Serveur d'exploration sur le lymphœdème

Attention, ce site est en cours de développement !
Attention, site généré par des moyens informatiques à partir de corpus bruts.
Les informations ne sont donc pas validées.

Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria

Identifieur interne : 004310 ( Pmc/Corpus ); précédent : 004309; suivant : 004311

Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria

Auteurs : James Obindo ; Jibril Abdulmalik ; Emeka Nwefoh ; Michael Agbir ; Charles Nwoga ; Aishatu Armiya ; Francis Davou ; Kurkat Maigida ; Emmanuel Otache ; Ajuma Ebiloma ; Samuel Dakwak ; John Umaru ; Elisha Samuel ; Christopher Ogoshi ; Julian Eaton

Source :

RBID : PMC:5453421

Abstract

Background

Lymphatic filariasis is a chronic, disabling and often disfiguring condition that principally impacts the world’s poorest people. In addition to the well-recognised physical disability associated with lymphedema and hydrocele, affected people often experience rejection, stigma and discrimination. The resulting emotional consequences are known to impact on the quality of life and the functioning of the affected individuals. However, the management of this condition has focused on prevention and treatment through mass drug administration, with scant attention paid to the emotional impact of the condition on affected individuals. This study aimed to determine the prevalence and severity of depression among individuals with physical disfigurement from lymphatic filariasis in Plateau State, Nigeria.

Methodology

A cross-sectional 2-stage convenience study was conducted at 5 designated treatment centers across Plateau State, Nigeria. All available and consenting clients with clearly visible physical disfigurement were recruited. A semi-structured socio-demographic questionnaire, Rosenberg Self-esteem and a 9-item Patient Health Questionnaire (PHQ-9) were administered at the first stage. Those who screened positive (with a PHQ-9 score of five and above) were further interviewed using the Depression module of the Composite International Diagnostic Interview (CIDI).

Results

Ninety-eight individuals met the criteria and provided consent. Twenty percent of the respondents met criteria for depression, with the following proportions based on severity: Mild (42.1%), Moderate (31.6%) and Severe (26.3%). History of mental illness (OR 40.83, p = 0.008); Median duration of the illness was 17 years (IQR 7.0–30 years) and being unemployed (OR 12.71, p = 0.003) were predictive of depression. High self-esteem was negatively correlated (OR 0.09, p<0.004).

Conclusion

Prevalence of depression is high among individuals with lymphatic filariasis and depression in sufferers is associated with low self-esteem and low levels of life satisfaction.


