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Neuroinfectious diseases; Public health; Meningitis; Encephalitis; Neuro-HIV; Global health; Diagnostic tools

Introduction

Neuroinfectious diseases, caused by bacterial, viral, fungal, or parasitic infections, represent a critical and underappreciated challenge in neurology. Conditions such as meningitis, encephalitis, neuro-HIV, and tuberculosis-related neurological complications can result in significant morbidity and mortality, particularly in low- and middle-income countries (LMICs) [1]. These infections can lead to lasting neurological deficits, including cognitive impairments, motor dysfunction, and epilepsy, severely impacting quality of life. Despite advances in medical research, the burden of neuroinfectious diseases remains disproportionately high in regions with limited healthcare infrastructure, where delayed diagnosis and treatment lead to poor outcomes [2,3]. Globally, neurological care for these conditions is hindered by the lack of integrated systems between infectious disease specialists and neurologists, as well as insufficient training and resources for accurate diagnosis and management. This paper seeks to confront the growing epidemic of neuroinfectious diseases by reviewing their global impact and calling for coordinated actions within neurology and public health sectors to improve diagnosis, treatment, and prevention [4].

Methodology

This study is a narrative review of the current state of neuroinfectious diseases, combining epidemiological data, clinical outcomes, and expert insights.

Data collection

Literature Review: A systematic review of peer-reviewed articles, guidelines from organizations such as the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC), and recent global health reports were conducted [5]. Major neuroinfectious diseases, including meningitis, encephalitis, neuro-HIV, neurocysticercosis, and neuro-tuberculosis, were covered.

Epidemiological Data: Global burden and incidence rates of neuroinfectious diseases were extracted from databases such as Global Burden of Disease (GBD) and published case reports. The geographic distribution and demographic factors influencing disease prevalence were analyzed [6]. Neurologists, infectious disease specialists, and public health professionals were consulted to identify current gaps in healthcare infrastructure, training, and collaboration between disciplines.

Data analysis

Data were categorized based on the type of neuroinfectious disease, geographical regions most affected, and clinical outcomes. Key challenges in diagnosing and managing these diseases were identified, alongside recommendations for addressing these challenges through coordinated action.

Results

Global burden of neuroinfectious diseases

Meningitis: The global burden of meningitis, particularly in sub-Saharan Africa (the "Meningitis Belt"), remains high despite vaccination efforts. Bacterial meningitis continues to be a major cause of mortality and long-term neurological disability [7]. Viral encephalitis, including cases caused by herpes simplex virus and arboviruses (e.g., West Nile, Zika), affects thousands globally. These infections are associated with high rates of cognitive impairment and epilepsy.

Neuro-HIV: Despite advances in antiretroviral therapy, neuro-HIV complications persist, particularly in regions with limited access to healthcare. HIV-associated neurocognitive disorders (HAND) remain a significant cause of disability in HIV-positive patients [8]. Neurocysticercosis and neuro-TB parasitic and tubercular neuroinfectious diseases are widespread in LMICs, leading to seizures, intracranial pressure, and permanent neurological damage.

Diagnostic and treatment gaps

Delayed Diagnosis: In many low-resource settings, the lack of advanced imaging, laboratory testing, and trained specialists contributes to delayed diagnosis and treatment of neuroinfectious diseases. Rapid diagnostic tools, particularly for rural or underserved areas, are urgently needed [9]. Management challenges even when diagnosed, treatment for neuroinfectious diseases is often inadequate due to the scarcity of medications, insufficient healthcare infrastructure, and the complexity of managing neurological complications.

Interdisciplinary Gaps: There is a significant gap in collaboration between infectious disease and neurology specialists, which hampers the ability to effectively diagnose and manage neuroinfectious diseases [10]. The need for integrated care models and cross-specialty training is evident.

Conclusion

Neuroinfectious diseases represent a critical but under-addressed crisis in neurology, particularly in LMICs where healthcare systems face significant challenges. Delayed diagnosis, inadequate treatment, and the lack of interdisciplinary collaboration contribute to poor outcomes for patients affected by conditions such as meningitis, encephalitis, neuro-HIV, and neuro-tuberculosis. This study highlights the need for coordinated global action, including improved training for healthcare providers, enhanced diagnostic capabilities, and the integration of neurology with infectious disease management. To confront the neuroinfectious disease epidemic, public health initiatives must prioritize research funding, access to rapid diagnostics, and development of comprehensive care models. By addressing these key gaps, we can reduce the burden of neuroinfectious diseases and improve outcomes for affected patients worldwide.

Acknowledgement

None

Conflict of Interest

None

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