Prevalence of neuropsychiatric disorders in patients with systemic lupus erythematosus in Pakistan: A systematic review and meta-analysis

Khan, Muhammad Imran; Qureshi, Humera; Akhtar, Sohail; Bae, Suk Joo; Hassan, Fazal

doi:10.3389/fpsyt.2023.1098734

Cited by 4 publications

(7 citation statements)

References 74 publications

(89 reference statements)

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“…We set the con dence interval (CI) at 99% with a margin of error (E) of 1.5%. A previously conducted systematic review (17) reported a pooled prevalence of malaria in Pakistan of 23.3%, which we set as our estimated population proportion (p). Based on the population size, these values were put into the software, which gave us a sample size of 2540 using the following equation:…”

Section: Sample Sizementioning

confidence: 99%

Investigating seroprevalence and vulnerability in a flood-affected internally displaced population: A cross-sectional study

Khan,

Asif

et al. 2024

Preprint

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Background Malaria is a communicable disease that affects millions of people throughout the world every year. Internally displaced people are a vulnerable group that can be disproportionately affected by mosquito-transmitted disease. Harsh climatic conditions such as floods are among the key factors that directly contribute to the displacement of people while simultaneously creating favourable breeding grounds for mosquitoes that transmit Plasmodium species. This study aimed to assess the epidemiological aspects of malaria transmission in flood-affected displaced people. Methods A cross-sectional study was conducted among the internally displaced persons, displaced by the 2022 floods in Pakistan, living in the ‘Tent City’ of Hyderabad, Sindh. A total of 2,640 participants were recruited from the camp via random sampling. Rapid diagnostic tests and microscopy techniques were utilized to assess blood samples, and a standardized questionnaire was used to gather demographic data. The seroprevalence of malarial infection and its subtypes was determined. Vulnerability to infection based on sex and age group was also assessed using stratified analysis. Results Of the 2640 participants, 354 (13.4%) were malaria positive. Rapid diagnostic tests showed a marginally greater (14.8%) seroprevalence than did microscopy (10.7%). Plasmodium vivax was found to be the predominant Plasmodium species among the displaced people, accounting for 87.5% of the total cases, followed by Plasmodium falciparum at 12.5%. Age-stratified analysis revealed that children under 12 years of age and pregnant women had a significantly greater risk of infection. The odds of becoming infected at < 12 years of age were 5.28 times greater than those at > 12 years of age. Similarly, the odds of malaria infection in pregnant women are approximately 2.17 times greater than in individuals above 12 years of age. Conclusion Malaria remains a significant hazard for internally displaced persons, with a high prevalence of malaria infection, indicating the need for prompt healthcare interventions, additional services, and preventative measures. The changing climate conditions pose a risk of increased frequency and intensity of floods leading to mass displacements. This necessitates a stronger effort to mitigate and manage such health disasters in the future.

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Section: Sample Sizementioning

confidence: 99%

Investigating seroprevalence and vulnerability in a flood-affected internally displaced population: A cross-sectional study

Khan,

Asif

et al. 2024

Preprint

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“…Autoantibodies, activation of the complement system and microglia mediate neurotoxicity, which results from disruption of the integrity of the blood-brain barrier [87]. Autoantibodies and cytokines can have local or widespread effects on the central nervous system [88,89]. Alternative theory says that Interferon-alpha (IFN-α) is the main factor in the pathogenesis of SLE.…”

Section: Cognitive Disordersmentioning

confidence: 99%

“…Autoprzeciwciała, aktywacja układu dopełniacza i mikrogleju pośredniczą w neurotoksyczności, która wynika z zaburzenia integralność bariery krew -mózg [87]. Autoprzeciwciała i cytokiny mogą mieć miejscowy lub rozległy wpływ na ośrodkowy układ nerwowy [88,89]. Odmienna teoria mówi o tym, że Interferon-alfa (IFN-α) to główny czynnik w patogenezie SLE.…”

