopes (400–1,000 m elevation). 1. Mataje, 2. Pampanal de Bolívar, 3. San Lorenzo, 4. Esmeraldas, 5. Atacames, and 6. Sabalito, Province of Esmeraldas; 7. Pedernales, 8. San Isidro, 9. Junin, 1...

STROBE Statement. (DOC)

The freshwater crabs collected in 2015 from the provinces of Manabi and Pichincha located in the Pacific coastal region of Ecuador are identified as three species of the genus Hypolobocera of the family Pseudothelphusidae, H. aequatorialis (Ortmann, 1897), H. guayaquilensis (Bott, 1967) and H. mindonensis Rodoríguez & Von Sternberg, 1998, and those...