Elephantiasis patients more likely to have depression
Many patients infected with filarial worms have no symptoms, but those who develop disfiguring lymphatic filariasis—more commonly known as elephantiasis—often struggle with discrimination and rejection. Now, researchers have quantified that burden, reporting in PLOS Neglected Tropical Diseases that lymphatic filariasis patients in Nigeria have about four times the rate of depression as other adults there.
Filarial worms are spread by mosquitos in the tropics. The disease impairs the lymphatic system and, in some cases, causes fluid to back up, leading to painful and disfiguring swelling of body parts. Over 120 million people are thought to be infected, with 40 million disfigured to some degree by lymphatic filariasis. Until now, the management of the condition has largely focused on developing mass drug administration programs for prevention and treatment.
In the new work, Jibril Abdulmalik of the University of Ibadan, Nigeria, and colleagues studied 98 adults with physical disability associated with lymphatic filariasis, from 5 treatment centers across Plateau State, Nigeria. Each patient completed questionnaires on their general health, self-esteem, and socio-demographics, as well as a depression rating scale.
Twenty percent of the individuals met the criteria for depression, and more than a quarter of those were severely depressed. By comparison, only 3 to 5 percent of adults in Nigeria have been reported to have depression. Participants with low self-esteem, and those who were unemployed, were more likely to have depression. Compared to the average, patients in the study with lymphatic filariasis were less likely to be married.
"The study underscores the need to go beyond just the physical needs of individuals with lymphatic filariasis," the researchers say. "Management must be holistic and attention must be focused on the emotional sequelae of lymphatic filariasis."