Malaria and mental disorder: a population study in an area endemic for malaria in Kenya

Jenkins, Rachel; Othieno, Caleb; Ongeri, Linnet; Ongecha, Michael; Sifuna, Peter; Omollo, Raymond; Ogutu, Bernhards

doi:10.1002/wps.20473

Cited by 13 publications

(11 citation statements)

References 9 publications

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“…Our prevalence rate of malaria [4], prevalence rates of mental disorders [[5], [6], [7], [8], [9], [10]], the influence of sociodemographic variables, and the association between malaria and mental disorders [11] have been previously reported.…”

Section: Methodsmentioning

confidence: 99%

“…There is long standing and extensive evidence of the two way association between mental and physical disorders, mostly focussed on non-communicable disease [2], but there has been rather less attention to the relationship of mental disorders and communicable disease, apart from HIV [3]. Malaria is endemic in Kenya around Lake Victoria, and we have previously reported adult population prevalence rates for malaria [4] and for mental disorders [[5], [6], [7], [8], [9], [10]], as well as the two way association of malaria and common mental disorder (CMD) in a health and demographic surveillance systems site in that region [11]. This paper reports their associations with inflammatory mediators.…”

Section: Introductionmentioning

confidence: 99%

“…Inflammation is a reflection of cell damage caused by infection, or physical injury or in the response of tissues to an antigenic challenge, and was first studied in relation to physical disease, but in recent years numerous clinical studies have established the presence of chronic low grade inflammation in major psychiatric disorders such as the affective and psychotic disorders and the anxiety disorders [[10], [11], [12], [13], [14], [15]]. Thus, cytokines have been associated with the pathogenesis of not only physical disorders such as malaria [[16], [17], [18], [19]], but also with depression [[20], [21], [22]] and schizophrenia [23].…”

Section: Introductionmentioning

confidence: 99%

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Malaria, mental disorders, immunity and their inter-relationships - A cross sectional study in a household population in a health and demographic surveillance site in Kenya

et al. 2019

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BackgroundBoth malaria and mental disorders are associated with immune changes. We have previously reported the associations between malaria and mental disorders. We now report associations between malaria, mental disorders and immunity.MethodsA household survey of malaria, mental disorders and immunity was conducted in a health and demographic surveillance system's site of 70,000 population in an area endemic for malaria in western Kenya. A random sample of 1190 adults was selected and approached for consent, blood samples and structured interview.FindingsWe found marginally raised CD4/CD3 ratios of participants with malaria parasites, but no difference in CD4/CD3 ratios for participants with common mental disorder (CMD) or psychotic symptoms. People with psychotic symptoms had increased levels of IL-6, IL-8, and IL-10, and lower levels of IL-1beta. People with CMD had higher levels of IL-8 and IL-10. People with malaria had higher levels of IL-10 and lower levels of TNF-alpha. At the bivariate level, CMD was associated with log TNF-α levels using unadjusted odds ratios, but not after adjusting for malaria. Psychotic symptoms were associated with log IL-10 and log TNF-α levels at the bivariate level while in the adjusted analysis, log TNF-α levels remained highly significant..InterpretationThis is the first population based study of immune markers in CMD and psychotic symptoms, and the first to examine the 3 way relationship with malaria. Our findings suggest that TNF-α may mediate the relationship between malaria and CMD.FundThe study was funded by UK Aid, , Kenya office.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Malaria, mental disorders, immunity and their inter-relationships - A cross sectional study in a household population in a health and demographic surveillance site in Kenya

et al. 2019

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“…It is not unusual in Kenya for patients to look for alternate explanations to mental illness given stigma, strongly held traditional beliefs, and limited access to psychiatric care and psychoeducation. Care providers have also been found to misdiagnose complaints of fatigue and general malaise as physical illness (e.g., malaria), rather than to consider depression as a diagnosis (Jenkins et al, 2017).…”

