Mental health and neglected tropical diseases – the neglected dimension of burden: identifying the challenges and understanding the burden

The relationship between mental health comorbidity and neglected tropical diseases (NTDs) has been highlighted over the last decade as a major component of the ill health of those affected by these diseases. The impact of mental illness is considered to be significantly underestimated in the calculations of the overall disability-adjusted life years (DALYs), in particular the years of life lived with disability (YLDs). This commentary raises questions on the overall DALY burden, taking account of anxiety, depression and stigma associated with NTDs, recommends that the economic losses incurred as a result of mental health conditions are assessed and highlights the potential impact on caregivers and their families. It recommends that mental healthcare is incorporated into NTDs programme planning and implementation. Research areas suggested as a priority are an estimation of the overall NTD burden of depressive and anxiety disorders, the impact of neuropsychiatric conditions consequent of some NTDs (such as epilepsy and pruritus from some skin NTDs) and an evaluation of the economic costs of mental ill health derived from NTDs causation