Url:
DOI: 10.1371/journal.pntd.0005567
PubMed: 28570585
PubMed Central: 5453421

Links to Exploration step

PMC:5453421

Le document en format XML

<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria</title>
<author>
<name sortKey="Obindo, James" sort="Obindo, James" uniqKey="Obindo J" first="James" last="Obindo">James Obindo</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Abdulmalik, Jibril" sort="Abdulmalik, Jibril" uniqKey="Abdulmalik J" first="Jibril" last="Abdulmalik">Jibril Abdulmalik</name>
<affiliation>
<nlm:aff id="aff002">
<addr-line>Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nwefoh, Emeka" sort="Nwefoh, Emeka" uniqKey="Nwefoh E" first="Emeka" last="Nwefoh">Emeka Nwefoh</name>
<affiliation>
<nlm:aff id="aff003">
<addr-line>CBM Country Co-ordination Office, Federal Capital Territory, Abuja, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Agbir, Michael" sort="Agbir, Michael" uniqKey="Agbir M" first="Michael" last="Agbir">Michael Agbir</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nwoga, Charles" sort="Nwoga, Charles" uniqKey="Nwoga C" first="Charles" last="Nwoga">Charles Nwoga</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Armiya, Aishatu" sort="Armiya, Aishatu" uniqKey="Armiya A" first="Aishatu" last="Armiya">Aishatu Armiya</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Davou, Francis" sort="Davou, Francis" uniqKey="Davou F" first="Francis" last="Davou">Francis Davou</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Maigida, Kurkat" sort="Maigida, Kurkat" uniqKey="Maigida K" first="Kurkat" last="Maigida">Kurkat Maigida</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Otache, Emmanuel" sort="Otache, Emmanuel" uniqKey="Otache E" first="Emmanuel" last="Otache">Emmanuel Otache</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ebiloma, Ajuma" sort="Ebiloma, Ajuma" uniqKey="Ebiloma A" first="Ajuma" last="Ebiloma">Ajuma Ebiloma</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dakwak, Samuel" sort="Dakwak, Samuel" uniqKey="Dakwak S" first="Samuel" last="Dakwak">Samuel Dakwak</name>
<affiliation>
<nlm:aff id="aff004">
<addr-line>QHC, Department of Psychology, University of Jos, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Umaru, John" sort="Umaru, John" uniqKey="Umaru J" first="John" last="Umaru">John Umaru</name>
<affiliation>
<nlm:aff id="aff005">
<addr-line>The Carter Centre, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Samuel, Elisha" sort="Samuel, Elisha" uniqKey="Samuel E" first="Elisha" last="Samuel">Elisha Samuel</name>
<affiliation>
<nlm:aff id="aff006">
<addr-line>Health and Development Support Programme (HANDS), Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ogoshi, Christopher" sort="Ogoshi, Christopher" uniqKey="Ogoshi C" first="Christopher" last="Ogoshi">Christopher Ogoshi</name>
<affiliation>
<nlm:aff id="aff006">
<addr-line>Health and Development Support Programme (HANDS), Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Eaton, Julian" sort="Eaton, Julian" uniqKey="Eaton J" first="Julian" last="Eaton">Julian Eaton</name>
<affiliation>
<nlm:aff id="aff007">
<addr-line>CBM International and London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line>
</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">28570585</idno>
<idno type="pmc">5453421</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453421</idno>
<idno type="RBID">PMC:5453421</idno>
<idno type="doi">10.1371/journal.pntd.0005567</idno>
<date when="2017">2017</date>
<idno type="wicri:Area/Pmc/Corpus">004310</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004310</idno>
</publicationStmt>
<sourceDesc>
<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria</title>
<author>
<name sortKey="Obindo, James" sort="Obindo, James" uniqKey="Obindo J" first="James" last="Obindo">James Obindo</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Abdulmalik, Jibril" sort="Abdulmalik, Jibril" uniqKey="Abdulmalik J" first="Jibril" last="Abdulmalik">Jibril Abdulmalik</name>
<affiliation>
<nlm:aff id="aff002">
<addr-line>Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nwefoh, Emeka" sort="Nwefoh, Emeka" uniqKey="Nwefoh E" first="Emeka" last="Nwefoh">Emeka Nwefoh</name>
<affiliation>
<nlm:aff id="aff003">
<addr-line>CBM Country Co-ordination Office, Federal Capital Territory, Abuja, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Agbir, Michael" sort="Agbir, Michael" uniqKey="Agbir M" first="Michael" last="Agbir">Michael Agbir</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Nwoga, Charles" sort="Nwoga, Charles" uniqKey="Nwoga C" first="Charles" last="Nwoga">Charles Nwoga</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Armiya, Aishatu" sort="Armiya, Aishatu" uniqKey="Armiya A" first="Aishatu" last="Armiya">Aishatu Armiya</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Davou, Francis" sort="Davou, Francis" uniqKey="Davou F" first="Francis" last="Davou">Francis Davou</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Maigida, Kurkat" sort="Maigida, Kurkat" uniqKey="Maigida K" first="Kurkat" last="Maigida">Kurkat Maigida</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Otache, Emmanuel" sort="Otache, Emmanuel" uniqKey="Otache E" first="Emmanuel" last="Otache">Emmanuel Otache</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ebiloma, Ajuma" sort="Ebiloma, Ajuma" uniqKey="Ebiloma A" first="Ajuma" last="Ebiloma">Ajuma Ebiloma</name>
<affiliation>
<nlm:aff id="aff001">
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dakwak, Samuel" sort="Dakwak, Samuel" uniqKey="Dakwak S" first="Samuel" last="Dakwak">Samuel Dakwak</name>
<affiliation>
<nlm:aff id="aff004">
<addr-line>QHC, Department of Psychology, University of Jos, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Umaru, John" sort="Umaru, John" uniqKey="Umaru J" first="John" last="Umaru">John Umaru</name>
<affiliation>
<nlm:aff id="aff005">
<addr-line>The Carter Centre, Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Samuel, Elisha" sort="Samuel, Elisha" uniqKey="Samuel E" first="Elisha" last="Samuel">Elisha Samuel</name>
<affiliation>
<nlm:aff id="aff006">
<addr-line>Health and Development Support Programme (HANDS), Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Ogoshi, Christopher" sort="Ogoshi, Christopher" uniqKey="Ogoshi C" first="Christopher" last="Ogoshi">Christopher Ogoshi</name>
<affiliation>
<nlm:aff id="aff006">
<addr-line>Health and Development Support Programme (HANDS), Jos, Plateau State, Nigeria</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Eaton, Julian" sort="Eaton, Julian" uniqKey="Eaton J" first="Julian" last="Eaton">Julian Eaton</name>
<affiliation>
<nlm:aff id="aff007">
<addr-line>CBM International and London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">PLoS Neglected Tropical Diseases</title>
<idno type="ISSN">1935-2727</idno>
<idno type="eISSN">1935-2735</idno>
<imprint>
<date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec id="sec001">
<title>Background</title>
<p>Lymphatic filariasis is a chronic, disabling and often disfiguring condition that principally impacts the world’s poorest people. In addition to the well-recognised physical disability associated with lymphedema and hydrocele, affected people often experience rejection, stigma and discrimination. The resulting emotional consequences are known to impact on the quality of life and the functioning of the affected individuals. However, the management of this condition has focused on prevention and treatment through mass drug administration, with scant attention paid to the emotional impact of the condition on affected individuals. This study aimed to determine the prevalence and severity of depression among individuals with physical disfigurement from lymphatic filariasis in Plateau State, Nigeria.</p>
</sec>
<sec id="sec002">
<title>Methodology</title>
<p>A cross-sectional 2-stage convenience study was conducted at 5 designated treatment centers across Plateau State, Nigeria. All available and consenting clients with clearly visible physical disfigurement were recruited. A semi-structured socio-demographic questionnaire, Rosenberg Self-esteem and a 9-item Patient Health Questionnaire (PHQ-9) were administered at the first stage. Those who screened positive (with a PHQ-9 score of five and above) were further interviewed using the Depression module of the Composite International Diagnostic Interview (CIDI).</p>
</sec>
<sec id="sec003">
<title>Results</title>
<p>Ninety-eight individuals met the criteria and provided consent. Twenty percent of the respondents met criteria for depression, with the following proportions based on severity: Mild (42.1%), Moderate (31.6%) and Severe (26.3%). History of mental illness (OR 40.83, p = 0.008); Median duration of the illness was 17 years (IQR 7.0–30 years) and being unemployed (OR 12.71, p = 0.003) were predictive of depression. High self-esteem was negatively correlated (OR 0.09, p<0.004).</p>
</sec>
<sec id="sec004">
<title>Conclusion</title>
<p>Prevalence of depression is high among individuals with lymphatic filariasis and depression in sufferers is associated with low self-esteem and low levels of life satisfaction.</p>
</sec>
</div>
</front>
<back>
<div1 type="bibliography">
<listBibl>
<biblStruct>
<analytic>
<author>
<name sortKey="Hotez, Pj" uniqKey="Hotez P">PJ. Hotez</name>
</author>
<author>
<name sortKey="Molyneux, Dh" uniqKey="Molyneux D">DH. Molyneux</name>
</author>
<author>
<name sortKey="Fenwick, A" uniqKey="Fenwick A">A. Fenwick</name>
</author>
<author>
<name sortKey="Kumaresan, J" uniqKey="Kumaresan J">J. Kumaresan</name>
</author>
<author>
<name sortKey="Sachs, Se" uniqKey="Sachs S">SE. Sachs</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Hotez, Pj" uniqKey="Hotez P">PJ. Hotez</name>
</author>
<author>
<name sortKey="Molyneus, Dh" uniqKey="Molyneus D">DH. Molyneus</name>
</author>
<author>
<name sortKey="Fenwick, A" uniqKey="Fenwick A">A. Fenwick</name>
</author>
<author>
<name sortKey="Ottessen, E" uniqKey="Ottessen E">E. Ottessen</name>
</author>
<author>
<name sortKey="Ehrlich, Ss" uniqKey="Ehrlich S">SS. Ehrlich</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ramaiah, Kd" uniqKey="Ramaiah K">KD. Ramaiah</name>
</author>
<author>
<name sortKey="Kumar, Kn" uniqKey="Kumar K">KN. Kumar</name>
</author>
<author>
<name sortKey="Ramu, K" uniqKey="Ramu K">K. Ramu</name>
</author>
<author>
<name sortKey="Pani, Sp" uniqKey="Pani S">SP. Pani</name>
</author>
<author>
<name sortKey="Das, Pk" uniqKey="Das P">PK. Das</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ottesen, Ea" uniqKey="Ottesen E">EA Ottesen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Zeldenryk, Lm" uniqKey="Zeldenryk L">LM Zeldenryk</name>
</author>
<author>
<name sortKey="Gray, M" uniqKey="Gray M">M Gray</name>
</author>
<author>
<name sortKey="Speare, R" uniqKey="Speare R">R Speare</name>
</author>
<author>
<name sortKey="Gordon, S" uniqKey="Gordon S">S Gordon</name>
</author>
<author>
<name sortKey="Melrose, W" uniqKey="Melrose W">W Melrose</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Evans, Db" uniqKey="Evans D">DB Evans</name>
</author>
<author>
<name sortKey="Gelband, H" uniqKey="Gelband H">H Gelband</name>
</author>
<author>
<name sortKey="Vlassof, C" uniqKey="Vlassof C">C Vlassof</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Bontha, V B" uniqKey="Bontha V">V.B Bontha</name>
