A decade of Ecuador´s efforts to raise its health research output: a bibliometric analysis

Figures & data

Figure 1. STROBE flowchart

Table 1. Study characteristics of Ecuadorian health sciences-related publications, 1999–2017

Characteristic	0verall period (1999–2017) n = 2784	Period I (1999–2008) n = 671	Period II (2009–2017) n = 2113	p-value^a
Articles, median (IQR)	105 (66–169)	66 (49–79)	182 (132–297)	<0.001
Language, n(%)				<0.01
English	2133 (76.6)	526 (78.5)	1607 (76)
Spanish	546 (19.6)	133 (19.8)	413 (19.5)
Other	105 (3.8)	12 (1.8)	93 (4.4)
Publication type, n(%)				<0.001
Original paper	2496 (89.6)	574 (85.5)	1922 (90.9)
Review	288 (10.3)	97 (14.4)	191 (9)
Study design, n(%)				<0.001
Ecologic	128 (4.6)	2 (0.3)	126 (5.9)
Cross-sectional	899 (32.3)	136 (20.3)	763 (36.1)
Case-control	90 (3.2)	9 (1.3)	81 (3.8)
Cohort	99 (3.5)	32 (4.8)	67 (3.2)
Randomized controlled trial	83 (2.9)	45 (6.7)	38 (1.8)
Meta-analysis	4 (0.1)	1 (0.1)	3 (0.1)
Review	335 (12)	86 (12.8)	249 (11.8)
Other	1146 (41.2)	360 (53.6)	786 (37.2)
Institution affiliation, n(%)				<0.001
Private University	681 (24.5)	106 (15.8)	575 (27.2)
Public University	523 (18.8)	66 (9.8)	457 (21.6)
Private and Public University	71 (2.5)	6 (0.9)	65 (3.1)
Private Hospital	250 (8.9)	118 (17.6)	132 (6.2)
Public Hospital^b	233 (8.4)	96 (14.3)	137 (6.5)
Hybrid Hospital (SOLCA)	39 (1.4)	10 (1.5)	29 (1.4)
Private and Public Hospital	49 (1.8)	25 (3.7)	24 (1.3)
University and Hospital	350 (12.6)	81 (12.1)	269 (12.7)
Industry	65 (2.3)	10 (1.5)	55 (2.6)
Other	523 (18.8)	153 (22.8)	370 (17.5)
Research focus, n(%)				<0.001
Basic science	606 (21.8)	136 (20.3)	470 (22.2)
Clinical/surgical	1372 (49.3)	378 (56.3)	994 (47)
Public health	783 (28.1)	156 (23.2)	627 (29.7)
Translational	23 (0.8)	1 (0.1)	22 (1)
Prometeo program, n(%)
Yes	60 (2.1)	0	60 (2.8)	<0.001
Mortality, n(%)
Yes	252 (9)	55 (8.2)	197 (9.3)	0.37

IQR = interquartile range; SOLCA = Sociedad de Lucha Contra el Cancer (Cancer Fighting Society).

^aContinuous variables were analyzed by using Wilcoxon Rank Sum test; all categorical data were analyzed through Chi-squared or Fisher’s exact tests as appropriate.

^bThis category encompasses all members of the Ecuadorian public health system, including Ministry of Public Health (MSP), Ecuadorian Social Security Institute (IESS), Army Social Security System (ISSFA) and Police Social Security System (ISPOL).

Figure 2. Ecuadorian trend of health science related-publications from 1999 to 2017 The period cut-off point is indicated by the dashed-red line

Figure 3. Distribution of Ecuadorian publications related to the top ten causes of mortality according to specific research lines

Table 2. Ecuadorian HSRA related with the top 10 causes of mortality according to the INEC, 1999–2017

Period I (1999–2008) n = 55		Period II (2009–2017) n = 197
Disease	n (%)	Disease	n (%)
Diabetes	10 (18.2)	Diabetes	49 (24.9)
Ischemic heart disease	3 (5.4)	Ischemic heart disease	19 (9.6)
Hypertension	6 (10.9)	Hypertension	23 (11.7)
Cerebrovascular disease	21 (38.2)	Cerebrovascular disease	53 (26.9)
Influenza & pneumonia	2 (3.6)	Influenza & pneumonia	28 (14.2)
Road injuries	0	Road injuries	2 (1)
Heart failure	0	Chronic liver disease (Cirrhosis)	5 (2.5)
Diseases related to the prenatal period	14 (25.4)	Urinary tract disease	4 (2)
Interpersonal violence	0	Lower respiratory tract disease	12 (6.1)
Other causes	0	Stomach cancer	2 (1)

HSRA = health sciences-related articles; INEC = national institute of statistics and census.