PRISMA 2020 Checklist.

<div> Background Several studies have highlighted alteration in the gut microbiome associated with the onset and progression of diseases. Recognizing the potential of gut microbiota as biomarkers, this systematic review seeks to synthesize current data on the intricate relationship between the host gut microbiome profiles and their usefulness for the development of diagnostic, prognostic and therapeutic approaches to control human schistosomiasis. Methods A systematic literature review was carried out by searching for relevant studies published until date, that is May 2024, using Medline, Embase, Global Health, Web of Science, and Global Index Medicus databases. The keywords used to select articles were "Gut microbiome", "Gut Microbiota", "Schistosomiasis", "Bilharziasis ", and "Human". Extracted data were analysed qualitatively from the selected articles. Results Of the 885 articles retrieved and screened, only 13 (1.47%) met the inclusion criteria and were included in this review. Of the included studies, 6 (46.2%) explored alterations of gut microbiome in schistosome-infected patients, 4 (30.7%) in patients with liver pathologies, and 3 (23.1%) in patients treated with praziquantel. Bacteria from the genera <i>Bacteroides</i>, <i>Faecalibacterium</i>, <i>Blautia</i> and <i>Megasphaera</i> were associated with <i>S</i>. <i>japonicum</i> and <i>S</i>. <i>haematobium</i> infection in school-aged children, whereas infection with <i>S</i>. <i>mansoni</i> rather associated with <i>Klebsiella</i> and <i>Enterobacter</i>. The gut microbiota signature in patient with schistosomiasis-induced liver pathology was reported only for <i>S</i>. <i>japonicum</i>, and the genus <i>Prevotella</i> appeared as a non-invasive biomarker of <i>S</i>. <i>japonicum</i>-associated liver fibrosis. For <i>S</i>. <i>mansoni</i>-infected school-aged children, it further appeared that the treatment outcome following praziquantel administration associated with the abundance in the gut microbiome of bacteria from the classes Fusobacteriales, Rickettsiales and Neisseriales. Conclusion The host gut microbiome appears to be a valuable, non-invasive, but still poorly utilized, source of host biomarkers potentially informative for better diagnosing, prognosing and treating schistosomiasis. Further studies are therefore needed to comprehensively define such gut microbial biomarkers of human schistosomiasis and catalyse the informed development of gut microbiome-based tools of schistosomiasis control. </div>