Health assessment of 4–13 years students living in a rural Andean region: The EVANES study design protocol

Summary: Background & aims: In Ecuador, stunting and overweight are the main nutritional problems identified at school age in the indigenous population, associated with infectious diseases and diarrhoea. The Andean region has the largest indigenous population in the country, which suffers from inequality and poverty, especially those inhabiting rural areas. Clinical studies have shown a high infection vulnerability of rural populations. Therefore, we aim to evaluate nutritional status according to dietary intake, intestinal parasitic infections, household and environmental conditions, ant their relation with cognitive development of schoolchildren in rural highlands of Ecuador in order to develop prevention and health promotion programmes adapted to the needs of these children and their families. Methods: The EVANES study is a multi- and interdisciplinary approach designed to evaluate the dietary intake, anthropometric parameters, intestinal parasitic infections, hygienic-sanitary and environmental conditions and cognitive development of Ecuadorian schoolchildren. Results: This exhaustive assessment may be useful for: identifying nutritional issues, establishing health programmes for disease prevention and health promotion, clarifying the aetiology of stunting in the indigenous population, and defining reference patterns for the diagnosis of anaemia in the highlands in childhood. Conclusions: The EVANES study could be a model protocol for other areas of Ecuador and countries, and can contribute to improving the health and development of children in Latin American and highland countries. It is expected to contribute to the scientific community with unique insights into the health status of rural indigenous schoolchildren living at high altitude, in order to develop appropriate health programmes and policies for disease prevention and health promotion in these populations.