Tuberculosis Deaths Surge 127% in Ecuador — Cases Hit 9,142 as Community Spread Outpaces Prison Outbreaks

Ecuador has a tuberculosis problem — and it’s getting worse fast.

The Ministry of Health’s epidemiological data shows TB deaths increased 127% in 2025 compared to the previous year. Confirmed infections climbed from 5,476 cases in 2024 to 9,142 in 2025 — a 67% year-over-year increase.

These aren’t prison statistics. Health experts emphasize that the outbreak has moved well beyond correctional facilities into the general population.

Beyond the Prisons

Ecuador’s prison system has been a known TB hotspot for years — overcrowding, poor ventilation, and limited healthcare access create ideal conditions for transmission. But epidemiologists now stress that community spread is driving the surge.

“The cases are not only from prisons but also community-spread,” health monitoring organizations have noted, calling for transparent information from the Ministry of Health about outbreak management.

Why the Spike

Several factors are converging:

• Post-pandemic detection gaps: COVID-19 disrupted TB screening and treatment programs for years. Cases that went undiagnosed in 2020-2023 are now presenting as advanced disease
• Healthcare system strain: Ecuador’s public health infrastructure — particularly IESS hospitals — has been under pressure from budget constraints, the security crisis, and pandemic recovery
• Poverty and crowding: TB thrives in crowded, poorly ventilated environments. Economic pressure has increased urban density in poorer neighborhoods
• Drug-resistant strains: While not confirmed as a primary driver, drug-resistant TB is a growing concern globally and may be a factor in Ecuador’s “unusual” case patterns

The Numbers in Context

| Year | Cases | Deaths | |------|-------|--------| | 2024 | 5,476 | Baseline | | 2025 | 9,142 (+67%) | +127% vs. 2024 |

A 127% increase in deaths with a 67% increase in cases suggests that cases are being detected later — when the disease is more advanced and harder to treat.

What This Means for Expats

• TB is airborne: Unlike many tropical diseases, tuberculosis spreads through the air — coughing, sneezing, even talking in enclosed spaces. You don’t need to visit a prison or hospital to be exposed
• Know the symptoms: Persistent cough lasting more than 2-3 weeks, fever, night sweats, unexplained weight loss. If you develop these, get tested. TB is treatable if caught early
• Healthcare access: If you’re on IESS, TB testing and treatment are covered. Private labs in major cities also offer TB testing (sputum culture, chest X-ray, GeneXpert)
• Crowded spaces: Public transportation, markets, and crowded waiting rooms are higher-risk environments. This isn’t a reason to avoid them, but it’s worth being aware of
• Ventilation matters: If you’re renting or buying, good natural ventilation isn’t just about comfort — it’s a genuine health advantage in a country experiencing a TB surge
• No panic necessary: TB is serious but treatable. The bigger issue is systemic — Ecuador’s public health system needs more resources for detection and treatment. Expats with access to private healthcare have significantly lower risk

Sources: Primicias, Ministry of Health epidemiological data