Section: Final Thoughtsmentioning

confidence: 99%

Case presentation: Mental health stigma and the effect on children in Kenya

Anglero‐Diaz¹

2018

Child Adolescent Behavior

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As part of our professional development and interest in global health, we embarked on a three‐week journey to Eldoret, the fifth‐largest city in Kenya. During this time, we engaged in various teaching and learning opportunities, collaborating with mental health professionals at Moi Teaching and Referral Hospital (MTRH) and Shoe4Africa Children's Hospital through the Academic Model Providing Access to Healthcare (AMPATH) program. AMPATH is a partnership of organizations (including the Kenyan government, local teaching hospitals, Indiana University, Brown University, other North American medical schools, and the National Hospital Insurance Fund) that works closely to improve health care in Kenya, empower communities, and educate future clinicians, researchers, and health care workers. To raise awareness of global health and the need for future research and development, we will present a relevant clinical case along with a discussion of challenges for mental health treatment of children in Kenya.

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“…Although extensive literature exists to characterize the pathophysiological effects of acute and chronic malarial episodes, much scarcer data exists regarding the psychological factors that may be associated with the manifestation of this disease. In 2017, Jenkins and colleagues were among the rst to explore this relationship and found that malaria parasitemia was associated with increased rates of depression and other common comorbid mental disorders (CCMDs) [2]. Of particular importance to this association is the prevalence of cerebral malaria; a severe complication of the disease that occurs in roughly 2% of cases and carries signi cant risk for neurological impairment.…”

Section: Introductionmentioning

confidence: 99%

Risk of depression and common comorbid mental disorders in persons with malaria: a protocol for a systematic review and meta-analysis

Yang

Ciarletta

Pan

et al. 2020

Preprint

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Aim To estimate the pooled prevalence and incidence of depression and its common comorbid mental disorders in persons with a malarial infection and its neurological complications Method We will conduct a systematic review and meta-analysis of studies published between January 1, 1960 and January 1, 2020, reporting the prevalence or incidence of common mental disorders and the risks in people with malaria. We will search the following databases: PubMed (MEDLINE), Scopus, OVID (HEALTH STAR), OVID (MEDLINE) and Joana Briggs Institute EBF Database. No age, geographical location, study-design or language limits will be applied. If multiple languages were used to describe and publish the same data, the English version was selected. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Three reviewers (MC, YP, YY) will independently screen citations, abstracts and will identify full-text articles for inclusion, extract data and appraise the quality and bias of included studies. Discrepancies will be resolved by consensus or consultation with a fourth researcher (AS). Risk of bias of included studies will be assessed by the Newcastle-Ottawa Quality Assessment Scale. The primary outcomes will be the overall prevalence or incidence of depression and common comorbid mental disorders (CCMDs) in persons with malaria. We will use the random-effects model with a logit transformation of proportions for the pooling of studies. We will assess the between-study heterogeneity using I2 statistics, and Cochrane’s Q statistic (significance level < 0.05). We will perform subgroup meta-analyses to investigate geographical differences in mental disorders and risks of different mental disorders. We will conduct a meta-regression analysis, using study level median age, race and gender proportions, the proportion of study population with malaria, and percentage of the study population with a diagnosis of common mental disorders. We will report absolute differences in the overall probability of common mental disorders. The Egger’s test and funnel plots will be used to assess publication bias.

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Malaria and mental disorder: a population study in an area endemic for malaria in Kenya

Cited by 13 publications

References 9 publications

Malaria, mental disorders, immunity and their inter-relationships - A cross sectional study in a household population in a health and demographic surveillance site in Kenya

Malaria, mental disorders, immunity and their inter-relationships - A cross sectional study in a household population in a health and demographic surveillance site in Kenya

Case presentation: Mental health stigma and the effect on children in Kenya

Risk of depression and common comorbid mental disorders in persons with malaria: a protocol for a systematic review and meta-analysis

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