High Prevalence and Regional Heterogeneity of Canine Ancylostoma spp. in Ecuador: A Systematic Review and Meta-Analysis and Its Potential One Health Implications.

Hookworms are zoonotic helminths that cause intestinal diseases in pets and humans, as well as cutaneous larva migrans in the latter; therefore, they are of importance to animal and public health. Stray and domestic dogs play a significant role in the transmission of hookworm disease. This study examines the prevalence of Ancylostoma spp. infections in dogs in Ecuador through a systematic review and meta-analysis. Although based exclusively on canine data, the findings are discussed in the context of available evidence on zoonotic transmission and potential One Health implications. A total of 370 records were screened, of which 9 studies published between 2010 and 2025 met the PRISMA 2020 inclusion criteria. Using a random-effects model with Freeman-Tukey double arcsine transformation, the pooled prevalence was estimated at 32% (95% CI: 17-49%), with substantial heterogeneity across studies (I2 = 98.3%). Regional analysis revealed significantly higher prevalence in the Insular region (50%) and the Coastal region (43%), compared to the Sierra (Andean region) (12%). These findings indicate marked spatial variability in canine Ancylostoma infections across Ecuador, likely reflecting underlying environmental, epidemiological, and methodological differences. While this study does not directly assess human or environmental data, the observed patterns are consistent with epidemiological conditions that may favor zoonotic transmission. Overall, this study highlights the need for integrated approaches consistent with a One Health perspective, including improved surveillance, veterinary interventions, and further research incorporating human and environmental components to better understand the epidemiology and potential zoonotic implications of hookworm infections.