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Cutaneous leishmaniasis and co-morbid major depressive disorder: A systematic review with burden estimates.

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Bailey, Freddie, Mondragon-Shem, Karina, Haines, Lee ORCID: https://orcid.org/0000-0001-8821-6479, Olabi, Amina, Alorfi, Ahmed, Ruiz-Postigo, José Antonio, Alvar, Jorge, Hotez, Peter, Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Vélez, Iván D, Al-Salem, Waleed, Eaton, Julian, Acosta Serrano, Alvaro ORCID: https://orcid.org/0000-0002-2576-7959 and Molyneux, David ORCID: https://orcid.org/0000-0001-8537-7947 (2019) 'Cutaneous leishmaniasis and co-morbid major depressive disorder: A systematic review with burden estimates.'. PLoS Neglected Tropical Diseases, Vol 13, Issue 2, e0007092.

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Abstract

BACKGROUND
Major depressive disorder (MDD) associated with chronic neglected tropical diseases (NTDs) has been identified as a significant and overlooked contributor to overall disease burden. Cutaneous leishmaniasis (CL) is one of the most prevalent and stigmatising NTDs, with an incidence of around 1 million new cases of active CL infection annually. However, the characteristic residual scarring (inactive CL) following almost all cases of active CL has only recently been recognised as part of the CL disease spectrum due to its lasting psychosocial impact.
METHODS AND FINDINGS
We performed a multi-language systematic review of the psychosocial impact of active and inactive CL. We estimated inactive CL (iCL) prevalence for the first time using reported WHO active CL (aCL) incidence data that were adjusted for life expectancy and underreporting. We then quantified the disability (YLD) burden of co-morbid MDD in CL using MDD disability weights at three severity levels. Overall, we identified 29 studies of CL psychological impact from 5 WHO regions, representing 11 of the 50 highest burden countries for CL. We conservatively calculated the disability burden of co-morbid MDD in CL to be 1.9 million YLDs, which equaled the overall (DALY) disease burden (assuming no excess mortality in depressed CL patients). Thus, upon inclusion of co-morbid MDD alone in both active and inactive CL, the DALY burden was seven times higher than the latest 2016 Global Burden of Disease study estimates, which notably omitted both psychological impact and inactive CL.
CONCLUSIONS
Failure to include co-morbid MDD and the lasting sequelae of chronic NTDs, as exemplified by CL, leads to large underestimates of overall disease burden.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 715 Visceral leishmaniasis
WM Psychiatry > WM 140 Mental disorders (General)
WM Psychiatry > WM 20 Research (General)
WR Dermatology > Parasitic Skin Diseases > WR 350 Tropical diseases of the skin. Mucocutaneous leishmaniasis. Leishmaniasis
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0007092
Depositing User: Stacy Murtagh
Date Deposited: 27 Feb 2019 14:43
Last Modified: 27 Sep 2019 15:30
URI: https://archive.lstmed.ac.uk/id/eprint/10263

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