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The main features of amoebiasis epidemiology a new approach

, : The main features of amoebiasis epidemiology a new approach. Meditsinskaya Parazitologiya i Parazitarnye Bolezni 47(6): 50-55

The epidemiology of amebiasis [the causative agent Entamoeba histolytica] is characterized by 2 enigmatic features: the majority of the clinical cases are concentrated in tropical and subtropical parts of the causative agent's area and in these countries the distribution of the disease is focal and no large epidemics involving considerable areas beyond the boundaries of these foci occur. These features may be explained according to recent concepts about the etiology and pathogenesis of clinical amoebiasis. The clinical primary lesion of amebiasis appears as a rule in the large intestine. This lesion arises only after simultaneous infection with the ameba and some specific bacteria. The propagation of the disease by the venereal route represents only an exception which confirms the rule. Separately these agents are nonpathogenic. Infection may arise only by the joint transmission of both components of the contagious material, before these components disintegrate in the environment. To keep the infection in the population, a considerable intensity of transmission is required. The coincidence of conditions for intensive simultaneous transmission of both agents exist mostly in some tropical and subtropical areas where the indigenous population is closely associated in everyday life with shallow water bodies used simultaneously for bathing, washing of vegetables, a source of drinking water, for laundry and other needs. Stable foci of clinical amebiasis occur around such water bodies. The transmission of the infection may be supported also by other, less effective ways. This explains the endemicity of clinical amebiasis in the tropics and subtropics and its absence in temperate zones in spite of the Entameba presence. The recognition of amebiasis as an endemic focal disease requires reconsideration of its control tactics.

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