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Navigating the web of mosquito-borne diseases, depression and stigma

Combating these diseases requires a holistic approach that addresses the mental health challenges intertwined with them. As more than 80% of the world population grapples with vector-borne diseases with mosquito-transmitted diseases being the major contributors, there’s a hidden battle taking place in the minds of those constantly under the threat of mosquito-borne illnesses. The link […]

Combating these diseases requires a holistic approach that addresses the mental health challenges intertwined with them.

As more than 80% of the world population grapples with vector-borne diseases with mosquito-transmitted diseases being the major contributors, there’s a hidden battle taking place in the minds of those constantly under the threat of mosquito-borne illnesses. The link between physical health and mental well-being is a complex web, and in the context of diseases like malaria, dengue, lymphatic filariasis (LF), Japanese Encephalitis (JE) chikungunya, Zika virus, and others, it unveils a multifaceted relationship.

Diseases and Depression
Research has unraveled a complex interplay between mosquito-borne diseases and mental health. On one hand, diseases like malaria, dengue, lymphatic filariasis, JE, chikungunya, Zika virus, as physically debilitating illnesses, can predispose individuals to depression. On the other hand, depression may act as a catalyst for these diseases by compromising immunity and altering behavior. This creates a vicious cycle where depression impedes the treatment and recovery from mosquito-borne diseases, and in turn, these diseases may exacerbate the symptoms of depression. The misdiagnosis of fatigue and malaise as mosquito-borne diseases, that research shows has taken place in African clinical settings, further complicates matters. Erroneous prescriptions of antimalarials may clear low-grade parasitaemia while leaving the underlying depression undiagnosed and untreated, potentially heightening the risk of recurring mosquito-borne diseases.

Stigma: A Silent Aggressor
Beyond the physical toll of mosquito-borne diseases, individuals also face the silent aggression of stigma, especially in the case of neglected tropical diseases (NTDs). Researchers have found a disturbingly high prevalence of depression and anxiety among those with NTDs compared to the general population. Stigma emerges as a key contributor to this mental health burden, perpetuating a cycle of suffering. The fear of judgment and societal misconceptions surrounding NTDs can lead to feelings of inferiority and isolation among affected individuals. This social stigma not only intensifies the psychological impact of the diseases but also hampers efforts to seek help and treatment.

Lymphatic Filariasis&Dengue
The specific example of lymphatic filariasis highlights the gravity of the mental health challenges intertwined with mosquito-borne diseases. The main vectors for Wuchereriabancrofti, which is the most common cause of LF, are primarily mosquitoes belonging to the genera Culex, in India. The other species Brugiamalayianother LF parasite transmitted by Mansoniais prevalent in Kerala causes severe deformities than W. bancrofti.
It’s important to note that the transmission of lymphatic filariasis is complex, involving the development of the filarial worms in the mosquito and their subsequent transmission to humans through mosquito bites. The type of mosquito species involved can vary depending on the geographic location and local ecology. In India, it is largely a rural disease, also called as elephantiasis.Two key strategies are employed in the pursuit of lymphatic filariasis (LF) elimination. The first involves mass drug administration, a comprehensive approach utilizing a combination of diethylcarbamazine, Albendazole, and Ivermectin. This targeted medication administration aims to reduce LF transmission by treating entire at-risk populations. The second strategy focuses on home-based morbidity management, addressing the aftermath of LF infection by providing effective and accessible care within the affected individuals’ residences. Together, these strategies form a dual-pronged approach aimed at not only interrupting LF transmission but also managing the morbidity associated with the disease.

Studies have revealed that between 8.5% and a staggering 97% of individuals with LF experience depression or related problems. Feelings of inferiority, a common consequence of the associated stigma, further contribute to the mental health burden. This underscores the urgency of recognizing the psychological toll of these diseases and integrating mental health considerations into comprehensive healthcare strategies.

On the other hand, JE affects mostly children with a high case fatality rate. But those who survive become a burden to the family with severe disabilities, which then further exacerbates mental health concerns.

Dengue is another case in point. Acute dengue fever not only inflicts physical suffering but also casts a shadow over mental well-being, creating a profound impact on the individual’s mental health and overall quality of life. Beyond the debilitating symptoms of fever, pain, and weakness, the emotional toll of dengue is often overlooked. Picture a scenario where an individual, serving as the sole provider for their family, is suddenly incapacitated for a month due to the illness. The stress and anxiety stemming from the financial strain, coupled with the inability to fulfill familial and economic responsibilities during this period, create a unique and severe mental health challenge. The individual grapples not only with the physical pain but also with the psychological distress of being unable to meet the basic needs of their family. This narrative underscores the critical need for comprehensive support systems and increased awareness not only about the physical severity of dengue but also the significant mental health consequences it imposes, urging society to address this dual dimension of the disease with empathy and understanding.

Beyond treating physical symptoms
The intricate interplay between mosquito-borne diseases and the mental well-being of affected individuals highlights the urgent need for a comprehensive approach that addresses both the physical and psychological aspects of health.
Combating these diseases goes beyond administering antimalarials; it requires a holistic approach that addresses the mental health challenges intertwined with them. Tackling stigma associated with NTDs is paramount, as it serves as a significant driving force behind elevated rates of depression and anxiety. By recognizing and addressing the intricate links between physical health, mental well-being, and societal perceptions, we can pave the way for a healthier and more resilient global community in the face of the persistent mosquito menace.

Viruses have been implicated in various mental health challenges, as exemplified by the far-reaching consequences of the COVID-19 pandemic. Beyond concerns of increased suicidal behavior, the pandemic has contributed to a spectrum of mental health issues, including heightened stress, anxiety, depression, and social isolation. The multifaceted impact underscores the need for comprehensive strategies to address the broader mental health repercussions associated with viral outbreaks.

Prasad Phadke, Founder & CEO at Eco BioTraps and Susanta Kumar Ghosh, Scientific Advisor at Eco BioTraps and Former ICMR-National Institute of Malaria Research, Bangalore.

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