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TropicalMed
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An Update on Syndemics
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An Update on Syndemics

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 6678

Special Issue Editors

Dr. Nicola Bulled

E-Mail Website
Guest Editor
Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
Interests: syndemics; HIV; biopolitics; refugee integration
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Merrill Singer

E-Mail Website
Guest Editor
Department of Anthropology, University of Connecticut, 354 Mansfield Road, Unit 1176, Storrs, CT 06269-1176, USA
Interests: syndemics; ecosyndemics; climate change
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The theory of syndemics hypothesizes that observed clusters of diseases in specific temporal and geographical contexts are the result of harmful socio-environmental conditions resulting in mutually enhancing deleterious consequences. For the past 25 years, the concept has informed an array of health-related disciplines, proving valuable in health research, policy, and practice.

This Special Issue aims to highlight new syndemic arrangements of infectious diseases in order to inform health policy and interventions. While HIV-related syndemics remain the most studied, new disease arrangements related to COVID-19 and other epidemics (e.g., SARS, Zika, Ebola, dengue, chikungunya, mucormycosis) have emerged that warrant investigation. Furthermore, while epidemics may transcend national borders, driven by analogous influencing social factors, syndemic factors take on unique arrangements in different social, political, economic, and geographic contexts. Place-based assessments are much needed to develop context-specific solutions.

For this Special Issue, we ask scholars working in the field to consider novel syndemic attributes of clusters of infectious diseases that result in worse health outcomes than each condition in isolation. Topics of interest include, but are not limited to, the following: (1) infectious diseases and other health conditions concentrated in a population; (2) the health conditions interacting biologically; and (3) social conditions interacting with health conditions in a manner that increases infectivity or disease progression.

Scholars are asked to present evidence of the observed syndemic, clearly addressing all three dimensions of syndemic theory (biological factors, social factors of populations affected, and synergistic interaction). Manuscripts are not limited to specific methods (qualitative, quantitative, or mixed) but should address how the findings inform effective public health control strategies beyond those currently employed and address novel syndemic arrangements.

Dr. Nicola Bulled
Prof. Dr. Merrill Singer
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infectious diseases
  • syndemics
  • tropical disease
  • social determinants of health
  • policy
  • intervention
  • global health

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Published Papers (5 papers)

