Co esponding au ho : Asad Riaz
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Neu oschis osomiasis: Explo ing he Clinical and Epidemiological Dimensions o a
Neglec ed T opical Disease
Abdul Muhymin Alam Kha ak 1, Sayyed Muhammad Taha Hussain 2, Muhammad Mus a a 3, Na eed Ahmed 3,
Muhammad Usman Sha i 3, Sadia Sha ique 4, Abdul Mohaimin Muhammad 5, Azlan Shah 6, Zahi Rehman 7,
Asad Riaz 8, * and Im iaz Khan 9
1 Depa men o Medical Oncology, S Vincen ’s P i a e Hospi al, Dublin, I eland.
2 Depa men o Pulmonology, Lady Reading Hospi al, Peshawa , Pakis an.
3 Depa men o In e nal Medicine, Ayub Teaching Hospi al, Abbo abad, Pakis an.
4 Depa men o Neu osu ge y, Lady Reading Hospi al, Peshawa , Pakis an.
5 Medical O ice a Shauka Khanum Memo ial Cance Hospi al and Resea ch Cen e, Peshawa , Pakis an.
6 Demons a o a Abbo abad In e na ional Medical College, Abbo abad, Pakis an
7 Depa men o Neu osu ge y, Shi a In e na ional Hospi als Limi ed, Islamabad, Pakis an.
8 Depa men o U ology, Ins i u e o Kidney Diseases, Peshawa , Pakis an.
9 Depa men o In e nal Medicine, Ayub Teaching Hospi al, Abbo abad, Pakis an.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 933-940
Publica ion his o y: Recei ed on 11 June 2025; e ised on 19 July 2025; accep ed on 21 July 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.0499
Abs ac
Neu oschis osomiasis is a a e bu se e e neu ological complica ion o schis osomiasis, a pa asi ic disease caused
by Schis osoma species. Al hough p ima ily a ec ing he gas oin es inal and u ogeni al sys ems, abe an mig a ion o
eggs o adul wo ms o he cen al ne ous sys em (CNS) can esul in signi ican mo bidi y and disabili y.
This na a i e e iew p o ides a comp ehensi e o e iew o neu oschis osomiasis, wi h a ocus on i s epidemiology,
pa hogenesis, clinical mani es a ions, diagnos ic challenges, ea men s a egies, and public heal h implica ions.
A li e a u e e iew was conduc ed using da abases such as PubMed, Scopus, and Google Schola o iden i y pee -
e iewed a icles, case epo s, clinical guidelines, and e iew a icles on neu oschis osomiasis. Emphasis was placed
on s udies desc ibing CNS pa hology, diagnos ic app oaches, he apeu ic ou comes, and disease bu den.
Neu oschis osomiasis occu s in less han 5% o in ec ed indi iduals bu may be unde epo ed. S. mansoni, S.
haema obium, and S. japonicum a e he p ima y species implica ed. Spinal o ms, p esen ing as ans e se myeli is o
conus medulla is synd ome, a e mos commonly seen, while ce eb al o ms may p esen wi h seizu es, ocal de ici s, o
signs o aised in ac anial p essu e. Diagnosis elies on MRI, CSF analysis, se ology, and occasionally CNS biopsy.
Managemen includes p aziquan el and co icos e oids, wi h suppo i e ehabili a ion. P ognosis depends on imely
in e en ion, and long- e m sequelae a e common.
Neu oschis osomiasis emains a neglec ed ye impo an cause o neu ological disease in endemic a eas and among
a ele s. Enhanced clinical awa eness, imp o ed diagnos ics, and coo dina ed public heal h in e en ions a e c ucial
o educe mo bidi y and imp o e ou comes. Fu he esea ch in o pa hogenesis and accine de elopmen is u gen ly
needed.
