Human scabies and pediculosis in Ecuador: spatial distribution and environmental determinants.

Parasitic diseases, including scabies and pediculosis, pose significant public health concerns, particularly in developing countries. Despite their non-lethal nature, these diseases can cause considerable morbidity. This study aimed to assess the national and subnational burden of scabies and pediculosis in Ecuador during 2021 and explore the spatial correlations between these diseases and environmental factors. An observational, cross-sectional study was conducted using 2021 outpatient data from Ecuador's Ministry of Public Health. Municipal incidence rates were calculated for scabies (ICD-10 B86) and pediculosis (ICD-10 B85). Local Indicators of Spatial Association analysis was performed to identify epidemiological hot and cold spots. Associations with climatic variables (rainfall, temperature and altitude) were examined using Wilcoxon tests and ordinary least squares regression. A total of 20 722 scabies cases and 3558 pediculosis cases were identified, with national incidences of 118.45 and 20.33 per 100 000 population, respectively. Both diseases were more frequent in women. Scabies hot spots were located in the Coast and Amazon regions and associated with higher rainfall, higher temperature and lower altitude. Pediculosis hot spots were located exclusively in the Amazon region and associated with higher rainfall and higher altitude. Climatic factors explained 24.3% of scabies variance but only 6.3% for pediculosis. This study underscores the importance of climatic and socio-environmental factors in the transmission of scabies and pediculosis and provides valuable epidemiological data for future control efforts in Ecuador.