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Research

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24 pages, 3407 KiB  
Article
Gender and Intersecting Barriers and Facilitators to Access the HIV Cascade of Care in Manitoba, Canada, Before and During the COVID-19 Pandemic: A Qualitative Study
by Enrique Villacis-Alvarez, Cheryl Sobie, Katharina Maier, Margaret Lavallee, Chantal Daniels, Heather Pashe, Joel Baliddawa, Nikki Daniels, Rebecca Murdock, Robert Russell, Clara Dan, Freda Woodhouse, Susie Cusson, Lisa Patrick, Marj Schenkels, Michael Payne, Ken Kasper, Lauren J. MacKenzie, Laurie Ireland, Kimberly Templeton, Kathleen Deering, Margaret Haworth-Brockman, Yoav Keynan and Zulma Vanessa Ruedaadd Show full author list remove Hide full author list
Trop. Med. Infect. Dis. 2024, 9(12), 287; https://doi.org/10.3390/tropicalmed9120287 - 25 Nov 2024
Viewed by 863
Abstract
Marginalized groups in Manitoba, Canada, especially females and people who inject drugs, are overrepresented in new HIV diagnoses and disproportionately affected by HIV and structural disadvantages. Informed by syndemic theory, our aim was to understand people living with HIV’s (PLHIV) gendered and intersecting [...] Read more.
Marginalized groups in Manitoba, Canada, especially females and people who inject drugs, are overrepresented in new HIV diagnoses and disproportionately affected by HIV and structural disadvantages. Informed by syndemic theory, our aim was to understand people living with HIV’s (PLHIV) gendered and intersecting barriers and facilitators across the cascade of HIV care before and during the COVID-19 pandemic. This study was co-designed and co-led alongside people with lived experience and a research advisory committee. We employed semi-structured interviews with thirty-two participants and three questionnaires. Interviews were audio-recorded, transcribed, and coded, and descriptive statistics were performed on the first two questionnaires. Qualitative data analysis used thematic analysis and focused on identifying categories (individual, healthcare, and social/structural) related to the barriers and facilitators to HIV care. A total of 32 PLHIV completed this study and over 70% of females and 50% of males reported severe and moderate sexual abuse among other traumatic childhood experiences. Barriers to accessing or continuing in the cascade of HIV care included navigating the initial shock of receiving an HIV diagnosis, mental health challenges and inaccessible supports, substance use, violence (including intimate partner), internalized and enacted compounded stigma related to houselessness and substance use, discrimination by primary care service providers and social networks, lack of preventative and social supports, lack of accessible housing, and programmatic issues. COVID-19 increased mental health problems and disrupted relationships with HIV service providers and peers living with HIV. Facilitators to HIV care included stopping substance use, caring service providers particularly during HIV diagnosis, welcoming healthcare environments, social opportunities and integrated supports, and supportive social networks. Women, men, and non-binary PLHIV experience interconnected factors complicating their experiences with HIV care. Interventions should consider holistic, person-centered, and trauma-informed care options to address the barriers found in this research and appropriately serve PLHIV. Full article
(This article belongs to the Special Issue An Update on Syndemics)
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24 pages, 2732 KiB  
Article
‘The Lost Peace’: Evidencing the Syndemic Relationship between Neglected Tropical Diseases and Mental Distress in Liberia
by Rosalind McCollum, Carrie Barrett, Georgina Zawolo, Rachel Johnstone, Tiawanlyn G. Godwin-Akpan, Hannah Berrian, Shahreen Chowdhury, Jerry Kollie, Karsor Kollie, Emerson Rogers, Colleen Parker, Maneesh Phillip, Lucas Sempe, Maaike Seekles, John Solunta Smith, Wede Seekey, Anna Wickenden, Zeela Zaizay, Sally Theobald and Laura Dean
Trop. Med. Infect. Dis. 2024, 9(8), 183; https://doi.org/10.3390/tropicalmed9080183 - 17 Aug 2024
Viewed by 1305
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue An Update on Syndemics)
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23 pages, 1606 KiB  
Article
Addressing the Syndemic Relationship between Lymphatic Filariasis and Mental Distress in Malawi: The Potential of Enhanced Self-Care
by Carrie Barrett, John Chiphwanya, Dorothy E. Matipula, Janet Douglass, Louise A. Kelly-Hope and Laura Dean
Trop. Med. Infect. Dis. 2024, 9(8), 172; https://doi.org/10.3390/tropicalmed9080172 - 31 Jul 2024
Cited by 1 | Viewed by 1341
Abstract
Lymphatic filariasis (LF) causes disfiguring and disabling lymphoedema, which can lead to mental distress and requires life-long self-care treatment. This study applies syndemic theory to understand the biosocial relationship between LF and mental distress in Malawi. Using in-depth qualitative methods, we critically evaluate [...] Read more.
Lymphatic filariasis (LF) causes disfiguring and disabling lymphoedema, which can lead to mental distress and requires life-long self-care treatment. This study applies syndemic theory to understand the biosocial relationship between LF and mental distress in Malawi. Using in-depth qualitative methods, we critically evaluate experiences of mental distress and LF through 21 life-history interviews, to narrate experiences from the perspective of persons affected by LF, and to understand how enhanced self-care (ESC) for lymphoedema management disrupts the syndemic relationship. Complementary key informant interviews with Ministry of Health LF programme staff were conducted to further understand intervention and health system delivery. All interviews were recorded, transcribed, and translated, and then subject to thematic analysis. Our findings suggest that for persons affected by LF in Malawi, before being trained in ESC, absent referral pathways, inequalities in healthcare provision or available treatment, and limited knowledge of the condition (LF) drove the syndemic of LF and mental distress. Distress was often exacerbated by stigma and social exclusion, and shaped by intersections of gender, generation, poverty, and extreme climate conditions. We argue that addressing the syndemic suffering associated with LF and mental distress through interventions which center the needs of persons affected is critical in effective and equitable LF care delivery. Full article
(This article belongs to the Special Issue An Update on Syndemics)
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Review

