Spatiotemporal trends of neglected tropical disease hospitalizations in Ecuador over 25-years from 2000 to 2024

ABSTRACT Background World Health Organization has identified 21 neglected tropical diseases (NTDs) affecting millions globally, for control or elimination. We analysed time trends and geographic distribution of hospitalizations attributed to NTDs between 2000 and 2024 in Ecuador. Methods We estimated hospitalization rates over the 25-year period using hospital discharge data from Ecuadorian national statistics. Time trends Joinpoint regression analysis was done for the 5 most frequent NTDs. Standardized morbidity ratios were estimated for these NTDs for census years (2001, 2010 and 2022) to explore relative changes in hospitalization rates over time and by geography. Results A total of 179,439 hospital discharges attributed to NTDs were recorded nationally in Ecuador. The five most frequent NTDs accounted for 97.1% of hospitalizations and included arboviral infections, dengue and chikungunya (62% of hospitalizations), snakebite envenoming (20%), soil-transmitted helminthiases (9%), taeniasis and cysticercosis (4%), and scabies and other ectoparasitoses (2%). Only 0.4% of hospitalizations resulted in death. NTD hospitalizations were more frequent in males (54%) with a median age of 19 years (Q 1 9 – Q 3 37). Although hospitalization rates for all NTDs increased over time, there was a downward trend in non-arboviral NTDs that was significant for snakebite (from 2014, annual percent change -7.81%, 95% CI -11.27, -5.69, P=0.006), soil-transmitted helminths (from 2000, -5.62%, 95% CI -6.56, -4.68, P