</author>
<author>
<name sortKey="Suchismila, M" uniqKey="Suchismila M">M Suchismila</name>
</author>
<author>
<name sortKey="Abhaya, Nn" uniqKey="Abhaya N">NN Abhaya</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ton, Tgn" uniqKey="Ton T">TGN. Ton</name>
</author>
<author>
<name sortKey="Mackenzie, C" uniqKey="Mackenzie C">C. Mackenzie</name>
</author>
<author>
<name sortKey="Molyneux, Dh" uniqKey="Molyneux D">DH. Molyneux</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Gureje, O" uniqKey="Gureje O">O. Gureje</name>
</author>
<author>
<name sortKey="Lasebikan, Vo" uniqKey="Lasebikan V">VO. Lasebikan</name>
</author>
<author>
<name sortKey="Kola, L" uniqKey="Kola L">L. Kola</name>
</author>
<author>
<name sortKey="Makanjuola, Va" uniqKey="Makanjuola V">VA. Makanjuola</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Olorunfemi, Amoran" uniqKey="Olorunfemi A">Amoran Olorunfemi</name>
</author>
<author>
<name sortKey="Lawoyin, Taiwo" uniqKey="Lawoyin T">Taiwo Lawoyin</name>
</author>
<author>
<name sortKey="Lasebikan, Victor" uniqKey="Lasebikan V">Victor Lasebikan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Gureje, O" uniqKey="Gureje O">O. Gureje</name>
</author>
<author>
<name sortKey="Uwakwe, R" uniqKey="Uwakwe R">R. Uwakwe</name>
</author>
<author>
<name sortKey="Oladeji, B" uniqKey="Oladeji B">B. Oladeji</name>
</author>
<author>
<name sortKey="Makanjuola, Vo" uniqKey="Makanjuola V">VO. Makanjuola</name>
</author>
<author>
<name sortKey="Esan, O" uniqKey="Esan O">O. Esan</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Katon, W" uniqKey="Katon W">W. Katon</name>
</author>
<author>
<name sortKey="Schulberg, H" uniqKey="Schulberg H">H. Schulberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Obindo, Jt" uniqKey="Obindo J">JT. Obindo</name>
</author>
<author>
<name sortKey="Munir, B" uniqKey="Munir B">B. Munir</name>
</author>
<author>
<name sortKey="Okeahialam, B" uniqKey="Okeahialam B">B. Okeahialam</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ali, S" uniqKey="Ali S">S. Ali</name>
</author>
<author>
<name sortKey="Stone, Ma" uniqKey="Stone M">MA. Stone</name>
</author>
<author>
<name sortKey="Peters, Jl" uniqKey="Peters J">JL. Peters</name>
</author>
<author>
<name sortKey="Davies, Mj" uniqKey="Davies M">MJ. Davies</name>
</author>
<author>
<name sortKey="Khunti, K" uniqKey="Khunti K">K. Khunti</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Kessler, Ronald C" uniqKey="Kessler R">Ronald C. Kessler</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Ahorlu, Ck" uniqKey="Ahorlu C">CK. Ahorlu</name>
</author>
<author>
<name sortKey="Dunyo, Sk" uniqKey="Dunyo S">SK. Dunyo</name>
</author>
<author>
<name sortKey="Koram, Ka" uniqKey="Koram K">KA. Koram</name>
</author>
<author>
<name sortKey="Nkrumah, Fk" uniqKey="Nkrumah F">FK. Nkrumah</name>
</author>
<author>
<name sortKey="Aagaard Hansen, J" uniqKey="Aagaard Hansen J">J. Aagaard-Hansen</name>
</author>
<author>
<name sortKey="Simonsen, Pe" uniqKey="Simonsen P">PE. Simonsen</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Weiss, Mg" uniqKey="Weiss M">MG Weiss</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Corrigan, P W" uniqKey="Corrigan P">P. W. Corrigan</name>
</author>
<author>
<name sortKey="Larson, J E" uniqKey="Larson J">J. E. Larson</name>
</author>
<author>
<name sortKey="Rusch, N" uniqKey="Rusch N">N. Rusch</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Lund, C" uniqKey="Lund C">C Lund</name>
</author>
<author>
<name sortKey="De Silva, M" uniqKey="De Silva M">M De Silva</name>
</author>
<author>
<name sortKey="Plagerson, S" uniqKey="Plagerson S">S Plagerson</name>
</author>
<author>
<name sortKey="Cooper, S" uniqKey="Cooper S">S Cooper</name>
</author>
<author>
<name sortKey="Chisholm, D" uniqKey="Chisholm D">D Chisholm</name>
</author>
<author>
<name sortKey="Das, J" uniqKey="Das J">J Das</name>
</author>
<author>
<name sortKey="Knapp, M" uniqKey="Knapp M">M Knapp</name>
</author>
<author>
<name sortKey="Patel, V" uniqKey="Patel V">V Patel</name>
</author>
</analytic>
</biblStruct>
<biblStruct>
<analytic>
<author>
<name sortKey="Patel, V" uniqKey="Patel V">V Patel</name>
</author>
<author>
<name sortKey="Araya, R" uniqKey="Araya R">R Araya</name>
</author>
<author>
<name sortKey="Chatterjee, S" uniqKey="Chatterjee S">S Chatterjee</name>
</author>
<author>
<name sortKey="Chisholm, D" uniqKey="Chisholm D">D Chisholm</name>
</author>
<author>
<name sortKey="Cohen, A" uniqKey="Cohen A">A Cohen</name>
</author>
<author>
<name sortKey="De Silva, M" uniqKey="De Silva M">M De Silva</name>
</author>
<author>
<name sortKey="Hosman, C" uniqKey="Hosman C">C Hosman</name>
</author>
<author>
<name sortKey="Mcguire, H" uniqKey="Mcguire H">H McGuire</name>
</author>
<author>
<name sortKey="Rojas, G" uniqKey="Rojas G">G Rojas</name>
</author>
<author>
<name sortKey="Van Ommeren, M" uniqKey="Van Ommeren M">M van Ommeren</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosntds</journal-id>
<journal-title-group>
<journal-title>PLoS Neglected Tropical Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">1935-2727</issn>
<issn pub-type="epub">1935-2735</issn>
<publisher>
<publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">28570585</article-id>
<article-id pub-id-type="pmc">5453421</article-id>
<article-id pub-id-type="doi">10.1371/journal.pntd.0005567</article-id>
<article-id pub-id-type="publisher-id">PNTD-D-16-00949</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Mental Health and Psychiatry</subject>
<subj-group>
<subject>Mood Disorders</subject>
<subj-group>
<subject>Depression</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Parasitic Diseases</subject>
<subj-group>
<subject>Helminth Infections</subject>
<subj-group>
<subject>Filariasis</subject>
<subj-group>
<subject>Lymphatic Filariasis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Tropical Diseases</subject>
<subj-group>
<subject>Neglected Tropical Diseases</subject>
<subj-group>
<subject>Lymphatic Filariasis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>People and Places</subject>
<subj-group>
<subject>Geographical Locations</subject>
<subj-group>
<subject>Africa</subject>
<subj-group>
<subject>Nigeria</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Sociology</subject>
<subj-group>
<subject>Social Discrimination</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Health Care</subject>
<subj-group>
<subject>Quality of Life</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Mental Health and Psychiatry</subject>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Social Sciences</subject>
<subj-group>
<subject>Economics</subject>
<subj-group>
<subject>Economic History</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3">
<subject>Medicine and Health Sciences</subject>
<subj-group>
<subject>Health Care</subject>
<subj-group>
<subject>Health Risk Analysis</subject>
</subj-group>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria</article-title>
<alt-title alt-title-type="running-head">Prevalence of depression among persons with lymphatic filariasis in Nigeria</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Obindo</surname>
<given-names>James</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<contrib-id authenticated="true" contrib-id-type="orcid">http://orcid.org/0000-0001-9486-5408</contrib-id>
<name>
<surname>Abdulmalik</surname>
<given-names>Jibril</given-names>
</name>
<xref ref-type="aff" rid="aff002">
<sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nwefoh</surname>
<given-names>Emeka</given-names>
</name>
<xref ref-type="aff" rid="aff003">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Agbir</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Nwoga</surname>
<given-names>Charles</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Armiya’u</surname>
<given-names>Aishatu</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Davou</surname>
<given-names>Francis</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Maigida</surname>
<given-names>Kurkat</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Otache</surname>
<given-names>Emmanuel</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ebiloma</surname>
<given-names>Ajuma</given-names>
</name>
<xref ref-type="aff" rid="aff001">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dakwak</surname>
<given-names>Samuel</given-names>
</name>
<xref ref-type="aff" rid="aff004">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Umaru</surname>
<given-names>John</given-names>
</name>
<xref ref-type="aff" rid="aff005">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Samuel</surname>
<given-names>Elisha</given-names>
</name>
<xref ref-type="aff" rid="aff006">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ogoshi</surname>
<given-names>Christopher</given-names>
</name>
<xref ref-type="aff" rid="aff006">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Eaton</surname>
<given-names>Julian</given-names>
</name>
<xref ref-type="aff" rid="aff007">
<sup>7</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001">
<label>1</label>
<addr-line>Department of Psychiatry, Jos University Teaching Hospital, Jos, Plateau State, Nigeria</addr-line>
</aff>
<aff id="aff002">
<label>2</label>
<addr-line>Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria</addr-line>
</aff>
<aff id="aff003">
<label>3</label>
<addr-line>CBM Country Co-ordination Office, Federal Capital Territory, Abuja, Nigeria</addr-line>
</aff>
<aff id="aff004">
<label>4</label>
<addr-line>QHC, Department of Psychology, University of Jos, Jos, Plateau State, Nigeria</addr-line>
</aff>
<aff id="aff005">
<label>5</label>
<addr-line>The Carter Centre, Jos, Plateau State, Nigeria</addr-line>
</aff>
<aff id="aff006">
<label>6</label>
<addr-line>Health and Development Support Programme (HANDS), Jos, Plateau State, Nigeria</addr-line>
</aff>
<aff id="aff007">
<label>7</label>
<addr-line>CBM International and London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line>
</aff>
<contrib-group>
<contrib contrib-type="editor">
<name>
<surname>Gyapong</surname>
<given-names>Margaret</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">
<addr-line>Dodowa Health Research Centre, GHANA</addr-line>
</aff>
<author-notes>
<fn fn-type="COI-statement" id="coi001">
<p>The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con">
<p>
<list list-type="simple">
<list-item>
<p>
<bold>Conceived and designed the experiments:</bold>
EN, JE, JO, JA & MA.</p>
</list-item>
<list-item>
<p>
<bold>Performed the experiments:</bold>
CN, AA, FD, KM, EO, AE, SD, JU, ES, CO.</p>
</list-item>
<list-item>
<p>
<bold>Analyzed the data:</bold>
CN, AA, FD, KM, EO, AE, SD, JU, ES, CO, EN, JE, JA, MA & JO.</p>
</list-item>
<list-item>
<p>
<bold>Contributed reagents/materials/analysis tools:</bold>
Not applicable.</p>
</list-item>
<list-item>
<p>
<bold>Wrote the paper:</bold>
CN, AA, FD, KM, EO, AE, SD, JU, ES, CO, EN, JE, JA, MA & JO.</p>
</list-item>
</list>
</p>
</fn>
<corresp id="cor001">* E-mail:
<email>jfutprints@yahoo.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>1</day>
<month>6</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection">
<month>6</month>
<year>2017</year>
</pub-date>
<volume>11</volume>
<issue>6</issue>
<elocation-id>e0005567</elocation-id>
<history>
<date date-type="received">
