Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Pan Afr Med J ; 39: 58, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422181

RESUMO

The use of social media to increase awareness on mental health is rapidly gaining momentum globally. However, despite evidence of a growing trend in social media use in sub Saharan Africa, little has been reported on tapping the potential of social media within a mental health practice to not only increase awareness but also facilitate linkage to specialist care. We describe one such mental health practice and its process of integration of the different social media platforms to promote mental health and increase linkage to specialist care. We further highlight the challenges and practical implication of social media use in the Kenyan setting. We conclude by advocating for this integration to raise awareness and also encourage peer support for persons with mental health problems and recommend research that measures the impact of such interventions in sub-Saharan Africa.


Assuntos
Serviços de Saúde Mental/organização & administração , Saúde Mental , Mídias Sociais , Humanos , Quênia , Transtornos Mentais/terapia , Grupo Associado , Apoio Social
2.
Artigo em Inglês | MEDLINE | ID: mdl-25657818

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder is the most common childhood neurobehavioral disorder with well documented adverse consequences in adolescence and adulthood, yet 60-80% of cases go undiagnosed. Routine screening is not practiced in most pediatric outpatient services and little information exists on factors associated with the condition in developing countries. METHODS: This was a questionnaire based cross-sectional survey whose primary objective was to determine prevalence of attention deficit hyperactivity disorder (ADHD) symptoms in children aged 6-12 years attending a tertiary care hospital Accidents and Emergency unit. Secondary objectives were to: (i) ascertain if physical injury and poor academic performance were associated with ADHD, (ii) compare diagnostic utility of parent-filled Vanderbilt Assessment Scale (VAS) against Statistical Manual of Mental Disorders-IV (DSM-IV) as the gold reference and (iii) establish if there exists an association between ADHD symptoms cluster and co-morbid conditions. RESULTS: Prevalence of cluster of symptoms consistent with ADHD was 6.3% (95% CI; 3.72-10.33) in 240 children studied. Those affected were more likely to repeat classes than the asymptomatic (OR 20.2; 95% CI 4.02-100.43). Additionally, 67% of the symptomatic had previously experienced burns and 37% post-traumatic open wounds. The odds of having an injury in the symptomatic was 2.9 (95% CI; 1.01-8.42) compared to the asymptomatic. Using DSM-IV as reference, VAS had a sensitivity of 66.7% (95%; CI 39.03-87.12) and specificity of 99.0% (95% CI; 96.1-99.2). Positive predictive value was 83.0% (95% CI; 50.4-97.3) and negative predictive value 98.0% (CI 95.1-99.1). Oppositional defiant disorder symptoms, anxiety, depression and conduct problems were not significantly associated with ADHD cluster of symptoms. CONCLUSION: The study found a relatively high prevalence of symptoms associated with ADHD. Symptomatic children experienced poor school performance. These findings support introduction of a policy on routine screening for ADHD in pediatric outpatient service. Positive history of injury and poor academic performance should trigger further evaluation for ADHD. Vanderbilt assessment scale is easier to administer than DSM-IV but has low sensitivity and high specificity that make it inappropriate for screening. It however provides a suitable alternative confirmatory test to determine who among clinically symptomatic patients requires referral to a psychiatrist.