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934
Keywo ds: Neu oschis osomiasis; Schis osomiasis; Bilha zia; Ka ayama Fe e ; Fla wo m; Pla yhelmin hs; Impo ed
Diseases; Acu e Schis osomiasis; Ce ca ial De ma i is; Ch onic Schis osomiasis
1. In oduc ion
1.1. O e iew o Schis osomiasis
Schis osomiasis, also e e ed o as bilha zia, is a neglec ed opical disease caused by pa asi ic blood lukes belonging
o he genus Schis osoma. I impac s o e 240 million indi iduals wo ldwide and is second only o mala ia in e ms o
i s socioeconomic and public heal h e ec s among pa asi ic diseases. The disease bu den is concen a ed in mo e han
70 endemic na ions, mainly in sub-Saha an A ica, Sou h Ame ica, he Middle Eas , and pa s o Asia, whe e limi ed
access o clean wa e and sani a ion acili a es i s ansmission. Human in ec ion occu s when skin comes in o con ac
wi h eshwa e con amina ed by ce ca iae, he la al s age o he pa asi e eleased om in ec ed snails. Clinically,
schis osomiasis usually mani es s as in es inal o u ogeni al disease, depending on he in ec ing species—S. mansoni
and S. japonicum p ima ily cause hepa oin es inal disease, while S. haema obium is linked o u ina y ac in ol emen .
Howe e , in a small numbe o cases, schis osome eggs o adul wo ms mig a e abno mally o he cen al ne ous
sys em (CNS), leading o neu oschis osomiasis. This a e bu se e e complica ion is ma ked by g anuloma ous
in lamma ion, immune-media ed issue damage, and neu ological dys unc ion, which can be disabling o e en a al i
no ea ed. Neu oschis osomiasis may a ec he spinal co d o b ain, wi h he clinical p esen a ion in luenced by he
in ec ing species, immune esponse, and iming o in e en ion. Spinal o ms o en esul in acu e o subacu e ans e se
myeli is, while ce eb al in ol emen may p esen as seizu es, ocal neu ological de ici s, o in ac anial hype ension.
Due o i s abili y o mimic o he neu ological condi ions such as umo s, au oimmune diso de s, o in ec ions, diagnosis
is o en delayed—especially in non-endemic a eas whe e clinical suspicion is low. Despi e i s se ious
consequences, neu oschis osomiasis emains unde - ecognized and unde epo ed, ep esen ing a c i ical gap in
global heal h awa eness. This na a i e e iew aims o syn hesize cu en knowledge on neu oschis osomiasis, ocusing
on i s clinical spec um, diagnos ic challenges, and e idence-based managemen s a egies. Th ough a comp ehensi e
examina ion o he li e a u e, his e iew also highligh s public heal h p io i ies and u u e di ec ions o esea ch in
add essing his neglec ed mani es a ion o a globally signi ican pa asi ic in ec ion. `
Epidemiology and Global Bu den Schis osomiasis emain one o he mos p e alen and impac ul neglec ed opical
diseases, a ec ing an es ima ed 220 million people wo ldwide, wi h o e 90% o cases occu ing in sub-Saha an A ica
[1]. In addi ion o A ica, endemic egions include pa s o Sou h Ame ica (pa icula ly B azil), he Middle Eas ,
Sou heas Asia, and ce ain p o inces in China. The disease is p ima ily caused by i e medically signi ican species o
Schis osoma: S. mansoni, S. haema obium, S. japonicum, S. in e cala e, and S. Mekong. Each species has a dis inc
geog aphic dis ibu ion and is associa ed wi h cha ac e is ic clinical synd omes, mos commonly hepa oin es inal o
u ogeni al o ms o schis osomiasis.
In con as , neu oschis osomiasis is a ela i ely a e ye se e e complica ion, ep esen ing a small ac ion—es ima ed
a less han 5%—o o e all schis osomiasis cases [2]. Howe e , his igu e may be an unde es ima ion because o he
disease’s non-speci ic neu ological p esen a ion and unde epo ing, especially wi hin low- esou ce se ings, as well as
lack o access o diagnos ic ools. Mos documen ed neu oschis osomiasis cases a e in B azil, Egyp , China, and a ious
sub-Saha an A ican coun ies [3]. Howe e , in ecen yea s, global a el, popula ion mig a ion, oge he wi h e ugee
mo emen s occu ed, leading o diagnoses ha we e spo adic in non-endemic egions like Eu ope and No h Ame ica.
