‘The Lost Peace’: Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia

McCollum, Rosalind, Barrett, Carrie, Zawolo, Georgina, Johnstone, Rachel, Godwin-Akpan, Tiawanlyn G., Berrian, Hannah, Chowdhury, Shahreen, Kollie, Jerry, Kollie, Karsor, Rogers, Emerson, Parker, Colleen, Phillip, Maneesh, Sempe, Lucas, Seekles, Maaike ORCID: https://orcid.org/0000-0002-7000-3624, Smith, John Solunta, Seekey, Wede, Wickenden, Anna, Zaizay, Zeela, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X and Dean, Laura ORCID: https://orcid.org/0000-0002-4910-9707 (2024) '‘The Lost Peace’: Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia'. Tropical Medicine and Infectious Disease, Vol 9, Issue 8, p. 183.

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Abstract

Abstract
Neglected Tropical Diseases (NTDs) are a group of chronic infectious diseases of poverty affecting over one billion people globally. Intersections of NTDs, disability, and mental ill-health are increasingly evidenced but are rarely studied from a mixed-methods perspective. Here, we advance syndemic understandings by further assessing and contextualising the syndemic relationship between NTDs (particularly their associated disability) and mental distress in Liberia. Participatory qualitative methods, including body mapping (56 participants), social mapping (28 participants), and in-depth interviews (12) provided space for persons affected by NTDs to narrate their experiences. Simultaneously, 201 surveys explored experiences of common mental health conditions among persons affected by skin NTDs. An intersectionality approach was applied within the analysis for both qualitative and quantitative methods informed by Meyer’s minority stress model, adapted for NTDs. Qualitative data was analysed thematically and gender-disaggregated, univariable and multivariable analyses were applied to survey data for the outcome measures depression (PHQ-9) and anxiety (GAD-7). Disability was associated with higher levels of depression and anxiety (p < 0.001). An interaction between disability and being a women increased incidence risk ratio of depression (p < 0.001). In alignment with qualitative findings, persons affected experienced additional generalised (financial concerns), external (experience of stigma) and internal (experience of pain and physical symptoms) minority stressors, to varying degrees, which contributed towards their mental distress, and mental health conditions. These findings were used to co-develop a syndemic-informed person-centred health system response to address the suffering associated with NTDs and mental distress, including a focus on strengthening relationships between formal and informal community health actors and the broader health system.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 305 Mental health of special population groups WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.3390/tropicalmed9080183
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	16 Sep 2024 07:55
Last Modified:	16 Sep 2024 08:08
URI:	https://archive.lstmed.ac.uk/id/eprint/25229

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