AUTHOR=Morales-Jadán Diana , Vallejo-Janeta Alexander Paolo , Bastidas Vanessa , Paredes-Espinosa Maria Belen , Freire-Paspuel Byron , Rivera-Olivero Ismar , Ortiz-Prado Esteban , Henriquez-Trujillo Aquiles Rodrigo , Lozada Tannya , The UDLA COVID-19 Team , Garcia-Bereguiain Miguel Angel , Jaramillo Tatiana , Gordon Daniela Santander , Iturralde Gabriel Alfredo , Teran Julio Alejandro , Vasquez Karen Marcela , Rondal Jonathan Dario , Granda Genoveva , Santamaria Ana Cecilia , Pino Cynthia Lorena , Espinosa Oscar Lenin , Buitron Angie , Grisales David Sanchez , Jimenez Karina Beatriz , Galvis Heberson , Coronel Barbara , Aguilar Dayana Marcela , Paredes Ines Maria , Bilvao Christian David , Pazmiño Sebastian Rodriguez , Laglaguano Juan Carlos , Herrera Henry , Espinosa Pablo Marcelo , Galarraga Edison Andrés , Zambrano-Mila Marlon Steven , Tito Ana María , Zapata Nelson David TITLE=High SARS-CoV-2 infection rates and viral loads in community-dwelling individuals from rural indigenous and mestizo communities from the Andes during the first wave of the COVID-19 pandemic in Ecuador JOURNAL=Frontiers in Medicine VOLUME=10 YEAR=2023 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1001679 DOI=10.3389/fmed.2023.1001679 ISSN=2296-858X ABSTRACT=Background

Neglected indigenous groups and underserved rural populations in Latin America are highly vulnerable to COVID-19 due to poor health infrastructure and limited access to SARS-CoV-2 diagnosis. The Andean region in Ecuador includes a large number of isolated rural mestizo and indigenous communities living under poverty conditions.

Objective

We herein present a retrospective analysis of the surveillance SARS-CoV-2 testing in community-dwelling populations from four provinces in the Ecuadorian Andes, carried out during the first weeks after the national lockdown was lifted in June 2020.

Results

A total number of 1,021 people were tested for SARS-CoV-2 by RT-qPCR, resulting in an overall high infection rate of 26.2% (268/1,021, 95% CI: 23.6–29%), which was over 50% in several communities. Interestingly, community-dwelling super spreaders with viral loads over 108 copies/mL represented 7.46% (20/268, 95% CI: 4.8–11.1%) of the SARS-CoV-2 infected population.

Conclusion

These results support that COVID-19 community transmission in rural communities from the Andean region was happening at the early stages of the COVID-19 pandemic in Ecuador and point out the weakness of the COVID-19 control program. Community-dwelling individuals in neglected rural and indigenous communities should be considered for a successful control and surveillance program in future pandemics in low- and middle-income countries.