Abstract
BackgroundNeglected Tropical Diseases (NTDs) afflict around one billion individuals in the poorest parts of the world with many more at risk. Lymphatic filariasis is one of the most prevalent of the infections and causes significant morbidity in those who suffer the clinical conditions, particularly lymphedema and hydrocele. Depressive illness has been recognised as a prevalent disability in those with the disease because of the stigmatising nature of the condition. No estimates of the burden of depressive illness of any neglected tropical disease have been undertaken to date despite the recognition that such diseases have major consequences for mental health not only for patients but also their caregivers.MethodsWe developed a mathematical model to calculate the burden of Disability- Adjusted Life Years (DALY) attributable to depressive illness in lymphatic filariasis and that of their caregivers using standard methods for calculating DALYs. Estimates of numbers with clinical disease was based on published estimates in 2012 and the numbers with depressive illness from the available literature.ResultsWe calculated that the burden of depressive illness in filariasis patients was 5.09 million disability-adjusted life years (DALYs) and 229,537 DALYs attributable to their caregivers. These figures are around twice that of 2.78 million DALYs attributed to filariasis by the Global Burden of Disease study of 2010.ConclusionsLymphatic filariasis and other neglected tropical diseases, notably Buruli Ulcer, cutaneous leishmaniasis, leprosy, yaws, onchocerciasis and trachoma cause significant co morbidity associated with mental illness in patients. Studies to assess the prevalence of the burden of this co-morbidity should be incorporated into any future assessment of the Global Burden of neglected tropical diseases. The prevalence of depressive illness in caregivers who support those who suffer from these conditions is required. Such assessments are critical for neglected tropical diseases which have such a huge global prevalence and thus will contribute a significant burden of co-morbidity attributable to mental illness.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-015-0068-7) contains supplementary material, which is available to authorized users.
Highlights
Neglected Tropical Diseases (NTDs) afflict around one billion individuals in the poorest parts of the world with many more at risk
We present an estimate of the Global Burden of Mental illness associated with lymphatic filariasis based on the published figures of depressive illness from the studies quoted above [12,13,14,15], and include the estimates of depression, which can be attributed to caregivers based on estimates of the need for care by chronically disabled patients with filariasis
Because mortality directly attributable to lymphatic filariasis is rare suicidal ideations have been reported, and because the Global Burden of Disease (GBD) classified no deaths from depression in 2010, we assumed that Years of Life Lost (YLL) is close to zero
Summary
Neglected Tropical Diseases (NTDs) afflict around one billion individuals in the poorest parts of the world with many more at risk. No estimates of the burden of depressive illness of any neglected tropical disease have been undertaken to date despite the recognition that such diseases have major consequences for mental health for patients and their caregivers. The impact of mental illness on the sufferers of Neglected Tropical Diseases (NTDs) appears to have been completely disregarded as a cause of morbidity and was not quantified in recent estimates in the Global Burden of Disease (GBD) study [1, 2]. Hotez et al [2] reviewed the Burden of NTDs [1] but did not include in any of the estimates the burden of mental health associated with NTDs. The GBD of 2010 [1] attributes to NTDs 1 % of the total global DALYs (excluding malaria) but the burden of NTDs varies regionally by a factor of 961 reflecting the relative importance of these diseases in the impoverished tropics where NTDs are amongst the commonest infections and where transmission remains intense. Within the context of resource poor rural settings, there is unlikely to be either the specialist skills or resources to implement such support given the almost complete dearth of psychological or psychiatric expertise in such settings in sub-Saharan Africa
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