<day>21</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>12</day>
<month>4</month>
<year>2017</year>
</date>
</history>
<permissions>
<copyright-statement>© 2017 Obindo et al</copyright-statement>
<copyright-year>2017</copyright-year>
<copyright-holder>Obindo et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article distributed under the terms of the
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pntd.0005567.pdf"></self-uri>
<abstract>
<sec id="sec001">
<title>Background</title>
<p>Lymphatic filariasis is a chronic, disabling and often disfiguring condition that principally impacts the world’s poorest people. In addition to the well-recognised physical disability associated with lymphedema and hydrocele, affected people often experience rejection, stigma and discrimination. The resulting emotional consequences are known to impact on the quality of life and the functioning of the affected individuals. However, the management of this condition has focused on prevention and treatment through mass drug administration, with scant attention paid to the emotional impact of the condition on affected individuals. This study aimed to determine the prevalence and severity of depression among individuals with physical disfigurement from lymphatic filariasis in Plateau State, Nigeria.</p>
</sec>
<sec id="sec002">
<title>Methodology</title>
<p>A cross-sectional 2-stage convenience study was conducted at 5 designated treatment centers across Plateau State, Nigeria. All available and consenting clients with clearly visible physical disfigurement were recruited. A semi-structured socio-demographic questionnaire, Rosenberg Self-esteem and a 9-item Patient Health Questionnaire (PHQ-9) were administered at the first stage. Those who screened positive (with a PHQ-9 score of five and above) were further interviewed using the Depression module of the Composite International Diagnostic Interview (CIDI).</p>
</sec>
<sec id="sec003">
<title>Results</title>
<p>Ninety-eight individuals met the criteria and provided consent. Twenty percent of the respondents met criteria for depression, with the following proportions based on severity: Mild (42.1%), Moderate (31.6%) and Severe (26.3%). History of mental illness (OR 40.83, p = 0.008); Median duration of the illness was 17 years (IQR 7.0–30 years) and being unemployed (OR 12.71, p = 0.003) were predictive of depression. High self-esteem was negatively correlated (OR 0.09, p<0.004).</p>
</sec>
<sec id="sec004">
<title>Conclusion</title>
<p>Prevalence of depression is high among individuals with lymphatic filariasis and depression in sufferers is associated with low self-esteem and low levels of life satisfaction.</p>
</sec>
</abstract>
<abstract abstract-type="summary">
<title>Author summary</title>
<p>Lymphatic filariasis is a chronic illness that is disabling and often results in disfigurement. Affected people experience rejection, and stigma and discrimination, which can result in significant emotional consequences. Overall functioning and the quality of life of such individuals can be further affected by this exclusion and psychosocial impacts. Little or no attention is presently paid to the emotional impact of this disease in the overall management of people affected. The study, therefore, aimed to determine the prevalence and severity of depression, as well as associated socio-demographic factors, in individuals with physical disfigurement from lymphatic filariasis in Plateau State, Nigeria. Ninety-four consecutive consenting individuals with physically disfiguring lymphatic filariasis at 5 established treatment centers across Plateau State, Nigeria, were recruited and had semi-structured sociodemographic, Patient Health (PHQ-9), the
<bold>depression</bold>
module of Composite International Diagnostic Interview (CIDI) and Rosenberg Self-esteem questionnaires administered using a 2-stage design. Twenty percent of the sample were found to be depressed, while history of mental illness, duration of the illness, being unemployed, and religion were predictive of depression. High self-esteem was negatively correlated. 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.</p>
</abstract>
<funding-group>
<award-group id="award001">
<funding-source>
<institution>CBM Australia</institution>
</funding-source>
<award-id>2829</award-id>
<principal-award-recipient>
<name>
<surname>Ogoshi</surname>
<given-names>Christopher</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>This project was facilitated by a Grant from Christian Blind Mission (CBM) Australia.
<ext-link ext-link-type="uri" xlink:href="https://www.cbm.org.au">https://www.cbm.org.au</ext-link>
Project Number 2829. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts>
<fig-count count="1"></fig-count>
<table-count count="4"></table-count>
<page-count count="10"></page-count>
</counts>
<custom-meta-group>
<custom-meta id="data-availability">
<meta-name>Data Availability</meta-name>
<meta-value>Data are available from the CBM Nigeria Institutional Data Access Base for researchers who meet the criteria for access to confidential data. Contact person: Dr Toyin Aderemi, CBM Nigeria Country Office; e-mail:
<email>toyin.aderemi@cbm.org</email>
The reason for this restriction is that the study population is a special and easily identifiable group living in a specified region. Thus, the ethical requirement is that the entire dataset, including sociodemographic details is only made available upon request and reasonable assurances that confidentiality will be respected.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes>
<title>Data Availability</title>
<p>Data are available from the CBM Nigeria Institutional Data Access Base for researchers who meet the criteria for access to confidential data. Contact person: Dr Toyin Aderemi, CBM Nigeria Country Office; e-mail:
<email>toyin.aderemi@cbm.org</email>
The reason for this restriction is that the study population is a special and easily identifiable group living in a specified region. Thus, the ethical requirement is that the entire dataset, including sociodemographic details is only made available upon request and reasonable assurances that confidentiality will be respected.</p>
</notes>
</front>
<body>
<sec sec-type="intro" id="sec005">
<title>Introduction</title>
<p>Neglected Tropical Diseases (NTDs) are a group of disabling conditions that are among the most common infections affecting the world’s poorest people [
<xref rid="pntd.0005567.ref001" ref-type="bibr">1</xref>
]. Many NTDs lead to chronic and often disfiguring conditions that result in significant disability and affect more than 1 billion people across the world [
<xref rid="pntd.0005567.ref002" ref-type="bibr">2</xref>
].</p>
<p>Lymphatic filariasis (LF) is a mosquito-borne disease caused by filarial parasitic worms like
<italic>Wuchereria bancrofti</italic>
,
<italic>Brugia malayi and Brugia timori</italic>
[
<xref rid="pntd.0005567.ref003" ref-type="bibr">3</xref>
]. Global estimates suggest that 120 million are affected in 80 countries throughout the tropics and subtropics with people at risk exceeding 1.3 billion [
<xref rid="pntd.0005567.ref004" ref-type="bibr">4</xref>
,
<xref rid="pntd.0005567.ref005" ref-type="bibr">5</xref>
]. LF often manifests as enlargement of the entire leg or arm, the genitals (scrotal hydrocele in men), vulva and breasts leading to significant physical disfigurement [
<xref rid="pntd.0005567.ref003" ref-type="bibr">3</xref>
]. Significant social stigma is associated with this stage of the disease [
<xref rid="pntd.0005567.ref006" ref-type="bibr">6</xref>
], and the psychosocial problems linked with the condition are believed to be more severe than the physical ones [
<xref rid="pntd.0005567.ref007" ref-type="bibr">7</xref>
].</p>
<p>In the 2010 Global Burden of Disease study, the Disability Adjusted Life Years (DALYs) associated with depressive illness in lymphatic filariasis was found to be twice that of the physical consequences of the disease (5.09 million global DALYs vs 2.78 million respectively) [
<xref rid="pntd.0005567.ref008" ref-type="bibr">8</xref>
]. Despite this report, very few studies have been carried out to explore the association between depressive illness and lymphatic filariasis.</p>
<p>This study, therefore, aimed to determine the prevalence and severity of depression and the social and clinical factors associated with depression in individuals with lymphatic filariasis in Plateau State, North Central Nigeria.</p>
</sec>
<sec sec-type="materials|methods" id="sec006">
<title>Methods</title>
<p>The study was carried out in five catchment areas in Plateau State where people living with LF periodically meet to receive physical care and support. These centers are run by the Carter Center, a US-based international Non-Governmental Organization (NGO). They include Tudunwada (Jos North Local Government Area (LGA)), Nyes (Mangu LGA), Ampier (Kanke LGA), Dadur (Langtang LGA) and Gwamlar (Kanam LGA). These sites include both rural and urban communities and were chosen as they have a high prevalence of LF.</p>
<p>The study population included all individuals accessing care at these five centers in Plateau State with obvious physical manifestation of the condition and who were available on site on the day of the visit of the research team. Advance notice was sent to all the Centers about a month before the visit, inviting potential participants to attend. There is no reason to believe that the attendees on these clinic days vary systematically from those attending on other days, though they are characterised by their access to clinical and rehabilitative care, which is not universal in Nigeria.</p>
<p>A cross-sectional 2-stage descriptive convenience study design was adopted. It involved the recruitment of all available and consenting individuals with physical manifestations of LF. Data was collected using a semi-structured socio-demographic questionnaire designed by the research team and a 9-item Patient Health Questionnaire (PHQ-9) for the first stage. Those who screened positive (with a score of 5 and above) were further interviewed using the Depression module of the Composite International Diagnostic Interview (CIDI) to make definitive diagnosis and rate the severity of the depression. Rosenberg Self-esteem scale was used to assess self-esteem in the study population.</p>
<p>On each day of the visit to a particular center, all participants were briefed on the purpose of the study. Each participant was then approached, given a more detailed explanation, consent obtained and the interview conducted in private. Six researchers (two consultant psychiatrists, a clinical psychologist, a social worker and two resident doctors in psychiatry) administered the socio-demographic, Rosenberg self-esteem and the PHQ-9 questionnaires to the participants and scored the PHQ-9. Those who scored 5 and above were sent to 2 consultant psychiatrists trained in the use of CIDI for the second stage. The participants were then formally diagnosed and rated for severity of the depression.</p>
<p>All those who screened positive for depression using the CIDI were given advice and information (psycho-education), and those who had moderate and severe depression were referred to a nearby comprehensive health facility for further treatment. They have subsequently been followed up in an on-going psychosocial service being developed at the Centers.</p>