3.
PLoS One ; 9(3): e90297, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24651115

RESUMO

The gap in Kenya between need and treatment for mental disorders is wide, and private providers are increasingly offering services, funded in part by private health insurance (PHI). Chiromo, a 30-bed psychiatric hospital in Nairobi, forms part of one of the largest private psychiatric providers in East Africa. The study evaluated the effects of insurance on service use and charge, questioning implications on access to care. Data derive from invoices for 455 sequential patients, including 12-month follow-up. Multi-linear and binary logistic regressions explored the effect of PHI on readmission, cumulative length of stay, and treatment charge. Patients were 66.4% male with a mean age of 36.8 years. Half were employed in the formal sector. 70% were admitted involuntarily. Diagnoses were: substance use disorder 31.6%; serious mental disorder 49.5%; common mental disorder 7%; comorbid 7%; other 4.9%. In addition to daily psychiatric consultations, two-thirds received individual counselling or group therapy; half received lab tests or scans; and 16.2% received ECT. Most took a psychiatric medicine. Half of those on antipsychotics were given only brands. Insurance paid in full for 28.8% of patients. Mean length of stay was 11.8 days and, in 12 months, 16.7 days (median 10.6). 22.2% were readmitted within 12 months. Patients with PHI stayed 36% longer than those paying out-of-pocket and had 2.5 times higher odds of readmission. Mean annual charge per patient was Int$ 4,262 (median Int$ 2,821). Insurers were charged 71% more than those paying out-of-pocket--driven by higher fees and longer stays. Chiromo delivers acute psychiatric care each year to approximately 450 people, to quality and human rights standards higher than its public counterpart, but at considerably higher cost. With more efficient delivery and wider insurance coverage, Chiromo might expand from its occupancy of 56.6% to reach a larger population in need.


Assuntos
Acesso aos Serviços de Saúde/economia , Hospitais Psiquiátricos/economia , Hospitais Psiquiátricos/estatística & dados numéricos , Pacientes Internados , Seguro/economia , Adulto , Feminino , Humanos , Quênia , Tempo de Internação/economia , Masculino , Readmissão do Paciente/economia , Análise de Regressão
4.
Int J Environ Res Public Health ; 9(5): 1748-56, 2012 05.
Artigo em Inglês | MEDLINE | ID: mdl-22754470

RESUMO

There have been few epidemiological surveys to establish prevalence and associated risk factors of psychosis in Sub-Saharan Africa. This paper reports a population-based epidemiological survey in rural Kenya of the prevalence of psychotic symptoms and their relationship with demographic, socio-economic and other risk factors. A random sample of 2% of all adults living in Maseno, Kisumu District of Nyanza province, Kenya (50,000 population) were studied, aiming for a sample size of 1,000 people. The psychosis screening questionnaire was used to assess the prevalence of psychotic symptoms in the preceding twelve months. The response rate was 87.6%. The prevalence of single psychotic symptoms in rural Kenya was 8% of the adult population, but only 0.6% had two symptoms and none had three or more psychotic symptoms in this sample size. Psychotic symptoms were evenly distributed across this relatively poor rural population and were significantly associated with presence of common mental disorders, and to a lesser extent with poor physical health and housing type. We conclude that single psychotic symptoms are relatively common in rural Kenya and rates are elevated in those with CMD, poor physical health and poor housing.


Assuntos
Transtornos Mentais/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
5.
Int J Environ Res Public Health ; 9(5): 1810-9, 2012 05.
Artigo em Inglês | MEDLINE | ID: mdl-22754474

RESUMO

Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. This paper reports a population-based epidemiological survey of a rural area in Kenya. A random sample of 2% of all adults living in private households in Maseno, Kisumu District of Nyanza Province, Kenya (50,000 population), were studied. The Clinical Interview Schedule-Revised (CIS-R) was used to determine the prevalence of common mental disorders (CMDs). Associations with socio-demographic and economic characteristics were explored. A CMD prevalence of 10.8% was found, with no gender difference. Higher rates of illness were found in those who were of older age and those in poor physical health. We conclude that CMDs are common in Kenya and rates are elevated among people who are older, and those in poor health.