Section: Zaburzenia Poznawczeunclassified

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

Szarpak,

Tomasik,

Stanicki

et al. 2024

Curr Probl Psychiatry

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Introduction: Systemic lupus erythematosus is an autoimmune disease affecting up to 210 per 100,000 people in Europe, more often among women. The inflammatory process in lupus causes changes in various organs. However, somatic changes are not the only effects of lupus. The neuropsychiatric manifestations of this disease have been given a separate name – neuropsychiatric lupus. Material and methods: A review of the literature available on the PubMed platform in the period of 1987-2023 was performed using the key words: neuropsychiatric systemic lupus erythematosus, mental disorders, mood disorders, sleep disorders, systemic lupus erythematosus. Original studies, review works, meta-analyses and Internet sources were analyzed. Results: Psychotic disorders in lupus occur with a frequency of up to 3%. Risk factors include young age, male gender and glucocorticoids treatment. Mood disorders occur in several to several dozen percent of lupus patients, including depression affecting up to ⅓ of patients. Belimumab, psychotherapy and improving the quality of sleep, the disturbance of which is observed in most patients with lupus, have potential in treatment. Anxiety disorders are seen primarily in the teenage age group, where social phobia predominates – the fear of rejection due to the disease – and they worsen and are exacerbated by rheumatic disease. Cognitive dysfunctions occur in up to 80% of lupus patients. They are probably related to enzymes of metabolic pathways, dyslipidemia and thyroid dysfunction. Conclusions: Mental disorders develop more often in patients with lupus than in the general population and they predispose to autoimmune diseases. Comprehensive diagnosis and psychiatric care of patients with lupus are necessary. Keywords: systemic lupus erythematosus, sleep disorders, mood disorders, neuropsychiatric systemic lupus erythematosus, mental disorders

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“…The autoimmune disorder systemic lupus erythematosus (SLE) is one of the most common types of lupus in which the immune system attacks its own tissues [ 1 ]. SLE can cause inflammation and damage to almost every organ system in the body including the brain, skin, joints, and lungs.…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review

Rice-Canetto,

Joshi,

Kyan

et al. 2024

Cureus

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Neuropsychiatric systemic lupus erythematosus (NPSLE) refers to the neurological and psychiatric manifestations of systemic lupus erythematosus (SLE), which remain poorly understood yet often have a profound effect on the lives of afflicted patients. The aim of this study is to synthesize the available information on the pathogenesis, diagnostics, management, and prognosis of this disease. Our hope is to increase awareness and call for further investigations that may optimize NPSLE patient outcomes and quality of life. We performed a literature review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, resulting in 11 studies of inclusion. Within each study, we extracted data on epidemiologic factors, diagnostics, therapeutic modalities, and prognosis for each neuropsychiatric condition. The most widely discussed neuropsychiatric manifestations of SLE based on the American College of Rheumatology (ACR) classifications included status epilepticus (SE) and seizures, transverse myelitis (TM), and cognitive dysfunction. SE and TM had a prevalence of 1-2%, while cognitive dysfunction was nearly 38%. Diagnostics varied depending on symptom presentation but often included brain magnetic resonance imaging (MRI) and antibody testing. Treatment for NPSLE is still widely understudied, but concurrent treatment with immunosuppressants and anti-inflammatories for symptom control and more targeted immunotherapies based on the specific condition is often effective. Prognosis is highly symptom dependent, ranging from a 12.5% one-year mortality in SE and seizure patients to near resolution of symptoms in certain presentations including idiopathic intracranial hypertension and cerebellar ataxia. Further studies are needed to better understand the pathophysiology, diagnostics, and effective therapeutic measures for NPSLE. The severity of these manifestations and generally poor prognosis highlight the need for more research to accurately diagnose and treat this disease. While there is still little data available, this literature review serves to provide updated context on this condition.

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Prevalence of neuropsychiatric disorders in patients with systemic lupus erythematosus in Pakistan: A systematic review and meta-analysis

Cited by 4 publications

References 74 publications

Investigating seroprevalence and vulnerability in a flood-affected internally displaced population: A cross-sectional study

Investigating seroprevalence and vulnerability in a flood-affected internally displaced population: A cross-sectional study

Patients with a rheumatological diagnosis in a psychiatrist's office - neuropsychiatric lupus

Neuropsychiatric Systemic Lupus Erythematosus: A Systematic Review

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