<sec id="sec007">
<title>Ethics statement</title>
<p>Ethical clearance for the study was obtained from the Institutional Research Ethical Committee of Jos University Teaching Hospital, Plateau State. Signed or thumb-printed written consent was individually obtained from each participant after due explanation of the purpose of the study and the voluntary nature of their participation. Respondents below the age of 18 years, required the consent of their parent or guardian in addition to their assent. The medical data as well as respondent scores on the instruments were anonymized in order to protect confidentiality.</p>
</sec>
<sec id="sec008">
<title>Data analysis</title>
<p>Data analysis was carried out using the Statistical Package for Social Sciences (SPSS), version 21, software using descriptive statistics to yield frequencies, percentages and proportions. Level of significance was kept at 5%. Logistic regression was used to identify predictors of depression among the respondents in this study using a few of the co-variates.</p>
</sec>
</sec>
<sec sec-type="results" id="sec009">
<title>Results</title>
<p>A total of ninety-eight participants, who met the inclusion criteria and gave consent for the study, were interviewed. Ninety-four (95.9%) had full documentation and were analysed. The majority, 58 respondents (61.7%), were female. Other socio-demographic details are provided in
<xref ref-type="table" rid="pntd.0005567.t001">Table 1</xref>
.</p>
<table-wrap id="pntd.0005567.t001" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pntd.0005567.t001</object-id>
<label>Table 1</label>
<caption>
<title>Socio-demographic characteristics of study participants.</title>
</caption>
<alternatives>
<graphic id="pntd.0005567.t001g" xlink:href="pntd.0005567.t001"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Characteristics</th>
<th align="center" rowspan="1" colspan="1">Frequency</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Age group (years)</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1"><18</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">3.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">19–30</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">10.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">31–40</td>
<td align="center" rowspan="1" colspan="1">9</td>
<td align="center" rowspan="1" colspan="1">9.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">41–50</td>
<td align="center" rowspan="1" colspan="1">15</td>
<td align="center" rowspan="1" colspan="1">16.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">51–60</td>
<td align="center" rowspan="1" colspan="1">18</td>
<td align="center" rowspan="1" colspan="1">19.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">>60</td>
<td align="center" rowspan="1" colspan="1">39</td>
<td align="center" rowspan="1" colspan="1">41.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Sex</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Female</td>
<td align="center" rowspan="1" colspan="1">58</td>
<td align="center" rowspan="1" colspan="1">61.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Male</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">38.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Marital Status</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Married</td>
<td align="center" rowspan="1" colspan="1">48</td>
<td align="center" rowspan="1" colspan="1">51.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Never married</td>
<td align="center" rowspan="1" colspan="1">13</td>
<td align="center" rowspan="1" colspan="1">13.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Separated/Divorced/Widowed</td>
<td align="center" rowspan="1" colspan="1">33</td>
<td align="center" rowspan="1" colspan="1">35.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Religion</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Christianity</td>
<td align="center" rowspan="1" colspan="1">72</td>
<td align="center" rowspan="1" colspan="1">76.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Islam</td>
<td align="center" rowspan="1" colspan="1">16</td>
<td align="center" rowspan="1" colspan="1">17.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Traditional Worshipper</td>
<td align="center" rowspan="1" colspan="1">6</td>
<td align="center" rowspan="1" colspan="1">6.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Employment Status</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Full time</td>
<td align="center" rowspan="1" colspan="1">57</td>
<td align="center" rowspan="1" colspan="1">60.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Part time</td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1">7.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">9</td>
<td align="center" rowspan="1" colspan="1">9.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Unemployed+</td>
<td align="center" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">22.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Highest level of education</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">No formal</td>
<td align="center" rowspan="1" colspan="1">44</td>
<td align="center" rowspan="1" colspan="1">46.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Primary</td>
<td align="center" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">22.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Secondary</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">18.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Tertiary</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">10.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Others
<xref ref-type="table-fn" rid="t001fn001">*</xref>
</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">2.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Occupation</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Artisan</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">3.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Civil Servant</td>
<td align="center" rowspan="1" colspan="1">5</td>
<td align="center" rowspan="1" colspan="1">5.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Farming</td>
<td align="center" rowspan="1" colspan="1">35</td>
<td align="center" rowspan="1" colspan="1">37.2</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Student</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">4.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Trading/Business</td>
<td align="center" rowspan="1" colspan="1">14</td>
<td align="center" rowspan="1" colspan="1">14.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Unemployed</td>
<td align="center" rowspan="1" colspan="1">26</td>
<td align="center" rowspan="1" colspan="1">27.7</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Others
<xref ref-type="table-fn" rid="t001fn002">**</xref>
</td>
<td align="center" rowspan="1" colspan="1">7</td>
<td align="center" rowspan="1" colspan="1">7.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t001fn001">
<p>* = Adult education</p>
</fn>
<fn id="t001fn002">
<p>** = Driver, bike rider, security personnel etc., + = unemployed or current students</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>The median duration of illness was 17 years (IQR 7.0–30.0 years). Twenty-three (24.5%) had the illness for more than 30 years. 21 respondents (22.3%) rated their level of functioning as poor. Other details of functioning, as well as perceived adequacy of support are presented in
<xref ref-type="table" rid="pntd.0005567.t002">Table 2</xref>
.</p>
<table-wrap id="pntd.0005567.t002" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pntd.0005567.t002</object-id>
<label>Table 2</label>
<caption>
<title>History of mental illness, economic status, functioning and adequacy of support.</title>
</caption>
<alternatives>
<graphic id="pntd.0005567.t002g" xlink:href="pntd.0005567.t002"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Characteristics</th>
<th align="center" rowspan="1" colspan="1">Frequency</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Family history of mental illness</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Present</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">10.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Absent</td>
<td align="center" rowspan="1" colspan="1">84</td>
<td align="center" rowspan="1" colspan="1">89.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Previous history of mental illness</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Present</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">2.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Absent</td>
<td align="center" rowspan="1" colspan="1">92</td>
<td align="center" rowspan="1" colspan="1">97.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Sources of income</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Pension</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">2.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Personal earning</td>
<td align="center" rowspan="1" colspan="1">62</td>
<td align="center" rowspan="1" colspan="1">66.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Support from family/friends</td>
<td align="center" rowspan="1" colspan="1">30</td>
<td align="center" rowspan="1" colspan="1">31.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Perceived adequacy of support</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Adequate</td>
<td align="center" rowspan="1" colspan="1">32</td>
<td align="center" rowspan="1" colspan="1">34.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not adequate</td>
<td align="center" rowspan="1" colspan="1">62</td>
<td align="center" rowspan="1" colspan="1">66.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Perceived adequacy of income</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Adequate</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">18.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not adequate</td>
<td align="center" rowspan="1" colspan="1">77</td>
<td align="center" rowspan="1" colspan="1">81.9</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Assessment of functioning</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Poor</td>
<td align="center" rowspan="1" colspan="1">21</td>
<td align="center" rowspan="1" colspan="1">22.3</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Average</td>
<td align="center" rowspan="1" colspan="1">56</td>
<td align="center" rowspan="1" colspan="1">59.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Good</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">18.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Income per month (Naira)</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">≤5,000</td>
<td align="center" rowspan="1" colspan="1">63</td>
<td align="center" rowspan="1" colspan="1">67.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">5,001–10,000</td>
<td align="center" rowspan="1" colspan="1">8</td>
<td align="center" rowspan="1" colspan="1">8.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">>10,000</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">24.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<italic>Median monthly income (Naira) = N27</italic>
