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Gender distribution in asymptomatic and invasive amebiasis
R Acuna-Soto1, J H Maguire, D F Wirth
1Departmento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, DF.
The American Journal of Gastroenterology
|May 16, 2000
Summary
Asymptomatic Entamoeba histolytica infections occur equally in men and women. However, invasive amebiasis is more common in men, suggesting a male susceptibility to severe disease.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Epidemiology
Background:
- Entamoeba histolytica (E. histolytica) causes subclinical infections in most individuals.
- A small subset of infected individuals develop severe invasive amebiasis, including amebic dysentery and liver abscess.
- Invasive amebiasis disproportionately affects men, with the prevailing hypothesis suggesting higher asymptomatic infection rates in males.
Purpose of the Study:
- To evaluate the evidence supporting the hypothesis that men have higher rates of asymptomatic Entamoeba histolytica infection.
- To determine if higher asymptomatic infection rates in men contribute to the increased frequency of invasive amebiasis observed in this gender.
Main Methods:
- A comprehensive review of published reports on invasive amebiasis and population-based parasitological studies was conducted.
- Data from 1929 to 1997 were analyzed to compare the gender ratios of asymptomatic and symptomatic E. histolytica infections.
- Distinction between E. histolytica and the nonpathogenic E. dispar was made whenever possible.
Main Results:
- Reports of invasive amebiasis (dysentery, liver abscess, etc.) indicated a significantly higher proportion of men (male:female ratio of 3.2:1).
- Epidemiological surveys revealed an equal distribution of asymptomatic E. histolytica infections between genders (1:1 ratio).
- The observed male predominance in invasive amebiasis contrasts with the equal prevalence of asymptomatic infections.
Conclusions:
- Asymptomatic infection with Entamoeba histolytica is equally prevalent in both men and women.
- The higher incidence of invasive amebiasis in men is likely attributable to a male-specific susceptibility to developing severe disease, rather than increased infection rates.