The intestinal protozoa: emerging impact on global health and development.
OBJECTIVE
To highlight new findings on the relevance of gastrointestinal protozoan infections to global public health in low-income and middle-income countries and suggest new large-scale interventions.


RESULTS
New disease burden assessments and epidemiological studies highlight the role of the major intestinal protozoa as important etiologic disease agents in low-income and middle-income countries. Despite their prevalence and adverse health impact, such information has not yet translated to the implementation of large-scale interventions as exist for helminth infections and other neglected tropical diseases. There are also several key research and development questions that must be addressed for intestinal protozoan infections and the potential need for new tools, for example, drugs, diagnostics, and vaccines. Additional studies have identified new and emerging species of intestinal protozoa relevant to global public health such as Dientamoeba fragilis and Blastocystis hominis and how they too might emerge as important gastrointestinal pathogens in the coming years.


CONCLUSIONS
New and emerging information on intestinal protozoa are reviewed with emphasis on aspects considered relevant to global health policymakers including prospects for scaling up interventions against intestinal protozoan infections in resource-poor countries.
aInternal Medicine, University of Michigan Health System, Ann Arbor, Michigan bInternal Medicine, Yale-New Haven Hospital, New Haven, Connecticut cNational School of Tropical Medicine, Baylor College of Medicine, Houston dSabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, Texas, USA *Joshua A. Turkeltaub and Thomas R. McCarty III contributed equally to the writing of this article.
Joshua A
JA
Turkeltaub
Thomas R
TR
McCarty
Peter J
PJ
Hotez
D016776:Blastocystis Infections / Q000453:epidemiology; D021821:Communicable Diseases, Emerging / Q000453:epidemiology; D003457:Cryptosporidiosis / Q000453:epidemiology; D003906:Developing Countries; D004030:Dientamoebiasis / Q000453:epidemiology; D004404:Dysentery, Amebic / Q000453:epidemiology; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D011528:Protozoan Infections / Q000453:epidemiology*