Are lymphatic filariasis patients more likely to suffer depression?

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Many individuals infected with filarial worms don’t suffer any symptoms; however, for those with lymphatic filariasis these patients can experience discrimination and rejection as a result of painful and disfiguring swellings. A new study has now quantified this burden, reporting that lymphatic filariasis patients in Nigeria have four times the rate of depression compared with the average population.

Lymphatic filariasis-causing worms impair the lymphatic system of an infected individual, causing fluid build-up and leading to the painful and disfiguring swelling of body parts. The WHO estimate that over 120 million are infected with lymphatic filariasis, 40 million of which are disfigured by this disease.

In this study, published recently in PLOS Neglected Tropical Diseases, the team from the University of Ibadan (Nigeria) have taken a new look at the management of lymphatic filariasis, which prior to this has focused on prevention and treatment via mass drug-administration programs.

The group enrolled 98 adults, all suffering from physical disability associated with lymphatic filariasis. The participants completed questionnaires about their health and self-esteem in addition to a depression rating scale.

The team discovered that 20% of participants met the criteria for depression, and over a quarter of these individuals could be considered severely depressed. This is in contrast with the average Nigerian population, where rates of depression are only 3–5%. The researchers further analyzed results, uncovering that depression may be associated with unemployment and low self-esteem.

With more studies now looking at the mental health consequences of diseases, for example in Post-Ebola syndrome, this research highlights the need to take more than physical well-being into account.

The team conclude: “The study underscores the need to go beyond just the physical needs of individuals with lymphatic filariasis. Management must be holistic and attention must be focused on the emotional sequelae of lymphatic filariasis.”

Sources: Obindo J, Abdulmalik J, Nwefoh E et al. Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria. PLoS Negl Trop Dis 11(6): e0005567 (2017); www.eurekalert.org/emb_releases/2017-06/p-epm052417.php

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