,
<italic>500 ($90</italic>
.
<italic>16)</italic>
<xref ref-type="table-fn" rid="t002fn001">****</xref>
</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Duration of illness (years)</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">1–10</td>
<td align="center" rowspan="1" colspan="1">33</td>
<td align="center" rowspan="1" colspan="1">35.1</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">11–20</td>
<td align="center" rowspan="1" colspan="1">28</td>
<td align="center" rowspan="1" colspan="1">29.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">21–30</td>
<td align="center" rowspan="1" colspan="1">10</td>
<td align="center" rowspan="1" colspan="1">10.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">>30</td>
<td align="center" rowspan="1" colspan="1">23</td>
<td align="center" rowspan="1" colspan="1">24.5</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<italic>Median duration of illness = 17 years (IQR 7</italic>
.
<italic>0–30</italic>
.
<italic>0 years)</italic>
</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t002fn001">
<p>**** = it is highly skewed</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>Nineteen respondents (20%) met criteria for depression, using CIDI, with the severity of the depression being Mild [8 (42.1%)], Moderate [6 (31.6%)] and Severe [5 (26.3%)]. See
<xref ref-type="fig" rid="pntd.0005567.g001">Fig 1</xref>
.</p>
<fig id="pntd.0005567.g001" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pntd.0005567.g001</object-id>
<label>Fig 1</label>
<caption>
<title>Severity of depression among respondents.</title>
</caption>
<graphic xlink:href="pntd.0005567.g001"></graphic>
</fig>
<p>Fourteen of the depressed respondents (73.7%) were female. Furthermore, 69 respondents (73.4%) reported low self-esteem. See
<xref ref-type="table" rid="pntd.0005567.t003">Table 3</xref>
.</p>
<table-wrap id="pntd.0005567.t003" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pntd.0005567.t003</object-id>
<label>Table 3</label>
<caption>
<title>Prevalence of depression and low self-esteem.</title>
</caption>
<alternatives>
<graphic id="pntd.0005567.t003g" xlink:href="pntd.0005567.t003"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Characteristics</th>
<th align="center" rowspan="1" colspan="1">Frequency</th>
<th align="center" rowspan="1" colspan="1">Percentage</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Diagnosis</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Depressed</td>
<td align="center" rowspan="1" colspan="1">19</td>
<td align="center" rowspan="1" colspan="1">20.0</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Not depressed</td>
<td align="center" rowspan="1" colspan="1">75</td>
<td align="center" rowspan="1" colspan="1">79.8</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
<tr>
<td align="left" colspan="3" rowspan="1">
<bold>Self Esteem Status</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">High self esteem</td>
<td align="center" rowspan="1" colspan="1">25</td>
<td align="center" rowspan="1" colspan="1">26.6</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Low self esteem</td>
<td align="center" rowspan="1" colspan="1">69</td>
<td align="center" rowspan="1" colspan="1">73.4</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">
<bold>Total</bold>
</td>
<td align="center" rowspan="1" colspan="1">94</td>
<td align="center" rowspan="1" colspan="1">100.0</td>
</tr>
</tbody>
</table>
</alternatives>
</table-wrap>
<p>Logistic regression analysis revealed that history of mental illness (OR 40.83, p = 0.008); duration of the illness between 11–20 years (OR 5.02, p = 0.079), being unemployed (OR 12.71, p = 0.003) and Self Esteem (OR 0.09, p = 0.004) were predictive of depression in the cohort. High self-esteem was negatively correlated to depression. See
<xref ref-type="table" rid="pntd.0005567.t004">Table 4</xref>
below.</p>
<table-wrap id="pntd.0005567.t004" orientation="portrait" position="float">
<object-id pub-id-type="doi">10.1371/journal.pntd.0005567.t004</object-id>
<label>Table 4</label>
<caption>
<title>Predictors of depression.</title>
</caption>
<alternatives>
<graphic id="pntd.0005567.t004g" xlink:href="pntd.0005567.t004"></graphic>
<table frame="hsides" rules="groups">
<colgroup span="1">
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
<col align="left" valign="middle" span="1"></col>
</colgroup>
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Factors</th>
<th align="left" rowspan="1" colspan="1">odds ratio</th>
<th align="left" rowspan="1" colspan="1">95% Confidence interval</th>
<th align="left" rowspan="1" colspan="1">P-value</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" colspan="4" rowspan="1">
<bold>Family history of Mental illness</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Present</td>
<td align="center" rowspan="1" colspan="1">0.63</td>
<td align="center" rowspan="1" colspan="1">0.005–7.7860</td>
<td align="center" rowspan="1" colspan="1">0.715</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Absent</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">-</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td align="left" colspan="4" rowspan="1">
<bold>Previous history of Mental illness</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Present</td>
<td align="center" rowspan="1" colspan="1">40.83</td>
<td align="center" rowspan="1" colspan="1">1.6300–5.3403</td>
<td align="center" rowspan="1" colspan="1">0.008
<xref ref-type="table-fn" rid="t004fn001">*</xref>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Absent</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">-</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td align="left" colspan="4" rowspan="1">
<bold>Self esteem</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">High</td>
<td align="center" rowspan="1" colspan="1">0.09</td>
<td align="center" rowspan="1" colspan="1">0.0183–0.4594</td>
<td align="center" rowspan="1" colspan="1">0.004
<xref ref-type="table-fn" rid="t004fn001">*</xref>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Low</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">-</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td align="left" colspan="4" rowspan="1">
<bold>Duration of illness (years)</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">11–20</td>
<td align="center" rowspan="1" colspan="1">5.02</td>
<td align="center" rowspan="1" colspan="1">0.8299–30.4181</td>
<td align="center" rowspan="1" colspan="1">0.079</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">21–30</td>
<td align="center" rowspan="1" colspan="1">1.41</td>
<td align="center" rowspan="1" colspan="1">0.0951–20.8282</td>
<td align="center" rowspan="1" colspan="1">0.804</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">> 30</td>
<td align="center" rowspan="1" colspan="1">4.71</td>
<td align="center" rowspan="1" colspan="1">0.6693–33.0767</td>
<td align="center" rowspan="1" colspan="1">0.120</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">1–10</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">-</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
<tr>
<td align="left" colspan="4" rowspan="1">
<bold>Employment status</bold>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Part time</td>
<td align="center" rowspan="1" colspan="1">1.25</td>
<td align="center" rowspan="1" colspan="1">0.1351–11.5473</td>
<td align="center" rowspan="1" colspan="1">0.845</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Retired</td>
<td align="center" rowspan="1" colspan="1">0.00</td>
<td align="center" rowspan="1" colspan="1">0.000 >1.0E12</td>
<td align="center" rowspan="1" colspan="1">0.964</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Unemployed</td>
<td align="center" rowspan="1" colspan="1">12.71</td>
<td align="center" rowspan="1" colspan="1">2.4510–6.7005</td>
<td align="center" rowspan="1" colspan="1">0.003
<xref ref-type="table-fn" rid="t004fn001">*</xref>
</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Full time</td>
<td align="center" rowspan="1" colspan="1">1</td>
<td align="center" rowspan="1" colspan="1">-</td>
<td align="center" rowspan="1" colspan="1">-</td>
</tr>
</tbody>
</table>
</alternatives>
<table-wrap-foot>
<fn id="t004fn001">
<p>*Statistically Significant, though sample size was too small to assess the impact</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec sec-type="conclusions" id="sec010">
<title>Discussion</title>
<p>Lymphatic filariasis cuts across all age-groups affecting both the elderly and the young with a slight preponderance in the mid to older age group. The over-representation of women (61.7%) in the study population is in keeping with the population of people receiving care at the Centers. The percentage of the participants who were separated/ divorced was higher than the expected in the general population (35.1% as against 6.8% in the general population) [
<xref rid="pntd.0005567.ref009" ref-type="bibr">9</xref>
] and is in keeping with typical findings among this study population in relevant literature. They are less likely to be married, often described as the “last choice” in qualitative studies, and when the disease manifest itself during their married life, it may lead to divorce (7, 8). Nearly half of the study population (46.8%) had no formal education but this is not a sharp departure from typical rates in the rural population of the country [
<xref rid="pntd.0005567.ref009" ref-type="bibr">9</xref>
]. The participants were largely self-employed as farmers and traders, which reflects the usual occupation of the people in the study areas. The average monthly income of more than three-quarter of the study population was less than N10, 000 (<$50 monthly) and this was described by more than 80 percent of the participants as inadequate. This is in keeping with the fact that NTDs principally impact the world’s poorest populations, as well as being a driver to poverty by itself [
<xref rid="pntd.0005567.ref001" ref-type="bibr">1</xref>
]. The median duration of illness was 17 years (IQR 7.0–30.0 years), with about a quarter being over 30 years, illustrating relatively early onset and the chronic nature of the condition.</p>
<p>The percentage of those found to be depressed among the people with lymphatic filariasis (20%) is higher than the reported prevalence of depression among adults in Nigeria (3.1–5.2%) [
<xref rid="pntd.0005567.ref010" ref-type="bibr">10</xref>
,
<xref rid="pntd.0005567.ref011" ref-type="bibr">11</xref>
,
<xref rid="pntd.0005567.ref012" ref-type="bibr">12</xref>
] and in primary care patients [
<xref rid="pntd.0005567.ref013" ref-type="bibr">13</xref>
]. It is, however, similar to reported prevalence of depression in chronic medical conditions [
<xref rid="pntd.0005567.ref014" ref-type="bibr">14</xref>
], who have been found to have two- to three- fold higher rates of major depression when compared with age- and gender- matched primary care patients [
<xref rid="pntd.0005567.ref015" ref-type="bibr">15</xref>
,
<xref rid="pntd.0005567.ref016" ref-type="bibr">16</xref>
].</p>
<p>More women were found to be depressed among the study population, with a female to male ratio of almost 3:1. This large difference cannot be explained by the higher representation of women (F:M ratio of 1.6:1) in the study sample, and is also higher than the reported two-fold greater prevalence of Major Depressive Disorder in women than men in the general population [
