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Pan Afr Med J ; 38: 389, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34381533


Introduction: despite the high prevalence and significant burden of mental disorders, they remain grossly under-diagnosed and undertreated. In low-income countries, such as Mali, integrating mental health services into primary care is the most viable way of closing the treatment gap. This program aimed to provide a mental health training intervention to rural general practitioners (GPs), to organize community awareness activities, and to evaluate the impact on mental health knowledge and through the number of new patients diagnosed with mental disorders and managed by these general practitioners. Methods: a pre-test/post-test design and the monthly monitoring of the number of new patients diagnosed with mental disorders by the trained GPs were used to evaluate the effect of the training interventions (two face-to-face group training workshops followed by individual follow-up supervisions) and of the community awareness activities. Results: the mean knowledge score of the 19 GPs who completed the initial 12-day group training raised from 24.6/100 at baseline, to 61.5/100 after training (p<0.001), a 150% increase. Among them, sixteen completed the second 6-day group training with a mean score increasing from 50.2/100 to 70.1/100 (p<0.001), a 39.6% improvement. Between July 2018 and June 2020, 2,396 new patients were diagnosed with a mental disorder by the 19 GPs who took part in the program. Conclusion: despite limited data regarding the effect of the community awareness component at this stage, the findings from this study suggest that the training intervention improved GPs' knowledge and skills, resulting in a significant number of new patients being identified and managed.

Fortalecimento Institucional , Clínicos Gerais/organização & administração , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Competência Clínica , Clínicos Gerais/educação , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Mali , Transtornos Mentais/diagnóstico , Saúde Mental , Atenção Primária à Saúde/organização & administração , Serviços de Saúde Rural/organização & administração
BMC Psychiatry ; 21(1): 413, 2021 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-34416862


BACKGROUND: Schizophrenia is a relatively common disease worldwide with a point prevalence of around 5/1000 in the population. The aim of this present work was to assess the demographic, clinical, familial, and environmental factors associated with schizophrenia in Mali. METHODS: This was a prospective descriptive study on a series of 164 patients aged at least 12 years who came for a follow-up consultation at the psychiatry department of the University Hospital Center (CHU) Point G in Mali between February 2019 and January 2020 for schizophrenia spectrum disorder as defined by DSM-5 diagnostic criteria. RESULTS: Our results revealed that the male sex was predominant (80.5%). The 25-34 age group was more represented with 44.5%. The place of birth for the majority of our patients was the urban area (52.4%), which also represented the place of the first year of life for the majority of our patients (56.1%). We noted that the unemployed and single people accounted for 56.1 and 61% respectively. More than half of our patients 58.5% reported having reached secondary school level. With the exception of education level, there was a statistically significant difference in the distribution of demographic parameters. Familial schizophrenia cases accounted for 51.7% versus 49.3% for non-familial cases. The different clinical forms were represented by the paranoid form, followed by the undifferentiated form, and the hebephrenic form with respectively 34, 28 and 17.1%. We noted that almost half (48.8%) of patients were born during the cold season. Cannabis use history was not observed in 68.7% of the patients. The proportions of patients with an out-of-school father or an out-of-school mother were 51.2 and 64.2%, respectively. CONCLUSION: The onset of schizophrenia in the Malian population has been associated with socio-demographic, clinical, genetic and environmental characteristics.

Esquizofrenia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Escolaridade , Humanos , Masculino , Estudos Prospectivos , Esquizofrenia/epidemiologia , Estações do Ano
Trans R Soc Trop Med Hyg ; 100(6): 515-20, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16233907


Use of official health services often remains low despite great efforts to improve quality of care. Are informal treatments responsible for keeping a number of patients away from standard care, and if so, why? Through a questionnaire survey with proportional cluster samples, we studied the case histories of 952 children in Bandiagara and Sikasso areas of Mali. Most children with reported uncomplicated malaria were first treated at home (87%) with modern medicines alone (40%), a mixture of modern and traditional treatments (33%), or traditional treatment alone (27%). For severe episodes (224 cases), a traditional treatment alone was used in 50% of the cases. Clinical recovery after uncomplicated malaria was above 98% with any type of treatment. For presumed severe malaria, the global mortality rate was 17%; it was not correlated with the type of treatment used (traditional or modern, at home or elsewhere). In the study areas, informal treatments divert a high proportion of patients away from official health services. Patients' experience that outcome after standard therapeutic itineraries is not better than after alternative care may help to explain low use of official health services. We need to study whether some traditional treatments available in remote villages should be considered real, recommendable first aid.

Serviços de Saúde/estatística & dados numéricos , Malária/terapia , Automedicação/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Malária/mortalidade , Mali , Medicina Tradicional Africana , Aceitação pelo Paciente de Cuidados de Saúde , Saúde da População Rural , Resultado do Tratamento
J Ethnopharmacol ; 92(2-3): 233-44, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15138006


Traditional medicine, being a significant element in the cultural patrimony, still remains the main recourse for a large majority of people in Dogonland, Mali, for treating various diseases and ailments. This paper reports an ethnopharmacological study in Dogonland with the aim to identify medicinal plants used in the treatment of wounds. Information obtained from traditional healers revealed 73 plant species being used as wound healing remedies, according to the definitions of wounds given by the healers themselves. The plants, belonging to 34 plant families, are used as first aids, in the washing of wounds, extraction of pus, as coagulants, as well as for infected wounds. The most frequently used preparations are decoctions and powdered plant material.

Etnofarmacologia , Medicina Tradicional Africana , Extratos Vegetais/uso terapêutico , Plantas Medicinais/classificação , Ferimentos e Lesões/tratamento farmacológico , Humanos , Mali