Psychosis Beyond the Seizure: A Neuropsychiatric Case Study in Postoperative Temporal Lobe Epilepsy.

Soil-transmitted helminths (STHs)—including , , and hookworms (, )—affect over a billion people globally, primarily in low-income regions [,]. These infections contribute to a spectrum of clinical effects, including anemia, malnutrition, stunted growth, and impaired cognitive development, which perpetuate cycles of poverty and disease [,]. The public health impact is substantial, with infections linked to an estimated 1.38 million disability-adjusted life years (DALYs) worldwide []. In Zambia, STH infections are endemic, with prevalence rates exceeding 50% in some regions []. School-aged children (5–15 years) are the most affected demographic globally, and this holds true in Zambia, where estimates suggest prevalence rates of 10–40% for , 1–30% for , and hookworms among children [–]. Transmission is driven by environmental and socioeconomic factors common in rural areas, such as inadequate sanitation, limited access to clean water, and poverty, which facilitate the contamination of soil with infectious eggs and larvae [,]. In sub-Saharan Africa, the high prevalence of STHs frequently overlaps with the burden of HIV/AIDS, with Zambia experiencing persistently high rates of both []. This co-occurrence presents unique clinical challenges due to bidirectional immunological interactions. Helminth infections can polarize host immune responses toward a T-helper 2 (Th2) profile, potentially dampening the cell-mediated immunity crucial for controlling HIV and accelerating its progression [,]. Conversely, HIV-induced immunosuppression can impair the host’s ability to clear helminths, potentially increasing susceptibility to STH acquisition and worsening their clinical severity [,]. For HIV-infected children, the clinical consequences of STHs—such as malnutrition and anemia—can further weaken the immune system, potentially reducing the efficacy of antiretroviral therapy (ART) and increasing the risk of opportunistic infections [].