Parasitic Infections and Associated Cognitive Outcome Among School-Aged Children in Africa: A Systematic Review

Parasitic infections remain endemic among children, yet the neurocognitive and educational impact of these infections has not been systematically synthesized. This systematic review investigates the potential associations between parasitic infections and neurocognitive and educational outcomes among school-aged children.

A comprehensive review was conducted in accordance with PRISMA guidelines. Included studies encompassed both observational and interventional designs, examining cognitive and educational outcomes in relation to infections with Schistosoma spp., soil-transmitted helminths (STHs), Plasmodium spp., and other common parasitic agents.

Of the 80 studies reviewed, 29 focused on Schistosoma spp., with 13 identifying significant cognitive impairments, particularly in memory, attention, and increased school absenteeism. STHs were investigated in 26 studies, 11 of which reported associations with reduced intelligence quotient (IQ), executive dysfunction, and poor academic performance. Plasmodium spp. was examined in 15 studies, with 9 highlighting cognitive deficits, especially postcerebral malaria. Additional parasitic infections, including tungiasis (3 studies), Giardia and Entamoeba spp. (4 studies), and Taenia spp. (2 studies), were consistently linked to adverse cognitive and educational outcomes.

The most frequently implicated parasites are Schistosoma spp., STHs, and Plasmodium spp. demonstrate consistent associations with neurocognitive deficits. Pharmacological treatment alone may be insufficient; comprehensive strategies integrating early medical intervention, nutritional rehabilitation, and improved educational access are warranted. Future research should emphasize longitudinal methodologies, harmonized cognitive assessment tools, and cross-sectoral approaches to mitigate these developments.