These o eign examples s ess a global need o mo e heal hca e p o ide clinical awa eness. Schis osomiasis is
ypically no encoun e ed in some se ings, pa icula ly so, and awa eness is necessa y [4].
2. Li e Cycle and Pa hogenesis
Schis osoma species ha e a complica ed li e cycle ha includes an in e media e hos o eshwa e snails as well as a
de ini i e hos o humans. Ce ca iae, he pa asi e's ee-swimming la al s age, a e discha ged om in ec ed snails and
en e humans h ough unb oken skin when hey come in o ouch wi h ain ed eshwa e . Once inside he hos ,
ce ca iae a el hema ogenous o he lungs and subsequen ly o he li e , whe e hey ma u e in o adul male and emale
wo ms. These adul wo ms pai and mo e o hei p e e ed enous si es: S. mansoni and S. japonicum o
he mesen e ic enous plexus, and S. haema obium o he *pel ic and esical enous plexus. F om he e, hey
lay eggs ha a e se issue walls and a e expelled in eces o u ine, depending on he species [5].
Bo h a human de ini i e hos and a eshwa e snail in e media e hos a e in ol ed in he complica ed li e cycle o
Schis osoma species. When con amina ed eshwa e comes in o ouch wi h undamaged human skin, he pa asi e's ee-
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swimming la al s age, ce ca iae, which a e eleased om in ec ed snails, causes human in ec ion. Following hei
hema ogenous mig a ion o he lungs and li e wi hin he hos , ce ca iae de elop in o adul male and emale wo ms. S.
mansoni and S. japonicum mig a e o he mesen e ic enous plexus, while S. haema obium mig a es o he *pel ic and
esical enous plexus. These ma u e wo ms couple and mig a e o hei chosen enous loca ions. Depending on he
species, hey hen lay eggs ha pass- h ough issue walls and a e expelled as ei he u ine o eces [5].
A eshwa e snail se es as he in e media e hos in he complica ed li e cycle o Schis osoma species, which also has a
de ini i e hos in humans. The pa asi e's ee-swimming la al s age, ce ca iae, a e discha ged om in ec ed snails and
en e he human body h ough undamaged skin when con amina ed eshwa e comes in o con ac wi h i . Once wi hin
he hos , ce ca iae unde go hema ogenous mig a ion o he li e and lungs, whe e hey de elop in o adul male and
emale wo ms. The p e e ed enous loca ions o hese adul wo ms a e he mesen e ic enous plexus o S. mansoni
and S. japonicum, and he *pel ic and esical enous plexus o S. haema obium. They pai up and mig a e, espec i ely.
Depending on he species, hei eggs a e hen expelled in ei he u ine o eces a e passing h ough issue walls [5].
Figu e 1 Schis osoma Li e Cycle and Neu ochis osomiasis
3. Clinical Mani es a ions
Eosinophils, mac ophages, lymphocy es, and ib oblas s media e he s ong g anuloma ous immunological esponse
ha schis osome eggs induce once hey a e deposi ed in he cen al ne ous sys em. In he end, his immune ac i a ion
causes neu ological symp oms ha di e depending on he egion o in ol emen h ough issue swelling,
demyelina ion, nec osis, and mass impac . The pa hogenic p ocess can esemble i al, au oimmune, o neoplas ic
illnesses, making p omp diagnosis and iden i ica ion much mo e di icul [8].
