02923nas a2200337   4500000000100000008004100001260003400042653005700076653002100133653002800154653002700182653001500209653003000224653001800254653002500272653002000297100001400317700001700331700001500348700001600363700001400379700001400393700001200407700001800419245017200437856026000609300001600869490000700885520166800892022002502560       2023                            d  bOxford University Press (OUP)10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aHealth (social science)10aacute filarial attacks10aDepression10aLymphatic filariasis (LF)10aMental Health10aMorbidity management10aQuality of Life1 aBarrett C1 aChiphwanya J1 aChaponda L1 aMatipula DE1 aTurner JD1 aTaylor MJ1 aRead JM1 aKelly-Hope LA00aMental health conditions in people affected by filarial lymphoedema in Malawi: prevalence, associated risk factors and the impact of an enhanced self-care intervention  uhttps://watermark.silverchair.com/ihad064.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA3cwggNzBgkqhkiG9w0BBwagggNkMIIDYAIBADCCA1kGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMUJ3Gtk4lMEgthmBGAgEQgIIDKln1fgYGE4XHz3qlOr8zLJ7AQl-vCvkq7FHSErxMlzTGGWY  aiii14-iii270 v153 a<p><strong>Background:</strong> This study aimed to determine the key mental health indicators affecting people affected by lymphatic filariasis (LF) lymphoedema by assessing the prevalence of depressive symptoms and quality of life (QOL), identifying associated sociodemographic and clinical risk factors, and evaluating the impact of an enhanced self-care intervention for lymphoedema management.</p>

<p><strong>Methods:</strong> A prospective cohort study of adults with filarial lymphoedema from two regions of Malawi was conducted over six months in 2021. Depressive symptoms and QOL were assessed using Patient Health Questionnaire (PHQ-9) and LF Specific QOL Questionnaire, respectively, at baseline (pre-intervention), 3- and 6-months (postintervention). Beta regression analysis identified risk factors, and assessed the impact of the intervention.</p>

<p><strong>Results:</strong> Three hundred eleven affected individuals were surveyed with 23% (95% CI 18%–29%) reporting mild/moderate depressive symptoms and 31% (95% CI 26%–37%) reporting moderately low/low QOL. Higher depressive symptom scores were associated with high frequency of acute filarial attack episodes. Individuals with higher depressive symptoms (Adjusted Odds Ratios (AOR) 0.93, 95% CI 0.93–0.93) and lower QOL (AOR 0.98, 0.98–0.98) showed greatest improvement in mental health indicators over 3-months but was not sustained to the same level at 6-months.</p>

<p><strong>Conclusion:</strong>&nbsp;Sustained morbidity management and psychological support is recommended for affected persons to ensure long-term positive mental health and clinical outcomes.&nbsp;</p>
  a1876-3413, 1876-3405