The following study, which involved our CISeAL researcher Venus Medina, analyzes how Ecuadorian women perceive nursing support and the use of non-pharmacological strategies to relieve pain during labor. Through a qualitative approach carried out at the Nueva Aurora Gyneco-Obstetric Pediatric Hospital in Quito, the experiences of 21 women in the immediate postpartum period were collected, revealing that interventions such as guided breathing, walking, sphere therapy, music therapy, and emotional support significantly contributed to transforming childbirth into a more tolerable, safe, and humanized experience. The findings show that participants not only perceived a reduction in pain and anxiety, but also experienced a greater sense of autonomy, calmness, and connection with their newborns.
The following study analyzed health-related quality of life in Ecuadorian patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), as well as its association with anxiety, depression, fatigue, and disability. The research was conducted at Hospital Carlos Andrade Marín between March and June 2025 and included 151 patients, of whom 117 had MS and 34 had NMOSD. The study involved the participation of CISeAL researcher Ruth Jimbo-Sotomayor. The results showed that patients with NMOSD had a significantly more impaired quality of life compared to patients with MS, particularly in the physical and mental components assessed using the MSQOL-54 scale. The most affected domains were physical and emotional limitations, pain, social functioning, and sexual functioning. Furthermore, the study demonstrated that neurological disability was considerably greater in patients with NMOSD, who presented higher EDSS scores, confirming the more disabling nature of this disease compared to multiple sclerosis. In both groups, females and the mestizo population predominated, a relevant finding within the Latin American epidemiological context.
Climate change has become established as one of the main challenges for global public health, with growing impacts on health systems and an urgent demand for trained professionals to address them. In this context, the study analyzes how undergraduate medical training programs in Ecuador have incorporated (or not) this topic between 2019 and 2024, as well as the role that student associations have taken on in addressing these gaps. With the participation of our CISeAL researchers, Damary Jaramillo-Aguilar, Anita G. Villacís, and Katherine Simbaña-Rivera, it is evident that, despite international and national recognition of the relevance of climate change, its integration into medical education remains limited, fragmented, and mostly indirect.
Based on a descriptive analysis of accredited programs and student activities, the findings show that fewer than half of the programs include related courses, and in very few cases is climate change explicitly addressed, even being reduced to isolated sessions within broader courses. This weak incorporation contrasts with the country’s high vulnerability to climate-related phenomena and their effects on communicable and non-communicable diseases, as well as on the social determinants of health. Consequently, this highlights a disconnect between the needs of the national context and the training of future health professionals, limiting their ability to anticipate, prevent, and respond to these challenges.
The analysis of health inequalities in Latin America requires going beyond biological differences and considering how social factors such as gender, ethnicity, and living conditions jointly shape health outcomes. In this context, the study in which our CISeAL principal investigator, Dr. Ana Lucía Moncayo, participates takes a comprehensive approach to examining the relationship between social determinants and the presence of chronic diseases in Brazil, Ecuador, and Mexico. It uses machine learning models to identify complex and non-linear patterns that often go unnoticed in traditional approaches. The findings show that variables such as occupation and education play a central role, although with differentiated effects by gender: occupation is more determinant in men, possibly due to its relationship with economic stability and the social role of provider, while education has a greater impact on women, being associated with self-care practices, greater health awareness, and more frequent use of medical services.
The study “Understanding Perceived Motives for Dating Violence Among Adolescents: A Mixed-Methods Approach,” with the participation of our principal investigator at CISeAL, Dr. Venus Medina, analyzes the perceived motives that Ecuadorian adolescents attribute to dating violence, understood as a priority public health issue that affects physical, psychological, and emotional well-being during a key stage of development. Using a concurrent mixed-methods design with equal quantitative and qualitative weight, applied to 703 adolescents in the quantitative phase and 103 in the qualitative phase, the study does not seek to identify objective causes of violence, but rather to understand how young people themselves interpret and justify situations that could trigger aggressive behaviors in their relationships. In line with the ecological model of the World Health Organization and coercive control theory, the findings show that perceived motives are shaped through the interaction of individual, relational, and contextual factors.
This study, led by Juan José Bustillos Herrera, adjunct researcher at CISeAL, comprehensively analyzed entomological and virological surveillance in areas with active dengue transmission in the province of Santo Domingo de los Tsáchilas, Ecuador, between June 2023 and September 2024, with the aim of assessing the epidemiological importance of Aedes aegypti and the recent presence of Aedes albopictus. Based on extensive sampling that included the inspection of more than 55,000 households and the collection of 3,918 mosquito specimens at both adult and immature stages, a clear predominance of Aedes aegypti was observed, accounting for more than 90% of the analyzed specimens, thus confirming its central role as the primary dengue vector in the area. Molecular analysis using RT-qPCR detected exclusively DENV-1 and DENV-2 serotypes in Aedes aegypti pools, with a positivity rate of 33.69%, while Aedes albopictus, although already established in the territory, showed no infection with any of the arboviruses screened. Entomological indices, particularly the Breteau Index, revealed high levels of infestation in several urban and rural parishes, identifying localities with high entomological risk, especially Chigüilpe, Río Verde, Río Toachi, Santo Domingo, and Zaracay.
The principal investigators Xavier Sánchez and Ruth Jimbo-Sotomayor, from CISeAL, together with a team affiliated with PUCE, conducted a study on the comorbidity of depression and anxiety in undergraduate and graduate medical students in Ecuador, focusing on estimating its prevalence and associated factors. The research, carried out between January and March 2025 with 700 participants, used validated psychiatric screening tools (PHQ-9 for depression, GAD-7 for anxiety, and AUDIT for alcohol use), defining comorbidity as clinically significant scores on both instruments. Results showed that 47.71% of students reported depression, 44.57% anxiety, and 36.71% depression-anxiety comorbidity, with higher prevalence among undergraduate students.
