Since the beginning of the last century, paleoparasitology has been focused on understanding the origin and evolution of infectious diseases, relying on archaeological and paleontological material to do so. A wide diversity of intestinal parasites has been retrieved from ancient remains, primarily from helminths (Gonçalves et al. 2003). However, although protozoa exhibit a global distribution, they are not recovered easily from archaeological contexts. This scarcity might be related to difficulties in detecting these organisms using traditional optical microscopy and to the sensitivity of parasitic structures, which are less resistant to taphonomic processes, leading to a low estimation of protozoa in the archaeological record.This literature review aims to identify and summarise the geographic distribution of protozoa in the archaeological record, with an emphasis on protozoa associated with humans, including both intestinal and tissue parasites and the methodologies used to study them in ancient remains. An electronic database search was performed targeting studies on protozoa in the fields of paleoparasitology, archaeology and paleopathology and authors showing previous research efforts on this subject. The search comprised all publications found on this topic in PubMed and ScienceDirect and their bibliographies were screened as well. The data extracted from the literature included parasite species, archaeological sites and dates, the methods applied and the results of the studies. There were no exclusions related to publication dates or languages.
Methodological approaches to the identification of protozoaAlthough macroscopic examinations of lesions are generally limited to making observations of body preservation and the presence of specific landmarks, this technique is the most direct way of approaching disease in archaeological remains. For example, Chagas disease was diagnosed based on an altered large intestinal tract in a pre-Columbian mummy and later confirmed via molecular biological methods (Dittmar et al. 2003). However, this finding was exceptional, as the majority of infectious diseases will not be detected using such methodology. Consulting historical documents provides an indirect method for approximating protozoan infections. By reviewing medical documents, autopsy reports and original death certificates recorded by court physicians, Gino Fornaciari et al. (2010a, b) reconstructed the medical history of one of the most influential families of the Italian Renaissance, the Medici (Nerlich et al. 2012).In a similar manner, the origin of leishmaniasis in the Americas was discussed based on ethno-historical documents and anthropomorphic representations on Mochica ceramics (huacos) showing lesions similar to those found in mucous leishmaniasis (Altamirano-Enciso et al. 2003).Microscopy has been the traditional method for parasite identification in paleoparasitological analyses and the first protozoa found in fossilised faeces (coprolites) were described using this technique (Pizzi & Schenone 1954...