Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
https://doi.org/10.62574/bhfw1c74
1
Evaluation of the epidemiological surveillance system in the reduction of
infectious diseases in Ecuador
Evaluación del sistema de vigilancia epidemiológica en la reducción de
enfermedades infecciosas en Ecuador
Jonathan Alexander González-Cano
jgonzalezc@unemi.edu.ec
Universidad Estatal de Milagro, Milagro, Guayas, Ecuador
https://orcid.org/0000-0002-3420-6109
Nahin Benjamín Cisneros-Zumba
ncisneros3295@upse.edu.ec
Universidad Estatal Península de Santa Elena, La Libertad, Santa Elena, Ecuador
https://orcid.org/0000-0002-8736-6333
Viviana Gabriela Avecillas-Morejón
viviana.avecillas@iess.gob.ec
Hospital Básico El Puyo – IESS, El Puyo, Pastaza, Ecuador
https://orcid.org/0009-0008-9629-5945
Ruth Elizabeth Salazar-Imbaquingo
ruty90.20@gmail.com
Hospital Gineco Obstétrico Isidro Ayora – MSP, Quito. Pichincha, Ecuador
https://orcid.org/0009-0006-4788-5338
ABSTRACT
Objective: To evaluate the epidemiological surveillance system in the reduction of infectious
diseases in Ecuador based on scientific papers published between 1999 and 2024. Method:
Descriptive document review at the national level, using 17 scientific articles as the population.
Results and conclusion: Seventeen scientific articles were used as the population. The Ecuadorian
epidemiological surveillance system has made significant achievements in mitigating infectious
diseases; however, challenges remain in regional coverage, data quality, and technological
integration. Overcoming these gaps through territorialised cooperative work and the implementation
of digital and genomic tools will strengthen early detection and rapid response, ensuring continued
progress in public health.
Descriptors: health services research; epidemiology; uses of epidemiology. (Source, DeCS).
RESUMEN
Objetivo: realizar una evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades
infecciosas en Ecuador desde el aporte de trabajos científicos publicados en el periodo 1999 al 2024. Método:
revisión documental descriptiva de alcance nacional, se empleó como población 17 articulos científicos.
Resultados y conclusión: Se empleó como población 17 articulos científicos. El sistema de vigilancia
epidemiológica ecuatoriano ha conseguido logros importantes en la mitigación de enfermedades infecciosas;
empero, persisten desafíos en cobertura regional, calidad de los datos e integración tecnológica. Superar estas
brechas desde un trabajo cooperativo territorializado, así como la implementación del uso de herramientas
digitales y genómicas fortalecerá la detección precoz y la respuesta rápida, asegurando la continuidad de los
avances en salud pública.
Descriptores: investigación en servicios de salud; epidemiología; usos de la epidemiología. (Fuente, DeCS).
Received: 03/03/2025. Reviewed: 07/04/2025. Approved: 11/04/2025. Published: 10/05/2025.
Short original
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
2
INTRODUCTION
Epidemiological surveillance is a fundamental pillar for the prevention and control of
infectious diseases, as it enables the timely detection of outbreaks, the monitoring
of trends, and the evaluation of the impact of public health interventions (1). In
Ecuador, the geographical and sociodemographic diversity from the coastal region
to the Amazon poses particular challenges for the coverage and quality of reporting
systems (6,9). Despite advances in infrastructure and training of health personnel,
gaps remain in data integration and rapid response to health emergencies (2,4).
On the other hand, scientific evidence has documented the effectiveness of active
surveillance in reducing cases of dengue and other arboviruses (16), as well as the
contribution of molecular surveillance to characterising foci of bacterial resistance
(4). However, it is necessary to comprehensively evaluate the performance of the
national epidemiological surveillance system to guide improvements that ensure
continuous, responsive surveillance adapted to regional particularities.
The objective of this article is to evaluate the epidemiological surveillance system in
the reduction of infectious diseases in Ecuador based on scientific studies published
between 1999 and 2024.
METHOD
A descriptive documentary review was conducted at the national level, focusing on
the evaluation of Ecuador's epidemiological surveillance system from 1999 to 2024.
Seventeen scientific articles directly contextualised to Ecuador were used as the
population, retrieved from the following databases:
Scopus: 3 articles
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
3
PubMed: 8 articles
Scielo: 4 articles
Other databases: 2 articles
MeSH and DeCS terms were used: ‘surveillance’, ‘epidemiological surveillance’,
‘Ecuador’, ‘infectious diseases’, ‘public health system’.
Documentary content analysis was applied to evaluate the information relevant to
the research objective.
