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Abstract ObjectivesUnderstanding disease transmission is a fundamental challenge in ecology. We used transmission potential networks to investigate whether a gastrointestinal protozoan (Blastocystisspp.) is spread through social, environmental, and/or zoonotic pathways in rural northeast Madagascar. Materials and MethodsWe obtained survey data, household GPS coordinates, and fecal samples from 804 participants. Surveys inquired about social contacts, agricultural activity, and sociodemographic characteristics. Fecal samples were screened forBlastocystisusing DNA metabarcoding. We also tested 133 domesticated animals forBlastocystis. We used network autocorrelation models and permutation tests (networkk‐test) to determine whether networks reflecting different transmission pathways predicted infection. ResultsWe identified six distinctBlastocystissubtypes among study participants and their domesticated animals. Among the 804 human participants, 74% (n = 598) were positive for at least oneBlastocystissubtype. Close proximity to infected households was the most informative predictor of infection with any subtype (model averaged OR [95% CI]: 1.56 [1.33–1.82]), and spending free time with infected participants was not an informative predictor of infection (model averaged OR [95% CI]: 0.95 [0.82–1.10]). No human participant was infected with the same subtype as the domesticated animals they owned. DiscussionOur findings suggest thatBlastocystisis most likely spread through environmental pathways within villages, rather than through social or animal contact. The most likely mechanisms involve fecal contamination of the environment by infected individuals or shared food and water sources. These findings shed new light on human‐pathogen ecology and mechanisms for reducing disease transmission in rural, low‐income settings. 

Abstract Market integration (MI), or the shift from subsistence to market-based livelihoods, profoundly influences health, yet its impacts on infectious diseases remain underexplored. Here, we synthesize the current understanding of MI and infectious disease to stimulate more research, specifically aiming to leverage concepts and tools from disease ecology and related fields to generate testable hypotheses. Embracing a One Health perspective, we examine both human-to-human and zoonotic transmission pathways in their environmental contexts to assess how MI alters infectious disease exposure and susceptibility in beneficial, detrimental and mixed ways. For human-to-human transmission, we consider how markets expand contact networks in ways that facilitate infectious disease transmission while also increasing access to hygiene products and housing materials that likely reduce infections. For zoonotic transmission, MI influences exposures to pathogens through agricultural intensification and other market-driven processes that may increase or decrease human encounters with disease reservoirs or vectors in their shared environments. We also consider how MI-driven changes in noncommunicable diseases affect immunocompetence and susceptibility to infectious disease. Throughout, we identify statistical, survey and laboratory methods from ecology and the social sciences that will advance interdisciplinary research on MI and infectious disease.