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16 pages, 1582 KiB  
Review
Convergence between Cardiometabolic and Infectious Diseases in Adults from a Syndemic Perspective: A Scoping Review
by Silvia Quiroz-Mena, Juan Gabriel Piñeros-Jimenez and Wilson Cañon-Montañez
Trop. Med. Infect. Dis. 2024, 9(9), 196; https://doi.org/10.3390/tropicalmed9090196 - 26 Aug 2024
Viewed by 1002
Abstract
Objective. Synthesize the approaches used to study the convergence between cardiometabolic and infectious diseases in adults from a syndemic perspective based on the scientific evidence available to date worldwide. Methods. Scoping review that follows the recommendations of the PRISMA statement. The [...] Read more.
Objective. Synthesize the approaches used to study the convergence between cardiometabolic and infectious diseases in adults from a syndemic perspective based on the scientific evidence available to date worldwide. Methods. Scoping review that follows the recommendations of the PRISMA statement. The protocol was registered in INPLASY202150048. The search for studies was carried out in MEDLINE, LILACS, Web of Science and Scopus. Results. Since the COVID-19 pandemic, there has been an increase in studies in the field of convergence between cardiometabolic and infectious diseases from a syndemic perspective, but only three studies were classified as true syndemics. There are weaknesses in the adherence to the elements of the syndemic theory, given a low incorporation of population measurements, and until now it has not been possible to find convincing empirical evidence that supports the bio–bio interface. Quantitative methods predominated through models focused on “sum scores”. Conclusions. Future studies should comprehensively address the elements of syndemics, review discrepancies between additive analyses versus other modeling, and incorporate the influence of large-scale social forces. The lack of these aspects distances studies from the notion of syndemic, bringing them closer to comorbidity or multimorbidity approaches. Full article
(This article belongs to the Special Issue An Update on Syndemics)
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18 pages, 632 KiB  
Review
Using a Syndemics Perspective to (Re)Conceptualize Vulnerability during the COVID-19 Pandemic: A Scoping Review
by Yisel Hernandez Barrios, Dennis Perez Chacon, Yosiel Molina Gomez, Charlotte Gryseels, Kristien Verdonck, Koen Peeters Grietens and Claudia Nieto-Sanchez
Trop. Med. Infect. Dis. 2024, 9(8), 189; https://doi.org/10.3390/tropicalmed9080189 - 22 Aug 2024
Cited by 1 | Viewed by 949
Abstract
Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to [...] Read more.
Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to better understand how this theoretical framework helped to define, operationalize, and tackle issues of vulnerability during the COVID-19 pandemic. Original research, reviews, and opinion pieces elaborating on syndemics, vulnerability, and COVID-19, published between December 2019 and October 2022 and available from PubMed, were eligible. We analyzed 40 records and identified three framings of syndemics operating during this period: (1) interactions between COVID-19, diseases/health conditions, and specific social factors; (2) interactions between COVID-19 and social determinants of health; and (3) impacts of COVID-19 on specific populations. Emerging conceptualizations described vulnerability to COVID-19 as a systemic issue, explained the impact of COVID-19 control measures on increased vulnerability, and presented COVID-19 as a syndemic on its own. However, this theory’s potential for deepening our understanding of vulnerability during this pandemic was constrained by superficial explorations of the interactions between biomedical and social spheres, and insufficient theoretical and methodological support from the social sciences. Full article
(This article belongs to the Special Issue An Update on Syndemics)
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