The mos p e alen clinical ype o spinal neu oschis osomiasis is caused by Schis osoma mansoni o Schis osoma
haema obium. Usually, i mani es s as conus medulla is synd ome, cauda equina synd ome, o acu e o subacu e
ans e se myeli is. Depending on he deg ee o in ol emen , pa ien s equen ly desc ibe bila e al lowe limb
weakness, which can be ei he laccid o spas ic. Common senso y abno mali ies ypically ha e a dis inc senso y le el
upon assessmen . Ea ly-s age a e lexia o la e -s age hype e lexia a e examples o e lex al e a ions. Wi h Schis osoma
mansoni o Schis osoma haema obium as he mos common cause, spinal neu oschis osomiasis is he mos common
clinical ype. Conus medulla is synd ome, cauda equina synd ome, o acu e o subacu e ans e se myeli is a e he
usual ways i mani es s. Bila e al lowe limb weakness, which can be ei he laccid o spas ic depending on he deg ee
o in ol emen , is equen ly epo ed by pa ien s. Senso y dis u bances a e equen and ypically exhibi a dis inc
senso y le el upon e alua ion. A e lexia in he ea ly s ages o he disease o hype e lexia as i wo sens a e examples o
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e lex al e a ions. I is no unusual o expe ience al e ed men al s a us, diso ien a ion, and beha io al o cogni i e
abno mali ies, pa icula ly when he e is di use co ical in ol emen . Because g anuloma ous lesions in he co ex o
whi e ma e can closely esemble umo s o abscesses on imaging, hese symp oms could be con used wi h
encephali is, s oke, o neoplas ic p ocesses. Vasculi is al e a ions in he ce eb al ascula u e may cause ischemic
s oke-like episodes in ce ain people [10].
The e is g owing ecogni ion o neu oschis osomiasis's unusual and ch onic mani es a ions. These include inc easing
myelopa hy, cogni i e de e io a ion, and e en men al mani es a ions like mood diso de s o psychosis, and hey migh
appea g adually o e weeks o mon hs. In a e cases, g anuloma ous blockage o he en icula sys em o poo CSF
abso p ion a he a achnoid g anula ions can cause hyd ocephalus. These a ypical cases o en elude ea ly diagnosis,
pa icula ly when p esen ing in non-endemic egions whe e schis osomiasis is no ou inely conside ed [11].
Figu e 2 Neu oschis osomiasis clinical mani es a ions and diagnos ic challenges
4. Diagnos ic Challenges
Because neu oschis osomiasis has nonspeci ic and a iable clinical symp oms, diagnosis is equen ly delayed.
Clinicians may ini ially mis ake symp oms o mo e p e alen neu ological condi ions such mul iple scle osis,
au oimmune o i al ans e se myeli is, malignancies, o ascula insul s in bo h endemic and non-endemic si ua ions.
F equen misdiagnosis is a esul o he condi ion's a i y as well as he way i mimics o he diseases on imaging and
clinical e alua ion.
Pa ien s wi h epidemiological isk ac o s, such as li ing in o isi ing endemic a eas, ha ing a his o y o eshwa e
exposu e, o ha ing sys emic schis osomiasis concu en ly, equi e a high index o suspicion. I e e sible neu ological
damage may a ise om delayed diagnosis, highligh ing he signi icance o heal hca e pe sonnel' unde s anding.
Combining labo a o y es s, a ge ed imaging, and clinical his o y
Pa ien s wi h epidemiological isk ac o s, such as li ing in o isi ing endemic a eas, ha ing a his o y o eshwa e
exposu e, o ha ing sys emic schis osomiasis concu en ly, equi e a high index o suspicion. I e e sible neu ological
damage may a ise om delayed diagnosis, highligh ing he signi icance o heal hca e pe sonnel' unde s anding. Timely
de ec ion and be e esul s can be achie ed by combining clinical his o y wi h a ge ed imaging, labo a o y es s, and,
i necessa y, se ologic o gene ic es ing.
5. Diagnosis
Pa icula ly in indi iduals wi h epidemiological isk ac o s including li ing in o isi ing endemic a eas, ha ing a his o y
o exposu e o eshwa e , o ha ing sys emic schis osomiasis concu en ly, a high index o suspicion is c ucial.
I e e sible neu ological damage migh a ise om delayed diagnosis, which emphasizes how c ucial i is o heal hca e
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937
p o essionals o be in o med. Clinical his o y combined wi h a ge ed imaging, lab wo k, and, i necessa y, molecula o
se ologic es ing can help iden i y p oblems ea ly and enhance esul s.