RESULTS
The analysis of the national epidemiological surveillance system reveals substantial
progress in the containment of infectious diseases in Ecuador. After strengthening
active and passive surveillance mechanisms between 2017 and 2021, a significant
decrease in the incidence of gestational malaria (6), infant giardiasis (8) and dengue
in endemic areas in the north of the country (11) has been documented.
These findings are consistent with Cartelle-Gestal et al., who describe how
strengthening epidemiological data collection and processing reduces neglected
tropical diseases (1). Similarly, Vitale et al. demonstrated that active surveillance for
dengue fever is more sensitive than the passive model, allowing for early detection
of outbreaks and enabling more timely responses (16).
However, gaps remain in the coverage and quality of the information reported. In
response, Soria-Segarra et al. identified foci of resistant Gram-negative bacilli in
urban hospitals, evidence of possible underreporting of nosocomial infections and
limiting the effectiveness of interventions (4). This deficiency is exacerbated by
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
4
regional disparities in laboratory infrastructure and human talent training, as warned
by Torres et al. in their study on chronic diseases (2).
The geographical heterogeneity of surveillance resources is another critical
challenge in the Amazon, where malaria and Chagas disease remain endemic.
Bracho-Á et al. and Aguilar V et al. found that, despite local improvements, coverage
does not reach the thresholds necessary to interrupt transmission (6,9). It is
therefore urgent to adapt strategies to specific sociodemographic and access
characteristics, incorporating solutions such as remote telemetry and satellite
networks in areas with difficult coverage.
Similarly, Chandler et al. highlight the need to standardise reporting protocols for
chronic mycoses such as mycetoma and to seamlessly coordinate primary and
secondary care (3). Without these improvements, the true magnitude of fungal
infections will continue to be underestimated, affecting resource allocation and staff
training.
Public health policies must go beyond strengthening supplies and equipment. It is
therefore a priority to implement interoperable digital platforms that facilitate real-
time data analysis and genomic surveillance, as molecular epidemiology studies of
resistant bacilli show that routine genomic sequencing optimises the identification of
transmission chains and guides targeted interventions (4).
Therefore, although the overall trend points to a reduction in multiple infectious
diseases, surveillance should not be relaxed during inter-epidemic periods.
Experience with chikungunya and dengue between 2014 and 2017 shows that a
reduction in control measures can trigger epidemic rebounds (10). Similarly,
phylogenetic analysis of dengue strains in different population sizes highlights the
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
5
complexity of transmission and the need to continuously adjust surveillance
strategies (11).
CONCLUSION
The Ecuadorian epidemiological surveillance system has made significant
achievements in mitigating infectious diseases; however, challenges remain in
regional coverage, data quality, and technological integration. Overcoming these
gaps through territorialised cooperative work and the implementation of digital and
genomic tools will strengthen early detection and rapid response, ensuring continued
progress in public health.
FUNDING
Non-monetary
CONFLICT OF INTEREST
There is no conflict of interest with individuals or institutions linked to the research.
ACKNOWLEDGEMENTS
To the epidemiological doctors of Ecuador.
CONTRIBUTION OF THE AUTHORS
Jonathan Alexander González-Cano: Contributed to the conceptualisation,
development and writing of the article, and was responsible for analysing the results
obtained from the selected articles and interpreting the data in the context of
Ecuador. Nahin Benjamín Cisneros-Zumba: Was responsible for analysing and
synthesising scientific articles related to infectious diseases and epidemiological
surveillance in the country, contributing to the identification of gaps in the coverage
and quality of reporting and surveillance systems. Viviana Gabriela Avecillas-
Morejón: Participated in the collection of information from secondary sources,
Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
6
contributing to the document review and identification of the main infectious diseases
affecting Ecuador. Ruth Elizabeth Salazar-Imbaquingo: Her collaboration focused on
identifying challenges at the local and regional levels, particularly in areas most
affected by diseases such as malaria and dengue, reviewing the final draft of the
manuscript, and adapting it to editorial standards.
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Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
7
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Sanitas
Revista arbitrada de ciencias de la salud
Vol. 4(2), 1-8, 2025
Evaluación del sistema de vigilancia epidemiológica en la reducción de enfermedades infecciosas en
Ecuador
Evaluation of the epidemiological surveillance system in the reduction of infectious diseases in
Ecuador
Jonathan Alexander González-Cano
Nahin Benjamín Cisneros-Zumba
Viviana Gabriela Avecillas-Morejón
Ruth Elizabeth Salazar-Imbaquingo
8
Copyright: 2025. By the authors. This article is open access and distributed under the terms
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International (CC BY-NC-SA 4.0) licence.
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