Editorial: Decoding the Impact of Tropical Diseases on the Gastrointestinal System

Taha Gul Shaikh^1*Abdulqadir J. Nashwan²Vivek Podder³

• ¹Dow University of Health Sciences, Karachi, Pakistan
• ²Hamad Medical Corporation, Doha, Qatar
• ³Mount Sinai Medical Center, Miami Beach, United States, Miami, United States

Tropical diseases continue to pose a significant global health burden, and their interaction with the gastrointestinal (GI) system remains an area of growing scientific interest. This special issue brings together recent studies that examine these relationships from microbiological, clinical, and public health perspectives. According to the 2025 global report on neglected tropical diseases (NTDs) published by the World Health Organization (WHO), an estimated 1.5 billion people worldwide need curative or preventive measures for these diseases. Although their overall burden has declined due to sustained public health efforts, significant gaps persist, especially in access to clean water, sanitation, and effective vector control (1). Importantly, many of these diseases have a profound impact on the GI system, which serves as both a major route of infection and a key site of disease-related morbidity. Beyond their clinical impact, NTDs impose substantial socioeconomic burdens, including stigmatization, physical disability, diminished social participation, and poverty (2).The skin, respiratory tract, and GI tract are major portals of entry for infectious organisms. The complexity of diagnosing tropical diseases becomes evident when conditions such as inflammatory bowel disease mimic amoebiasis or tuberculosis, creating diagnostic and therapeutic challenges in tropical regions (3). Diarrheal illnesses remain the leading cause of childhood mortality globally (4). Despite increased global awareness, a significant knowledge gap persists regarding the intricate relationship between tropical infections and the GI system (5).A study by Nguélé et al. assessed the impact of Trichuris infection, a common soil-transmitted helminth, on the function and composition of the gut microbiome in women of reproductive age using shotgun metagenomic sequencing. Their findings show that Trichuris infection disrupts both fungal and bacterial components of the gut microbiota, highlighting that pathogens not only cause direct damage to the host but also significantly alter the gut ecosystem.A review article by Ayalew et al. further explores the crucial link between tropical infections and the gut microbiome. Imbalance within the gut microbiome results in dysbiosis, which has a harmful impact on the digestive system. The authors explain that reduced microbial biodiversity is a major contributor to the overgrowth of proteobacteria, promoting gut inflammation and infection. Pathogens such as Salmonella and Escherichia Coli thrive in this inflamed environment. Tropical infections also increase intestinal permeability and compromise mucosal integrity, facilitating microbial translocation into the bloodstream. During infection, the production of short-chain fatty acids (SCFA) remains low, which not only serves as a source of energy for metabolic processes but also helps limit inflammation. The recovery from infections depends on host factors such as age, genetics, comorbid conditions, and immune status, leaving children and the elderly particularly vulnerable due to their immature microbiome and declining microbial biodiversity. Infection characteristics, such as type, duration, and site, as well as environmental exposures, also influence outcomes. Extraintestinal manifestations and postinfectious GI disorders, including malnutrition and growth stunting, further underscore the significant long-term impact of tropical diseases. The authors also highlight expanding therapeutic strategies aimed at restoring the gut microbiota. These interventions include probiotics, prebiotics, and symbiotics, and in severe cases, fecal microbiota transplantation for conditions such as inflammatory bowel disease, recurrent Clostridium Difficile infection, and antibiotic-associated dysbiosis. Dietary interventions, such as the Mediterranean, low-FODMAP, and plant-based diets, may additionally support microbial restoration through their prebiotic and anti-inflammatory components (e.g., polyphenols and phytochemicals).Another narrative review by Ghazy et al. emphasized the broader interaction between tropical pathogens and the GI tract. The authors discuss major pathogens, their modes of transmission, and the clinical features of common tropical diseases. Helminthic and protozoal infections, for instance, can cause tissue damage through migration, feeding, and intracellular replication. These pathogens release enzymes that impair immune responses and disrupt the gut mucosa, leading to inflammation, fibrosis, and oxidative stress. Importantly, significant morbidity may persist even after parasitic clearance, including lipo-lymphedema and lymphadenopathy. Diagnostic challenges frequently arise due to symptom overlap with other GI disorders. Although laboratory investigations play a crucial role in such cases, many resource-limited settings depend on cost-effective alternatives. New technologies such as point-of-care diagnostics and artificial intelligence-assisted microscopy have begun to improve diagnostic accuracy.Ultimately, prevention remains the most effective strategy. Strengthened surveillance systems, preventive chemotherapy, vaccination programs, and the One Health approach. This approach, which recognizes the interconnectedness of human, animal, and environmental health, is essential for addressing the ecological and socioeconomic factors that sustain tropical diseases.Through global collaboration, technological innovation, and strengthened public health strategies, the complex interplay between tropical diseases and gut health can be better understood and addressed, an effort that carries profound implications for global health and economic stability.