Detection and treatment initiation for depression and alcohol use disorders: facility-based cross-sectional studies in five low-income and middle-income country districts.
Detection and treatment initiation for depression and alcohol use disorders: facility-based cross-sectional studies in five low-income and middle-income country districts.
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DOI：
10.1136/bmjopen-2018-023421
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发表时间：
2018-10-10
期刊：
影响因子：
2.9
通讯作者：
Shidhaye R
中科院分区：
文献类型：
--
作者：
Rathod SD;Roberts T;Medhin G;Murhar V;Samudre S;Luitel NP;Selohilwe O;Ssebunnya J;Jordans MJD;Bhana A;Petersen I;Kigozi F;Nakku J;Lund C;Fekadu A;Shidhaye R
旨在估计低收入和中等收入国家 (LMIC) 中经临床检测并开始治疗抑郁症和酒精使用障碍 (AUD) 的成人初级保健门诊患者的比例。五项横断面研究。埃塞俄比亚索多区36个初级医疗机构的成人门诊服务（9个机构）；印度 Sehore 区 (3)；尼泊尔奇特旺区 (8)； Kenneth Kaunda 博士 南非区 (3)；和乌干达卡穆利区（13）。每个地区有 760 至 1893 名成年人接受了筛查。在五个地区，4.2% 至 20.1% 的抑郁症筛查呈阳性，1.2% 至 16.4% 的 AUD 筛查呈阳性。 96% 的筛查结果呈阳性的参与者提供了当天临床咨询的详细信息。抑郁症检测、抑郁症治疗开始、AUD 检测和 AUD 开始治疗。在抑郁症筛查呈阳性的参与者中，抑郁症的临床检出率从印度的 0% 到尼泊尔的 11.7%。一小部分筛查呈阳性的参与者接受了治疗（埃塞俄比亚、印度和南非为 0%，乌干达为 4.2%）。在 AUD 筛查呈阳性的参与者中，AUD 的临床检出率从埃塞俄比亚和印度的 0% 到尼泊尔的 7.8%。除尼泊尔为 2.2% 外，所有国家的治疗率为 0%。这项研究的结果表明，成人初级保健患者的检测和治疗差距很大，这可能是造成中低收入国家人口层面心理健康治疗差距的原因。初级保健设施在减少中低收入国家人群疾病负担方面仍未实现干预点。
To estimate the proportion of adult primary care outpatients who are clinically detected and initiate treatment for depression and alcohol use disorder (AUD) in low-income and middle-income country (LMIC) settings. Five cross-sectional studies. Adult outpatient services in 36 primary healthcare facilities in Sodo District, Ethiopia (9 facilities); Sehore District, India (3); Chitwan District, Nepal (8); Dr Kenneth Kaunda District, South Africa (3); and Kamuli District, Uganda (13). Between 760 and 1893 adults were screened in each district. Across five districts, between 4.2% and 20.1% screened positive for depression and between 1.2% and 16.4% screened positive for AUD. 96% of screen-positive participants provided details about their clinical consultations that day. Detection of depression, treatment initiation for depression, detection of AUD and treatment initiation for AUD. Among depression screen-positive participants, clinical detection of depression ranged from 0% in India to 11.7% in Nepal. Small proportions of screen-positive participants received treatment (0% in Ethiopia, India and South Africa to 4.2% in Uganda). Among AUD screen-positive participants, clinical detection of AUD ranged from 0% in Ethiopia and India to 7.8% in Nepal. Treatment was 0% in all countries aside Nepal, where it was 2.2%. The findings of this study suggest large detection and treatment gaps for adult primary care patients, which are likely contributors to the population-level mental health treatment gap in LMIC. Primary care facilities remain unfulfilled intervention points for reducing the population-level burden of disease in LMIC.
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DOI：
10.1017/gmh.2016.14
发表时间：
2016
期刊：
Global mental health (Cambridge, England)
影响因子：
--
作者：
Nakku JEM;Rathod SD;Kizza D;Breuer E;Mutyaba K;Baron EC;Ssebunnya J;Kigozi F
通讯作者：
Kigozi F
影响因子：
15.8
作者：
Dua T;Barbui C;Clark N;Fleischmann A;Poznyak V;van Ommeren M;Yasamy MT;Ayuso-Mateos JL;Birbeck GL;Drummond C;Freeman M;Giannakopoulos P;Levav I;Obot IS;Omigbodun O;Patel V;Phillips M;Prince M;Rahimi-Movaghar A;Rahman A;Sander JW;Saunders JB;Servili C;Rangaswamy T;Unützer J;Ventevogel P;Vijayakumar L;Thornicroft G;Saxena S
通讯作者：
Saxena S
影响因子：
4.4
作者：
Kohrt, Brandon A.;Luitel, Nagendra P.;Jordans, Mark J. D.
通讯作者：
Jordans, Mark J. D.
影响因子：
6.9
作者：
Patel, V.;Araya, R.;Weiss, H. A.
通讯作者：
Weiss, H. A.
影响因子：
2.8
作者：
Hutton, Catherine;Gunn, