The life cycle of Balantidium nawaraoi

Dear Editor, the recent description, for the first time in the Republic of Ecuador, of Balantidium nawaraoi (Neobalantidium nawaraoi or Balantioides nawaraoi) specifically in the province of Manabí, and a second discovery, also in 2025, but this time in the province of Cotopaxi, triggered an epidemiological alert to disseminate all relevant information on this new ciliate in humans so that the various stakeholders in the health system can better understand how to address this new intestinal parasitic problem (1,2).Based on recent epidemiological information collected from infected patients in both Ecuador and Venezuela, the likely life cycle of this ciliate species has been possible to design.