Assuntos
Transtornos Mentais/epidemiologia , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Adulto Jovem
7.
World Psychiatry ; 9(2): 118-20, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20671901

RESUMO

Integration of mental health into primary care is essential in Kenya, where there are only 75 psychiatrists for 38 million population, of whom 21 are in the universities and 28 in private practice. A partnership between the Ministry of Health, the Kenya Psychiatric Association and the World Health Organization (WHO) Collaborating Centre, Institute of Psychiatry, Kings College London was funded by Nuffield Foundation to train 3,000 of the 5,000 primary health care staff in the public health system across Kenya, using a sustainable general health system approach. The content of training was closely aligned to the generic tasks of the health workers. The training delivery was integrated into the normal national training delivery system, and accompanied by capacity building courses for district and provincial level staff to encourage the inclusion of mental health in the district and provincial annual operational plans, and to promote the coordination and supervision of mental health services in primary care by district psychiatric nurses and district public health nurses. The project trained 41 trainers, who have so far trained 1671 primary care staff, achieving a mean change in knowledge score of 42% to 77%. Qualitative observations of subsequent clinical practice have demonstrated improvements in assessment, diagnosis, management, record keeping, medicine supply, intersectoral liaison and public education. Around 200 supervisors (psychiatrists, psychiatric nurses and district public health nurses) have also been trained. The project experience may be useful for other countries also wishing to conduct similar sustainable training and supervision programmes.

8.
Psychiatr Serv ; 61(3): 229-34, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20194398

RESUMO

This article synthesizes the views of participants in two roundtables that were convened in Nairobi (March 2007) and London (July 2008) to identify key challenges to the prioritization of mental health in Africa and possible solutions. Participants included leading development experts and policy makers from head and country offices of international donors, national directors of mental health for several African countries, key mental health and public health professionals, epidemiologists, and an international nongovernmental organization. The challenges they identified to mainstreaming mental health include lack of understanding of the contribution of mental disorders to morbidity and mortality, competition for limited resources within health reform efforts, poor distribution of interventions and lack of inclusion of mental health among core generic health indicators, lack of economic research evidence, lack of a strategic approach to human resources planning, lack of partnerships with the social development sector, and mental health professionals' need for public health skills to effectively conduct national advocacy. Potential solutions include further investment in economic research, better strategic identification of the levers and entry points for integrating mental health into health sector reform plans, more vigorous engagement of mental health professionals in general health sector reforms, strengthening the linkage between mental health and social development, and intensive resource mobilization. In summary, partnerships, underpinned by collaborative training, research, and mutual dialogue with other health and nonhealth sectors, are needed.


Assuntos
Prioridades em Saúde , Saúde Mental , África ao Sul do Saara , Processos Grupais , Acesso aos Serviços de Saúde , Humanos
9.
Ment Health Fam Med ; 7(1): 37-47, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22477921

RESUMO

Integration of mental health into primary care is essential to meet population needs yet faces many challenges if such projects are to achieve impact and be sustainable in low income countries alongside other competing priorities. This paper describes the rationale and progress of a collaborative project in Kenya to train primary care and community health workers about mental health and integrate mental health into their routine work, Within a health systems strengthening approach. So far 1877 health workers have been trained. The paper describes the multiple challenges faced by the project, and reviews the mechanisms deployed which have strengthened its impact and sustainability to date.

10.
Curr Opin Psychiatry ; 22(5): 457-61, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19561504

RESUMO

PURPOSE OF REVIEW: To establish the nature of publications emanating from or relating to intellectual disability in Africa in the previous 12-18 months, and to critically analyse the nature and content of any new knowledge arising from them. RECENT FINDINGS: Three papers satisfied the criteria set, one from Nigeria on epilepsy and intellectual disability, the other two were from South Africa. Kromberg's paper puts intellectual disability in context for South Africa, emphasizing the role potentially played by traditional healers. Pillay's paper tackles emerging issues in the psycholegal arena in South Africa, many of which are relevant to the rest of the continent. SUMMARY: Of the many challenges facing persons with intellectual disability in Africa, high prevalence, discrimination, and access to justice and education are key considerations, in all countries, and without exception are coupled with poor resource allocation. The challenges posed by HIV, wars and internal displacement are significant and demand examination by researchers. Opportunities for beneficial research exist between Africa and the centres of academic excellence around the rest of the world. Those centres with the skill and will to collaborate with Africa will be handsomely rewarded by the wide scope of challenges in intellectual disability that are available for scientific enquiry. Opportunities for skills transfer are many and available.