Analysis o ce eb ospinal luid (CSF) p o ides addi ional suppo o he diagnosis, bu i is no e y speci ic. Ele a ed
p o ein le els and lymphocy ic pleocy osis a e common obse a ions ha indica e a con inuing in lamma o y esponse.
E en hough i s ongly sugges s a pa asi e e iology, CSF eosinophilia is no always p esen and may no be p esen in a
sizable po ion o cases. Al hough hey a e mo e equen ly linked o au oimmune diseases and can complica e he
diagnos ic p ocess, oligoclonal bands can also occasionally be iden i ied [13].
The diagnosis is u he suppo ed by ce eb ospinal luid (CSF) analysis; howe e , his me hod is no e y speci ic.
Common signs o an ongoing in lamma o y eac ion include ele a ed p o ein le els and lymphocy ic pleocy osis. CSF
eosinophilia is no usually p esen and may no be p esen in a signi ican numbe o cases, despi e he ac ha i
s ongly suppo s a pa asi e o igin. On occasion, oligoclonal bands can also be de ec ed, bu hey a e mo e commonly
associa ed wi h au oimmune diso de s and can make diagnosis mo e di icul [13].
Se ology and pa asi e es s p o ide aluable addi ional in o ma ion. connec ed o enzymes.
Tes s o pa asi es and se ology o e use ul u he da a. Schis osoma-speci ic an ibodies in se um can be ound wi h
high sensi i i y and speci ici y using immunoblo and enzyme-linked immunoso ben assays (ELISA), especially in
pa ien s om endemic a eas [14]. Howe e , because egg exc e ion does no usually occu a he same ime as
neu ological in ol emen , egula s ool and u ine mic oscopy o o a may p oduce nega i e esul s in pa ien s wi h
CNS-limi ed disease. In si ua ions when con en ional echniques a e equi ocal, molecula diagnos ics, such as
polyme ase chain eac ion (PCR)-based assays on CSF o se um, ha e demons a ed p omise in imp o ing diagnos ic
sensi i i y and can assis in con i ming in ec ion.
6. T ea men and Managemen
The managemen o neu oschis osomiasis ocuses on wo p ima y goals: e adica ion o he pa asi ic in ec ion and
modula ion o he hos ’s in lamma o y esponse o p e en pe manen neu ological damage.
Tes ing o pa asi es and se ous diseases yields use ul supplemen a y da a. Immunoblo and enzyme-linked
immunoso ben assay (ELISA) es s ha e good sensi i i y and speci ici y o de ec ing Schis osoma-speci ic an ibodies
in se um, especially in indi iduals om endemic a eas [14]. Howe e , because neu ological in ol emen is no
equen ly accompanied by egg expulsion, con en ional s ool and u ine mic oscopy o o a may p oduce nega i e
esul s in pa ien s wi h CNS-limi ed disease. When con en ional app oaches a e unable o con i m an in ec ion,
molecula diagnos ics, such as polyme ase chain eac ion (PCR)-based assays on CSF o se um, ha e demons a ed
p omise in imp o ing diagnos ic sensi i i y.
P aziquan el is equen ly used in conjunc ion wi h co icos e oids o ea he in lamma o y componen . These a e
essen ial o lessening he immune-media ed issue damage and edema b ough on by egg deposi ion in he cen al
ne ous sys em. One g am o me hylp ednisolone is usually adminis e ed in a enously o h ee o i e days, a e
which o al p ednisone is g adually ape ed down. Indi idualized co icos e oid he apy du a ion is de e mined by
pa ien ole ance, adiologic imp o emen , and clinical esponse [17]. In many cases, ex ended co icos e oid he apy
may be equi ed o achie e ull neu ologic eco e y, pa icula ly in spinal neu oschis osomiasis.
Toge he , imely diagnosis and a combined he apeu ic s a egy a ge ing bo h he pa hogen and he hos esponse o e
he bes chance o neu ological imp o emen and p e en ion o long- e m sequelae in pa ien s
wi h neu oschis osomiasis.
