03061nas a2200229 4500000000100000008004100001260003400042653005700076653001700133653002400150653002100174100001300195700001200208700001600220700001300236245011500249856026000364300001200624490000800636520216200644022002502806 2020 d bOxford University Press (OUP) 10 aPublic Health, Environmental and Occupational Health 10 aParasitology 10 aInfectious Diseases 10 aGeneral Medicine 1 aSemrau M 1 aDavey G 1 aBayisenge U 1 aDeribe K 00 aHigh levels of depressive symptoms among people with lower limb lymphoedema in Rwanda: a cross-sectional study uhttps://watermark.silverchair.com/traa139.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAqswggKnBgkqhkiG9w0BBwagggKYMIIClAIBADCCAo0GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM9MjCX3xcmeNoxy0YAgEQgIICXvciEik-uW79IPose2IdyXrhc6pdfEFknXoXmwMxXggGy8c a974-982 0 v114 3 aAbstract
Background
There is a growing body of evidence that mental distress and disorder are common among people with lower limb lymphoedema, although no research has been conducted on this subject in Rwanda.
Methods
This research was embedded within a mapping study to determine the national prevalence and geographical distribution of podoconiosis in Rwanda. Using a cluster sampling design, adult members of households within 80 randomly selected sectors in all 30 districts of Rwanda were first screened and 1143 patients were diagnosed with either podoconiosis (n=914) or lower limb lymphoedema of another cause (n=229). These 1143 participants completed the Patient Health Questionnaire (PHQ)-9 to establish the prevalence of depressive symptoms.
Results
Overall, 68.5% of participants reported depressive symptoms- 34.3% had mild depressive symptoms, 24.2% had moderate, 8.8% moderately severe and 1.2% severe depressive symptoms. The mean PHQ-9 score was 7.39 (SD=5.29) out of a possible 0 (no depression) to 27 (severe depression). Linear regression showed unemployment to be a consistently strong predictor of depressive symptoms; the other predictors were region (province), type of lymphoedema and, for those with podoconiosis, female gender, marital status and disease stage.
Conclusions
Levels of depressive symptoms were very high among people with lower limb lymphoedema in Rwanda, which should be addressed through holistic morbidity management and disability prevention services that integrate mental health, psychosocial and economic interventions alongside physical care.
a0035-9203, 1878-3503