Discussion

Mental health is estimated to be the leading cause of global morbidity as calculated by the Global Burden of Disease (GBD) studies with depressive disorders the most common amongst these conditions and estimated to be the condition which results in the greatest in terms of Years of Life lived with disability (YLDs). However, in the mental health literature these diseases do not figure in the spectrum of conditions which have a consequence for the mental wellbeing of individuals. Our studies on the Neglected Tropical Diseases (NTDs) have to date focussed on parasitic infections -lymphatic filariasis (LF), cutaneous leishmaniasis (CL) and human African trypanosomiasis - to estimate the mental health burden of these conditions when compared with published figures of mental health burden by the GBD. Studies on specific conditions have identified variable levels of prevalence of depressive illness but up to 90% in some studies have been reported. Calculations of the burden of disease are based on Disability Weights (DWs); the DWs used in calculation of mental health burden are 0.655 for patients with major depressive disorders, a much higher figure, than the attribution of DWs for LF and CL ( 0.109 and 0.013 respectively). Patients with these parasitic conditions are stigmatised, have a high prevalence of anxiety and depression, have reduced a quality of life but the condition does not impact on longevity. Calculations suggest that the hitherto estimated Burden of these infections is grossly under-estimated if mental health co-morbidity is considered. The talk will also address the impact on the social and mental health consequences on caregivers of those disabled; neurocysticercosis, as one of the leading causes of global epilepsy and the mental health conditions associated with toxoplasmosis infection.