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Figu e 3 Neu oschis osomiasis managemen p ocess
7. Suppo i e Ca e and Follow-Up
Suppo i e ca e is essen ial o he o e all managemen o neu oschis osomiasis, especially in pa ien s wi h mode a e o
se e e neu ological impai men s, in addi ion o an ipa asi ic and an i-in lamma o y ea men . Rehabili a ion equi es
physical and occupa ional ea men , pa icula ly o hose wi h unc ional impai men s b ough on by spinal co d
in ol emen , mo o weakness, o abno mali ies in gai . The likelihood o a unc ional eco e y is inc eased and quali y
o li e is imp o ed wi h ea ly ehabili a ion commencemen . An iepilep ic medica ions should be used when seizu es
a e a p esen ing symp om o ce eb al neu oschis osomiasis in o de o gua an ee seizu e con ol and lowe he chance
o ecu ence o neu ological decline. In o de o p e en u ina y ac in ec ions and main ain enal unc ion, bladde
dys unc ion—which is commonly seen in cases wi h spinal in ol emen —may also call o bladde aining,
in e mi en ca he e iza ion, o e en long- e m u ological ollow-up [18].
Suppo i e ca e, especially o pa ien s wi h mode a e o se e e neu ological impai men s, is essen ial o he o e all
managemen o neu oschis osomiasis in addi ion o an ipa asi ic and an i-in lamma o y ea men .
Rehabili a ion equi es physical and occupa ional he apy, pa icula ly o people wi h spinal co d in ol emen - ela ed
unc ional de ici s, mo o weakness, o abno mali ies in gai . Ea ly ehabili a ion imp o es quali y o li e and inc eases
he likelihood o a unc ional eco e y. When seizu es a e a p esen ing symp om o ce eb al neu oschis osomiasis,
an iepilep ic medica ions should be used o manage seizu es and lowe he chance o neu ological decline o ecu ence.
Fu he mo e, bladde dys unc ion, which is commonly seen in cases o spinal in ol emen , may equi e in e mi en
ca he e iza ion, bladde aining, o e en long- e m u ological ollow-up in o de o main ain enal unc ion and a oid
UTIs [18].
7.1. P ognosis and Ou comes
In he en i e managemen o neu oschis osomiasis, suppo i e ca e is essen ial, especially o pa ien s wi h mode a e
o se e e neu ological impai men s, in addi ion o an ipa asi ic and an i-in lamma o y ea men . Pa icula ly o hose
wi h mo o weakness, abno mali ies in gai , o unc ional impai men s b ough on by spinal co d in ol emen , physical
and occupa ional he apy a e c ucial o ehabili a ion. Rehabili a ion ha is s a ed ea ly inc eases quali y o li e and
inc eases he likelihood o a unc ional eco e y. An iepilep ic medica ions should be used when seizu es a e a
p esen ing symp om o ce eb al neu oschis osomiasis in o de o gua an ee seizu e con ol and lowe he chance o
ecu ence o neu ological decline. Fu he mo e, pe iodic ca he e iza ion, bladde aining, o e en long- e m
u ological ollow-up may be necessa y o a oid UTIs and main ain enal unc ion in cases o bladde dys unc ion, which
is commonly seen in spinal in ol emen [18].
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The imely diagnosis and imely ini ia ion o adequa e medica ion a e c i ical ac o s in he p ognosis
o neu oschis osomiasis. Ea ly ea men o en has posi i e esul s o pa ien s, wi h many ob aining pa ial o ull
neu ological eco e y, pa icula ly du ing he acu e pe iod o symp om de elopmen . On he o he hand, ch onic pain
synd omes, pa aplegia, senso y loss, and sphinc e dys unc ion a e among he i e e sible neu ological impai men s
ha a e mo e likely o occu in cases o delayed diagnosis. Mo ali y is uncommon, al hough i can happen in ex eme
ci cums ances because o complica ions like sepsis, hyd ocephalus, o aspi a ion pneumonia, especially when b ain
in ol emen aises in ac anial p essu e.
