13
IMPORTANCE OF DIAGNOSING BALANTIDIUM NAWARAOI
IN MANABÍ, ECUADOR.
IMPORTANCIA DEL DIAGNÓSTICO DE BALANTIDIUM NAWARAOI
EN MANABÍ, ECUADOR.
Luis Traviezo Valles1*
1 Universidad Centroccidental Lisandro Alvarado
(UCLA). Barquisimeto – Venezuela.
Abstract
The recent report of Balantidium nawaraoi in the Manabí, province of Ecuador,
a new ciliate that causes gastrointestinal symptoms in humans, raises the need
for its correct diagnosis, based on knowledge of its unique morphological
characteristics. These characteristics are described in this manuscript to facilitate
its differentiation from other human intestinal protozoa.
Resumen
El reciente reporte de Balantidium nawaraoi en la provincia de Manabí en
Ecuador, el cual es un nuevo ciliado en humanos productor de sintomatología
gastrointestinal, motiva la necesidad de su correcto diagnóstico, basado en el
conocimiento de sus características morfológicas únicas, las cuales se describen
en el presente manuscrito pretendiendo facilitar su diferenciación del resto de
protozoarios intestinales humanos.
Dear Editor:
As part of the responsibility that every healthcare professional must
have to contribute to preventing the spread of infectious agents, it is
important to report, the recent report by BSc. Byron Cervantes Baque
(Chone General Hospital) and BSc. Lenin Vera Macías (Bahía Health
Center), who indicated the presence, for the rst time in Ecuador, of
Balantidium nawaraoi.
Therefore, it is essential to increase the information on the main
characteristics of this ciliate so that it does not go unnoticed in Ecuadorian
laboratories, since its ability to cause diarrhea and other gastrointestinal
problems has been demonstrated (1).
Balantidium nawaraoi was rst described in 2021 in an indigenous
Warao community in the Orinoco River, Delta rainforest (Venezuela) in
polyparasitized patients with diarrhea. It was more recently described
(Revista Salud Amazónica y Bienestar) in a native patient from the canton
of Sucre, Manabí province, in western Ecuador. Therefore, it is important
to highlight its morphological characteristics so as not to overlook it or
confuse it with other enteroparasites in stool examinations (1-3).
Among its notable characteristics are that its macronucleus is more oval
and less kidney-shaped than that of Balantidium coli, which is located
diagonally, close to the middle of the body. The micronucleus tends to
be spherical or slightly oval, located close to the macronucleus (Figures
1 and 2) (1-3).
It has a contractile vacuole located in the posterior region of the soma,
with an approximate diameter of between 3 and 10 μm. The posterior
* Corresponding author:
Luis Traviezo Valles
E-mail: ltravies@ucla.edu.ve
Key words: Balantidium, ciliate, Ecuador, infection, protozoan.
Palabras clave: Balantidium, ciliado, Ecuador, infección, protozoario.
Forma de citar este artículo: Travieso
Valles L. IMPORTANCE OF DIAGNOSING
BALANTIDIUM NAWARAOI IN MANABÍ,
ECUADOR. Med Vozandes. 2025; 36 (1):
13 - 14
ORCID ID:
Luis Traviezo Valles:
orcid.org/0000-0003-4544-6965
LETTER TO THE EDITOR
Conflict of interest: The author was free to
prepare the manuscript and there were no potential
conicts of interest.
Financial disclosure: The author has no nancial
relationships relevant to this article to disclose..
CRediT – Contributor Roles Taxonomy:
Conceptualización, Curación de datos, Análisis formal,
Investigación, Metodología, Visualización, Redacción –
borrador original, Redacción – revisión y edición: LTV
Este artículo está bajo una
licencia de Creative Com-
mons de tipo Reconocimien-
to – No comercial – Sin obras
derivadas 4.0 International.
DOI: 10.48018/RMVv36i11
Received: 14 – May – 2025
Accepted: 02 – Jul – 2025
Publish: 05 – Jul – 2025
Revista Médica Vozandes
Volumen 36 , Número 1, 2025
14 Revista Médica Vozandes
Volumen 36 , Número 1, 2025
IMPORTANCE OF DIAGNOSING BALANTIDIUM NAWARAOI
IN MANABÍ, ECUADOR. Valles LT.
Referencias
1. Cervantes Baque B, Acurero E, Traviezo L. Primer reporte de Balantidium
nawaraoi en Ecuador. Revista Salud Amazónica y Bienestar. 2025; 4(2)
e945. https://doi.org/10.51252/rsayb.v4i2.945
2. Traviezo Valles L. Balantidium nawaraoi n. sp., en la comunidad warao
de Nabasanuka, Venezuela. Rev Med Sinergia. 2021; 6(2): e637. https://
dialnet.unirioja.es/servlet/articulo?codigo=8373587
3. Traviezo Valles L. Balantidium nawaraoi, un nuevo ciliado en humanos.
Rev Vet Zootec Amaz. 2022; 2(1): e223. https://revistas.unsm.edu.pe/in-
dex.php/revza/article/view/223/389
Figure 2. Balantidium nawaraoi trophozoite, with the
posterior third (TP), cilia (C), and cytostome (Ct) indi-
cated. At the top right, a fertile egg of Ascaris lumbri-
coides (Al) allows for a comparison of both sizes. Stool
sample in isotonic saline solution, 40X objective
Source. Image and photographic description by the
author.
Alternatively, it could be the beginning of an
autochthonous outbreak that warrants a precise
response from health authorities. However, in both cases,
it is necessary to be prepared for timely laboratory
diagnosis, which will allow for both the identication and
resolution of the problem quickly and safely.
end is narrower, specically the posterior third (TP), which
has a seemingly empty, spiral structure resembling the
shell of the snail Nautilus pompilius (Linnaeus, 1758).
This posterior third is more transparent than the rest of
the body, making it completely different from other
described species of the genus Balantidium.
The TP measures between 26 and 30 μm in length
(average 28 μm) and 27 to 31 μm in width (average 29
μm). Another important characteristic observed was its
progressive, rapid, and energetic movements, as well
as its corkscrew-like rotational movements as it moved
forward haphazardly (2,3).
Figure 1. Design of Balantidium nawaraoi, the posterior
third in yellow, the anterior two-thirds in brown, and the
cytostome (CT).
Source. Sketch courtesy of BSc. Antonella Traviezo
Triolo.
To date, the cystic form, the complete cycle, or
its reservoir have not been reported; however, it is
presumed, based on concordance, that it could be
similar to that of Balantidium coli. Gastrointestinal
symptoms, especially diarrhea, have been observed
in all patients where this species was found, and
symptomatic and parasitological cure was observed
after the use of metronidazole (in adults, 500 mg every
twelve hours for seven days) (1-3).
The presence of an infected patient in the province of
Manabí could be an isolated case, an opportunistic
and accidental infection that would be eliminated with
treatment, preventing an outbreak.