<xref rid="pntd.0005567.ref017" ref-type="bibr">17</xref>
]. This may be associated with greater social exclusion or stigmatisation experienced by women than men.</p>
<p>History of mental illness is an important and recognised risk factor, as such individuals are at greater risk of a relapse or development of another mental illness. Individuals with previous history of mental illness are almost 41 times more likely to be depressed than those without a previous history in our study.</p>
<p>Participants with low self-esteem, as measured by the Rosenberg self-esteem questionnaire in this study, were more likely to have depression when compared to those with high self-esteem. This could be attributable to the fact that people with depression are more likely to have low self-esteem. Our study, and many others in the region [
<xref rid="pntd.0005567.ref018" ref-type="bibr">18</xref>
] and elsewhere have found that low self-esteem is often seen in people with NTDs possibly as a consequence of self-stigma, discrimination and limitations in functioning. This would suggest that high self-esteem is protective against the development of depression among this group. This is in keeping with recognised mechanisms linking stigma and depression, and may point towards potential therapeutic or health promotion interventions [
<xref rid="pntd.0005567.ref019" ref-type="bibr">19</xref>
]. The link between social stigma and mental illness, including depression, are reported to be cyclical and reinforcing [
<xref rid="pntd.0005567.ref019" ref-type="bibr">19</xref>
]. Self-stigma, a self-imposed restriction of expectations is common and may negatively affect expectations and motivation to engage socially [
<xref rid="pntd.0005567.ref020" ref-type="bibr">20</xref>
]. In fact, people affected by LF will experience both the stigma associated with their physical condition and of their comorbid mental health problems.</p>
<p>Duration of the illness may be associated with higher prevalence of depression for a number of reasons. This may include the chronicity of exposure to risk factors inherent in the condition (disfigurement, pain, disability) which would be further compounded by the severity of the illness (likely to be greater in longer-term illness). It is also possible that there will be a greater extent of social drift over time. In keeping with this, unemployment was also found to be associated with greater prevalence of depression. This is the pattern found with many psychiatric disorders, where there is a vicious cycle of mental illness provoking poverty (through mechanisms summarised as social drift) and poverty being a risk factor for mental illness (social causation, or poverty as a social determinant) [
<xref rid="pntd.0005567.ref021" ref-type="bibr">21</xref>
].</p>
<sec id="sec011">
<title>Limitations</title>
<list list-type="order">
<list-item>
<p>The sample method in the study, being a convenience sampling technique, is a major limitation. The study population being from a treatment center potentially excludes those in the community who are not accessing care, and may not be representative of the total relevant population. A community study would address this problem, though it is likely that the most physically affected individuals are those most likely to be accessing services.</p>
</list-item>
<list-item>
<p>The sample size is relatively small. This limits generalization and may have affected the analysis of co-variates.</p>
</list-item>
</list>
</sec>
</sec>
<sec sec-type="conclusions" id="sec012">
<title>Conclusion</title>
<p>Beyond the physical burden of living with lymphatic filariasis, people with the condition also have significant psychiatric complications (particularly depression). Appropriate treatment for depression has been found to improve outcomes in other chronic conditions [
<xref rid="pntd.0005567.ref022" ref-type="bibr">22</xref>
]. Therefore, given the high prevalence of depression, providing access to mental health screening and interventions should be integral to NTD programmes. Thus, in addition to attending to physical needs, emotional needs should also be routinely assessed and catered for.</p>
<p>It is recommended that staff should be sensitised to the high risk of depression and be trained to recognize basic signs and symptoms of depression. Simple screening instruments for depression, such as the PHQ-9 can also be utilized in routine clinics, and those found to be depressed can be treated or referred appropriately. Health promotion strategies geared towards assessing and addressing factors associated with depression (for example self-esteem) should be incorporated in routine community engagement, including health talks in the clinic. These are simple steps that can easily be incorporated into specific NTD services, and general health care for endemic populations, providing the possibility of improving the quality of life of affected persons, and reducing the negative impact of depression on an already marginalised population.</p>
</sec>
<sec sec-type="supplementary-material" id="sec013">
<title>Supporting information</title>
<supplementary-material content-type="local-data" id="pntd.0005567.s001">
<label>S1 STROBE checklist</label>
<caption>
<p>(DOC)</p>
</caption>
<media xlink:href="pntd.0005567.s001.doc">
<caption>
<p>Click here for additional data file.</p>
</caption>
</media>
</supplementary-material>
</sec>
</body>
<back>
<ack>
<p>The authors acknowledge the support of the Health and Development Support (HANDS) Programme and The Carter Center, who provided access to their programmes, and the Jos University Teaching Hospital, who provided the local research expertise. We also acknowledge the contribution of Dr Toyin Aderemi, of the CBM Nigeria Country Office, towards the success of this project.</p>
</ack>
<ref-list>
<title>References</title>
<ref id="pntd.0005567.ref001">
<label>1</label>
<mixed-citation publication-type="journal">
<name>
<surname>Hotez</surname>
<given-names>PJ.</given-names>
</name>
,
<name>
<surname>Molyneux</surname>
<given-names>DH.</given-names>
</name>
,
<name>
<surname>Fenwick</surname>
<given-names>A.</given-names>
</name>
,
<name>
<surname>Kumaresan</surname>
<given-names>J.</given-names>
</name>
,
<name>
<surname>Sachs</surname>
<given-names>SE.</given-names>
</name>
,
<etal>et al</etal>
(
<year>2007</year>
)
<article-title>Control of NeglectedTropical Diseases</article-title>
.
<source>N. Engl J Med</source>
;
<volume>357</volume>
(
<issue>10</issue>
):
<fpage>1018</fpage>
<lpage>1027</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1056/NEJMra064142">10.1056/NEJMra064142</ext-link>
</comment>
<pub-id pub-id-type="pmid">17804846</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref002">
<label>2</label>
<mixed-citation publication-type="journal">
<name>
<surname>Hotez</surname>
<given-names>PJ.</given-names>
</name>
,
<name>
<surname>Molyneus</surname>
<given-names>DH.</given-names>
</name>
,
<name>
<surname>Fenwick</surname>
<given-names>A.</given-names>
</name>
,
<name>
<surname>Ottessen</surname>
<given-names>E.</given-names>
</name>
,
<name>
<surname>Ehrlich</surname>
<given-names>SS.</given-names>
</name>
,
<etal>et al</etal>
(
<year>2006</year>
).
<article-title>Incorporating a rapid-impact package for Neglected Tropical Diseases with program HIV/AIDS, Tuberculosis and Malaria</article-title>
.
<source>PLoS Med</source>
<volume>3</volume>
:
<fpage>e102</fpage>
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1371/journal.pmed.0030102">10.1371/journal.pmed.0030102</ext-link>
</comment>
<pub-id pub-id-type="pmid">16435908</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref003">
<label>3</label>
<mixed-citation publication-type="other">World Health Organization (2010b). Global Programme to Eliminate Lymphatic Filariasis: progress report 2000–2009 and strategic plan 2010–2020. Geneva. (WHO/HTM/NTD/PCT/2010.6).WHO 2000.</mixed-citation>
</ref>
<ref id="pntd.0005567.ref004">
<label>4</label>
<mixed-citation publication-type="journal">
<name>
<surname>Ramaiah</surname>
<given-names>KD.</given-names>
</name>
,
<name>
<surname>Kumar</surname>
<given-names>KN.</given-names>
</name>
,
<name>
<surname>Ramu</surname>
<given-names>K.</given-names>
</name>
,
<name>
<surname>Pani</surname>
<given-names>SP.</given-names>
</name>
,
<name>
<surname>Das</surname>
<given-names>PK.</given-names>
</name>
(
<year>1997</year>
).
<article-title>Functional impairment caused by lymphatic filariasis in rural areas of South India</article-title>
.
<source>Tropical Medicine & International Health</source>
,
<volume>2</volume>
:
<fpage>832</fpage>
<lpage>838</lpage>
.
<pub-id pub-id-type="pmid">9315041</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref005">
<label>5</label>
<mixed-citation publication-type="journal">
<name>
<surname>Ottesen</surname>
<given-names>EA</given-names>
</name>
. (
<year>2006</year>
).
<article-title>Lymphatic filariasis: Treatment, control and elimination</article-title>
.
<source>Adv Parasitol</source>
;
<volume>61</volume>
:
<fpage>395</fpage>
<lpage>441</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/S0065-308X(05)61010-X">10.1016/S0065-308X(05)61010-X</ext-link>
</comment>
<pub-id pub-id-type="pmid">16735170</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref006">
<label>6</label>
<mixed-citation publication-type="journal">
<name>
<surname>Zeldenryk</surname>
<given-names>LM</given-names>
</name>
,
<name>
<surname>Gray</surname>
<given-names>M</given-names>
</name>
,
<name>
<surname>Speare</surname>
<given-names>R</given-names>
</name>
,
<name>
<surname>Gordon</surname>
<given-names>S</given-names>
</name>
,
<name>
<surname>Melrose</surname>
<given-names>W</given-names>
</name>
(
<year>2011</year>
)
<article-title>The Emerging Story of Disability Associated with Lymphatic Filariasis: A Critical Review</article-title>
.
<source>PLoS Negl Trop Dis</source>
<volume>5</volume>
(
<issue>12</issue>
):
<fpage>e1366</fpage>
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1371/journal.pntd.0001366">10.1371/journal.pntd.0001366</ext-link>
</comment>
<pub-id pub-id-type="pmid">22216361</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref007">
<label>7</label>
<mixed-citation publication-type="journal">
<name>
<surname>Evans</surname>
<given-names>DB</given-names>
</name>
,
<name>
<surname>Gelband</surname>
<given-names>H</given-names>
</name>
. and
<name>
<surname>Vlassof</surname>
<given-names>C</given-names>
</name>
. (
<year>1993</year>
).
<article-title>Social and economic factors and the control of Lymphatic filariasis</article-title>
.
<source>Acta Tropica</source>
<volume>53</volume>
:
<fpage>1</fpage>
<lpage>2</lpage>
.
<pub-id pub-id-type="pmid">8096106</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref008">
<label>8</label>
<mixed-citation publication-type="journal">
<name>
<surname>Bontha</surname>
<given-names>V.B</given-names>
</name>
,
<name>
<surname>Suchismila</surname>
<given-names>M</given-names>
</name>
,
<name>
<surname>Abhaya</surname>
<given-names>NN</given-names>
</name>
. (
<year>2009</year>
).
<article-title>Marriage, Sex, and Hydrocele: An ethnographic study on the effect of filarial hydrocele on conjugal life and marriageability from Orissa,India</article-title>