7.2. Public Heal h, P e en ion, and Resea ch Gaps
Neu oschis osomiasis has bo h oppo uni ies o p e en i e in e en ion and p oblems o public heal h because i is a
neglec ed opical illness. Mass d ug adminis a ion (MDA) o p aziquan el o a - isk g oups, especially school-aged
child en, who ha e he la ges in ec ion bu den, is he co ne s one o p e en ion in endemic a eas. Fu he mo e,
limi ing exposu e o con amina ed eshwa e h ough heal h educa ion p og ams, sani a y in as uc u e, and
enhanced access o clean wa e a e essen ial elemen s in b eaking ansmission cycles [20].
Howe e , se e al challenges con inue o hinde e ec i e con ol. These include limi ed access o diagnos ic imaging and
se ologic es ing in esou ce-poo se ings, low clinical awa eness o neu oschis osomiasis among heal hca e p o ide s
in non-endemic egions, and he absence o obus su eillance sys ems o neu ological complica ions o
schis osomiasis. These ac o s con ibu e o unde diagnosis and unde ea men , exace ba ing pa ien mo bidi y.
None heless, a numbe o obs acles s ill s and in he way o e icien con ol. These include he lack o e ec i e
moni o ing sys ems o schis osomiasis neu ological sequelae, low clinical knowledge o neu oschis osomiasis among
heal hca e pe sonnel in non-endemic loca ions, and es ic ed access o diagnos ic imaging and se ologic es ing in
se ings wi h minimal esou ces. These elemen s exace ba e pa ien mo bidi y by causing unde diagnosis and
unde ea men .
The de elopmen o mo e p ecise and sensi i e diagnos ic ins umen s, especially poin -o -ca e assays app op ia e o
use in endemic egions, is u gen ly needed om a scien i ic s andpoin . To imp o e ea men plans, including he bes
dosage, leng h o ime, and combina ions o an ipa asi ic and an i-in lamma o y medica ions, andomized clinical ials
a e also equi ed. Addi ionally, a deepe comp ehension o he hos -pa asi e in e ac ions and immunopa hogenesis in
CNS disease may p o ide new a ge s o ea men . Las ly, esea ch in o accines agains Schis osoma species is s ill
ongoing.
8. Conclusion
A dange ous and usually unde diagnosed side e ec o Schis osoma in ec ion, neu oschis osomiasis p esen s
o midable diagnos ic and ea men obs acles. F om acu e spinal co d synd omes o long- e m cogni i e and
beha io al abno mali ies, i s clinical p esen a ion is qui e di e se and equen ly esembles ha o mo e p e alen
neu ological condi ions like umo s, mul iple scle osis, o s oke. In non-endemic a eas o among e u ning ou is s,
whe e schis osomiasis is no equen ly aken in o accoun in he di e en ial diagnosis, his clinical a iabili y leads o
a high a e o misdiagnosis o delayed de ec ion.
Signi ican diagnos ic and ea men issues a ise om neu oschis osomiasis, a dange ous and commonly
unde diagnosed consequence o Schis osoma in ec ion. Acu e spinal co d synd omes and pe sis en cogni i e and
beha io al abno mali ies a e jus wo examples o i s ex emely a ied clinical p esen a ion, which equen ly mimics
mo e p e alen neu ological condi ions like umo s, mul iple scle osis, o s oke. Because schis osomiasis is no
equen ly aken in o accoun in he di e en ial diagnosis, his clinical a iabili y equen ly esul s in misdiagnosis o
delayed de ec ion, especially in non-endemic a eas o among e u ning ou is s.
Imp o emen s in diagnos ic echniques, such as he c ea ion o molecula and sensi i e se ologic assays, as well as
inc eased accessibili y o imaging in endemic a eas, a e also necessa y o add ess he bu den o neu oschis osomiasis.
F om a public heal h s andpoin , p e en ing CNS in ol emen and educing ansmission equi e in eg a ed measu es
ha include mass d ug adminis a ion (MDA), enhanced sani a ion, heal h educa ion, and su eillance sys ems. In o de
o add ess his o e looked bu signi ican mani es a ion o a pa asi e disease ha is widesp ead a ound he wo ld, mo e
s udy in o he immunopa hogenesis, he apy op imiza ion, and accine de elopmen will be essen ial.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 933-940
940
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
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