Determining the Burden of Mental Health in Lymphatic Filariasis Endemic Communities and the Impact of Enhanced Self-care Protocols in Malawi

确定马拉维淋巴丝虫病流行社区的心理健康负担以及加强自我护理方案的影响

• 批准号: 2267306
• 金额: --
• 依托单位: Liverpool School of Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2267306
• 关键词: Determining; Burden; Mental; Health; Lymphatic

Lymphatic filariasis (LF) is profoundly painful, disabling and disfiguring disease, threatening 893 million people in 49 countries across the globe. The prevalence of depressive illness is high amongst individuals affected by LF, due to the stigmatizing nature of the disease which can lead to social exclusion and discrimination. LF has been shown to be twice as disabling when depressive illness is included in Disability-adjusted Life Years (DALYs) estimates in comparison to filariasis DALY Global Burden of Disease estimates alone. Many countries have achieved the first elimination strategy (1) interrupting disease transmission through mass drug administration. Now, efforts much shift to focus on the second LF elimination strategy (2) to alleviate suffering, disability and disfigurement through morbidity management and disability prevention (MMDP). This has led to the development of an enhanced self-care (ESC) protocols for lymphoedema management and prevention. ESC protocols include deep-breathing and self-massage exercises which have proven to be beneficial in cancer related-lymphoedema. To effectively and successfully implement MMDP or enhanced self-care protocols, good case estimates within countries are required. Whole country LF surveillance is unfeasible in Malawi due to limited funding and resources. This has prompted the following research objectives (i) to explore alternative methods to predict the number of LF cases, (ii) to predict case numbers in regions where real case data is unavailable, and use this (iii) to map the geographical distribution of LF in Malawi. One potential barrier to successful MMDP implementation is patient adherence. In other chronic diseases, depressive illness has been shown to reduce adherence to treatment and therefore reduce health outcomes. Understanding how mental health impacts on LF elimination strategy (2) or within wider Neglected Tropical Disease elimination agendas, is lacking. Therefore, the following objectives will be addressed (iv) to determine the prevalence of depressive illness in persons affected by LF and differences in gender, age, the severity of disease and socio-economic status, (v) to measure the impact of ESC protocols on the condition of lymphoedema and depressive illness over time and (vi) to assess the impact of depressive illness on adherence of ESC protocol over time.

淋巴丝虫病（LF）是一种严重的疼痛、致残和毁容疾病，威胁着地球仪49个国家的8.93亿人。抑郁症的患病率在受LF影响的个体中很高，这是由于该疾病的污名化性质，可能导致社会排斥和歧视。与丝虫病DALY全球疾病负担估计值相比，当将抑郁症纳入残疾调整生命年（DALY）估计值时，LF的致残性是两倍。许多国家已经实现了第一个消除战略（1）通过大规模药物管理阻断疾病传播。现在，工作重点转向第二个LF消除战略（2），通过发病率管理和残疾预防（MMDP）减轻痛苦，残疾和毁容。这导致了淋巴水肿管理和预防的增强型自我护理（ESC）协议的发展。ESC方案包括深呼吸和自我按摩练习，这些练习已被证明对癌症相关淋巴水肿有益。为了有效且成功地实施MMDP或增强型自我护理方案，需要在各国进行良好的病例估计。由于资金和资源有限，在马拉维进行全国LF监测是不可行的。这促使实现了以下研究目标：（一）探索预测LF病例数量的替代方法;（二）预测无法获得真实的病例数据的地区的病例数量;（三）绘制LF在马拉维的地理分布图。成功实施MMDP的一个潜在障碍是患者依从性。在其他慢性疾病中，抑郁症已被证明会降低对治疗的依从性，从而降低健康结果。缺乏对心理健康如何影响LF消除战略（2）或更广泛的被忽视的热带病消除议程的理解。因此，将讨论以下目标：（iv）确定LF患者中抑郁症的患病率以及性别、年龄、疾病严重程度和社会经济地位的差异;（v）测量ESC方案对淋巴水肿和抑郁症病情随时间的影响;（vi）评估抑郁症对ESC方案依从性随时间的影响。