Assuntos
Política de Saúde , Acesso aos Serviços de Saúde/tendências , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/reabilitação , Serviços de Saúde Mental/organização & administração , Adulto , África/epidemiologia , Criança , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Deficiência Intelectual/etiologia , Pesquisa/tendências
11.
World Psychiatry ; 8(2): 95-6, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19516933
13.
Int Psychiatry ; 5(2): 46-48, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31507940

RESUMO

The prevalence of psychiatric morbidity among rural and urban Kenyan primary care attenders has been reported to be as high as 63% (Ndetei & Muhangi, 1979; Dhapdale & Ellison, 1983; Dhapdale et al, 1989; Sebit, 1996). For its population of 32 million, Kenya has only 16 psychiatrists and 200-300 psychiatric nurses, but there are just over 2000 primary healthcare centres, staffed by general nurses and clinical officers, and the main burden for assessing and caring for people with mental disorders falls upon members of the primary care teams. However, mental disorders are poorly recognised (Dhapdale & Ellison, 1983) and inadequately treated in primary care (Muluka & Dhapdale, 1986). Moreover, Kenyan primary care workers often lack training in mental health (Dhapdale et al, 1989; see also Ndetei, this issue, p. 31).

15.
Int Psychiatry ; 4(1): 3-4, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31507871

RESUMO

Nearly all low-income countries are either just themselves emerging from conflict or neighbour a country that has just emerged from one. According to the Office of the United Nations High Commissioner for Refugees (http://www.unhcr.org), of the 38 million uprooted people in 2003 worldwide, Africa played host to 13 million internally displaced persons and 3.5 million refugees.

16.
World Psychiatry ; 6(3): 166-7, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18188441
17.
World Psychiatry ; 5(2): 97, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16946948
18.
World Psychiatry ; 5(1): 38-9, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16757994
19.
J Clin Psychiatry ; 67 Suppl 2: 56-63, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16602817

RESUMO

Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.


Assuntos
Centros Comunitários de Saúde Mental/organização & administração , Desastres/estatística & dados numéricos , Socorro em Desastres/organização & administração , Transtornos de Estresse Pós-Traumáticos/reabilitação , Planejamento em Desastres , Explosões/estatística & dados numéricos , Educação em Saúde/métodos , Humanos , Quênia/epidemiologia , Meios de Comunicação de Massa/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Terrorismo/psicologia , Terrorismo/estatística & dados numéricos , Venezuela/epidemiologia
20.
J Clin Psychiatry ; 67 Suppl 2: 74-9, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16602819

RESUMO

The Asian tsunami on December 26, 2004, has had a profound impact on the mental health of large numbers of people in several South Asian nations. Many psychological interventions with relevance to this disaster have been shown to be effective in a Western context. For these psychological interventions to prove effective in the tsunami-affected regions, they must be understood and accepted by health-care practitioners and patients in their individual cultural settings and must be adapted to these settings on the basis of careful dialogue between health-care professionals, community and religious leaders, and patients. Religious, socioeconomic, and other cultural influences all affect the acceptability and success of various psychological assessment and treatment tools. The cultural specificity of these tools needs careful validation in the tsunami-affected countries. The challenge in each local situation is to find the optimal means of adapting tools such as cognitive-behavioral therapy into appropriate strategies for local communities. We advocate a culturally sensitive approach to ensure that the impact of interventions is optimized to benefit the communities recovering from such a traumatic disaster.


Assuntos
Características Culturais , Atenção à Saúde/organização & administração , Planejamento em Desastres/organização & administração , Desastres , Socorro em Desastres/organização & administração , Transtornos de Estresse Pós-Traumáticos/reabilitação , Ásia/epidemiologia , Terapia Cognitivo-Comportamental/métodos , Serviços Comunitários de Saúde Mental/organização & administração , Desastres/estatística & dados numéricos , Humanos , Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...