Dispersion and bias: can we trust geometric means?

Geometric means are frequently used to estimate the intensity of parasite infection within a population. In this article, Tony Fulford uses Schistosoma mansoni field data to illustrate that such estimates are biased and, more importantly, that the degree of bias can vary markedly with host age. Similar problems plague the interpretation of prevalence. The cause can be traced back to age-dependent differences in the dispersion of parasites among hosts.