.
<source>PloSNegl Trop Dis</source>
.
<volume>3</volume>
(
<issue>4</issue>
):
<fpage>e414</fpage>
.</mixed-citation>
</ref>
<ref id="pntd.0005567.ref009">
<label>9</label>
<mixed-citation publication-type="journal">
<name>
<surname>Ton</surname>
<given-names>TGN.</given-names>
</name>
,
<name>
<surname>Mackenzie</surname>
<given-names>C.</given-names>
</name>
,
<name>
<surname>Molyneux</surname>
<given-names>DH.</given-names>
</name>
(
<year>2015</year>
).
<article-title>The burden of Mental health in Lymphatic filariasis</article-title>
.
<source>Infectious Diseases of Poverty</source>
;
<volume>4</volume>
:
<fpage>34</fpage>
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1186/s40249-015-0068-7">10.1186/s40249-015-0068-7</ext-link>
</comment>
<pub-id pub-id-type="pmid">26229599</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref010">
<label>10</label>
<mixed-citation publication-type="book">
<collab>Nigeria. National Population Commission and ORC Macro</collab>
. (1999)
<source>Nigeria Demographic and Health Survey</source>
.
<publisher-name>National Population Commission</publisher-name>
,
<year>2000</year>
.</mixed-citation>
</ref>
<ref id="pntd.0005567.ref011">
<label>11</label>
<mixed-citation publication-type="journal">
<name>
<surname>Gureje</surname>
<given-names>O.</given-names>
</name>
,
<name>
<surname>Lasebikan</surname>
<given-names>VO.</given-names>
</name>
,
<name>
<surname>Kola</surname>
<given-names>L.</given-names>
</name>
,
<name>
<surname>Makanjuola</surname>
<given-names>VA.</given-names>
</name>
(
<year>2006</year>
).
<article-title>Lifetime and 12-month prevalence of mental disorders in the Nigerian seurvey of Mental Health and well-being</article-title>
.
<source>British Journal of Psychiatry</source>
;
<volume>188</volume>
:
<fpage>465</fpage>
<lpage>71</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1192/bjp.188.5.465">10.1192/bjp.188.5.465</ext-link>
</comment>
<pub-id pub-id-type="pmid">16648534</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref012">
<label>12</label>
<mixed-citation publication-type="journal">
<name>
<surname>Olorunfemi</surname>
<given-names>Amoran</given-names>
</name>
,
<name>
<surname>Lawoyin</surname>
<given-names>Taiwo</given-names>
</name>
, and
<name>
<surname>Lasebikan</surname>
<given-names>Victor</given-names>
</name>
. (
<year>2007</year>
).
<article-title>Prevalence of depression among adults in Oyo State, Nigeria: a comparative study of rural and urban communities</article-title>
.
<source>Australian Journal of Rural Health</source>
<volume>15.3</volume>
:
<fpage>211</fpage>
<lpage>215</lpage>
.
<pub-id pub-id-type="pmid">17542795</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref013">
<label>13</label>
<mixed-citation publication-type="journal">
<name>
<surname>Gureje</surname>
<given-names>O.</given-names>
</name>
,
<name>
<surname>Uwakwe</surname>
<given-names>R.</given-names>
</name>
,
<name>
<surname>Oladeji</surname>
<given-names>B.</given-names>
</name>
,
<name>
<surname>Makanjuola</surname>
<given-names>VO.</given-names>
</name>
,
<name>
<surname>Esan</surname>
<given-names>O.</given-names>
</name>
(
<year>2010</year>
).
<article-title>Depression in adult Nigerians: Results from the Nigerian Survey of Mental Health and well-being</article-title>
.
<source>J. Affect Disord</source>
;
<volume>120</volume>
(
<issue>1–3</issue>
):
<fpage>158</fpage>
<lpage>164</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.jad.2009.04.030">10.1016/j.jad.2009.04.030</ext-link>
</comment>
<pub-id pub-id-type="pmid">19450883</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref014">
<label>14</label>
<mixed-citation publication-type="journal">
<name>
<surname>Katon</surname>
<given-names>W.</given-names>
</name>
,
<name>
<surname>Schulberg</surname>
<given-names>H.</given-names>
</name>
(
<year>1992</year>
).
<article-title>Epidemiology of depression in a Canadian population in Primary care</article-title>
.
<source>Gen Hosp Psychiatry</source>
.
<volume>1</volume>
:
<fpage>237</fpage>
<lpage>247</lpage>
.</mixed-citation>
</ref>
<ref id="pntd.0005567.ref015">
<label>15</label>
<mixed-citation publication-type="journal">
<name>
<surname>Obindo</surname>
<given-names>JT.</given-names>
</name>
,
<name>
<surname>Munir</surname>
<given-names>B.</given-names>
</name>
,
<name>
<surname>Okeahialam</surname>
<given-names>B.</given-names>
</name>
(
<year>2011</year>
).
<article-title>Anxio-depressive Symptoms in Patients with Cardiac Failure in Jos University Teaching Hospital (JUTH)</article-title>
.
<source>Nigerian Journal of Psychiatry</source>
;
<volume>9</volume>
(
<issue>2</issue>
):
<fpage>18</fpage>
<lpage>21</lpage>
.</mixed-citation>
</ref>
<ref id="pntd.0005567.ref016">
<label>16</label>
<mixed-citation publication-type="journal">
<name>
<surname>Ali</surname>
<given-names>S.</given-names>
</name>
,
<name>
<surname>Stone</surname>
<given-names>MA.</given-names>
</name>
,
<name>
<surname>Peters</surname>
<given-names>JL.</given-names>
</name>
,
<name>
<surname>Davies</surname>
<given-names>MJ.</given-names>
</name>
,
<name>
<surname>Khunti</surname>
<given-names>K.</given-names>
</name>
(
<year>2006</year>
)
<article-title>The prevalence of Co-morbid depression in Adults with Type 2 diabetes: a systematic review and meta-analysis</article-title>
.
<source>Diabet Med</source>
;
<volume>23</volume>
:
<fpage>1165</fpage>
<lpage>1173</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1111/j.1464-5491.2006.01943.x">10.1111/j.1464-5491.2006.01943.x</ext-link>
</comment>
<pub-id pub-id-type="pmid">17054590</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref017">
<label>17</label>
<mixed-citation publication-type="journal">
<name>
<surname>Kessler</surname>
<given-names>Ronald C.</given-names>
</name>
(
<year>2003</year>
). "
<article-title>Epidemiology of women and depression</article-title>
."
<source>Journal of affective disorders</source>
;
<volume>74</volume>
(
<issue>1</issue>
):
<fpage>5</fpage>
<lpage>13</lpage>
.
<pub-id pub-id-type="pmid">12646294</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref018">
<label>18</label>
<mixed-citation publication-type="journal">
<name>
<surname>Ahorlu</surname>
<given-names>CK.</given-names>
</name>
,
<name>
<surname>Dunyo</surname>
<given-names>SK.</given-names>
</name>
,
<name>
<surname>Koram</surname>
<given-names>KA.</given-names>
</name>
,
<name>
<surname>Nkrumah</surname>
<given-names>FK.</given-names>
</name>
,
<name>
<surname>Aagaard-Hansen</surname>
<given-names>J.</given-names>
</name>
,
<name>
<surname>Simonsen</surname>
<given-names>PE.</given-names>
</name>
(
<year>1999</year>
).
<article-title>Lymphatic filariasis related perceptions and practices on the coast of Ghana: implications for prevention and control</article-title>
.
<source>Acta Trop</source>
15;
<volume>73</volume>
(
<issue>3</issue>
):
<fpage>251</fpage>
<lpage>61</lpage>
.
<pub-id pub-id-type="pmid">10546843</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref019">
<label>19</label>
<mixed-citation publication-type="journal">
<name>
<surname>Weiss</surname>
<given-names>MG</given-names>
</name>
. (
<year>2008</year>
)
<article-title>Stigma and the social burden of neglected tropical diseases</article-title>
.
<source>PLoS Negl Trop Dis</source>
;
<volume>2</volume>
(
<issue>5</issue>
):
<fpage>e237</fpage>
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1371/journal.pntd.0000237">10.1371/journal.pntd.0000237</ext-link>
</comment>
<pub-id pub-id-type="pmid">18478049</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref020">
<label>20</label>
<mixed-citation publication-type="journal">
<name>
<surname>Corrigan</surname>
<given-names>P. W.</given-names>
</name>
,
<name>
<surname>Larson</surname>
<given-names>J. E.</given-names>
</name>
,
<name>
<surname>Rusch</surname>
<given-names>N.</given-names>
</name>
(
<year>2009</year>
).
<article-title>Self-stigma and the “why try” effect: impact on life goals and evidence-based practices</article-title>
.
<source>World Psychiatry</source>
,
<volume>8</volume>
(
<issue>2</issue>
),
<fpage>75</fpage>
<lpage>81</lpage>
.
<pub-id pub-id-type="pmid">19516923</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref021">
<label>21</label>
<mixed-citation publication-type="journal">
<name>
<surname>Lund</surname>
<given-names>C</given-names>
</name>
,
<name>
<surname>De Silva</surname>
<given-names>M</given-names>
</name>
,
<name>
<surname>Plagerson</surname>
<given-names>S</given-names>
</name>
,
<name>
<surname>Cooper</surname>
<given-names>S</given-names>
</name>
,
<name>
<surname>Chisholm</surname>
<given-names>D</given-names>
</name>
,
<name>
<surname>Das</surname>
<given-names>J</given-names>
</name>
,
<name>
<surname>Knapp</surname>
<given-names>M</given-names>
</name>
,
<name>
<surname>Patel</surname>
<given-names>V</given-names>
</name>
(
<year>2011</year>
).
<article-title>Poverty and mental disorders: breaking the cycle in low-income and middle-income countries</article-title>
.
<source>Lancet</source>
;
<volume>378</volume>
:
<fpage>1502</fpage>
<lpage>14</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/S0140-6736(11)60754-X">10.1016/S0140-6736(11)60754-X</ext-link>
</comment>
<pub-id pub-id-type="pmid">22008425</pub-id>
</mixed-citation>
</ref>
<ref id="pntd.0005567.ref022">
<label>22</label>
<mixed-citation publication-type="journal">
<name>
<surname>Patel</surname>
<given-names>V</given-names>
</name>
,
<name>
<surname>Araya</surname>
<given-names>R</given-names>
</name>
,
<name>
<surname>Chatterjee</surname>
<given-names>S</given-names>
</name>
,
<name>
<surname>Chisholm</surname>
<given-names>D</given-names>
</name>
,
<name>
<surname>Cohen</surname>
<given-names>A</given-names>
</name>
,
<name>
<surname>De Silva</surname>
<given-names>M</given-names>
</name>
,
<name>
<surname>Hosman</surname>
<given-names>C</given-names>
</name>
,
<name>
<surname>McGuire</surname>
<given-names>H</given-names>
</name>
,
<name>
<surname>Rojas</surname>
<given-names>G</given-names>
</name>
,
<name>
<surname>van Ommeren</surname>
<given-names>M</given-names>
</name>
(
<year>2007</year>
).
<article-title>Treatment and prevention of mental disorders in low-income and middle-income countries</article-title>
.
<source>Lancet</source>
,
<volume>370</volume>
:
<fpage>991</fpage>
<lpage>1005</lpage>
.
<comment>doi:
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/S0140-6736(07)61240-9">10.1016/S0140-6736(07)61240-9</ext-link>
</comment>
<pub-id pub-id-type="pmid">17804058</pub-id>
</mixed-citation>
</ref>
</ref-list>
</back>
</pmc>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004310 | SxmlIndent | more

Ou

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 004310 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
   |flux=    Pmc
   |étape=   Corpus
   |type=    RBID
   |clé=     PMC:5453421
   |texte=   Prevalence of depression and associated clinical and socio-demographic factors in people living with lymphatic filariasis in Plateau State, Nigeria
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i   -Sk "pubmed:28570585" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a LymphedemaV1 

Wicri

This area was generated with Dilib version V0.6.31.
Data generation: Sat Nov 4 17:40:35 2017. Site generation: Tue Feb 13 16:42:16 2024