Trachoma and Mental Health

Date of Completion: September 2021

Funder: Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD), funded at The Task Force for Global Health primarily by the Bill & Melinda Gates Foundation, by the UK aid from the British government, and by the United States Agency for International Development through its Neglected Tropical Diseases Program.

Aim: Explore the impact of Trachomatous Trichiasis (TT) on common mental disorders such as depression, anxiety and suicidality.

Background

The blinding stage of trachoma, trachomatous trichiasis (TT), is associated with substantial pain and visual impairment, which can lead to significant physical, psychosocial, and mental health consequences. However, the relationship between TT and mental health disorders has not been systematically examined. This study addresses this evidence gap by investigating the mental health impact of TT.

Key Findings

• TT cases had substantially higher risk of depression (17.7% in TT cases vs 8.2% in non-TT participants. p=0.0006)

• TT cases had substantially higher risk of generalised anxiety disorder (GAD) (4.9% vs 1.6%, p=0.035)

• TT cases had substantially higher risk of suicidal behavior (7.9% vs 3.3%, p=0.025).

• Stigma in TT cases was independently associated with suicidal behavior (odds ratio (OR)=1.37, 95% CI, 1.09–1.72, p=0.0071).

• Vision impairment was strongly associated with depression (OR=2.04, 95% CI, 1.14–3.67, p=0.017).

• Common mental health disorders in general were highly prevalent in TT cases than their non-trichiatic counterparts (22.0% vs 10.5%, p=0.0002).