Left behind in America: Our nation's neglected infections of poverty

The neglected tropical infections or 'NTDs' are a group of chronic parasitic and other infections such as hookworm, schistosomiasis, and lymphatic filariasis represent the most common infections of the world's poorest people. An estimated 1.2 billion people are infected, with approximately one-half in sub-Saharan Africa. NTDs were introduced into the Americas during the Middle Passage and today, high rates of these infections are found among people of African descent in the Caribbean, particularly Haiti and the Dominican Republic, and Brazil. In the United States, the "classic NTDs" are no longer endemic, but similar neglected infections of poverty occur in areas of poverty, such as in post Katrina Louisiana and elsewhere in the Mississippi Delta, inner cities, the Mexican borderlands, and Appalachia. Among Hispanic populations cysticercosis is a leading cause of epilepsy affecting an estimated 169,000, and Chagas disease is of increasing importance. Among African Americans toxocariasis affects an estimated 2.8 million people, and trichomoniasis and congenital CMV are important neglected infections. The neglected infections of poverty in the U.S. represent one of our nation's greatest health disparities for people of color, and a living reminder of slavery in the Americas.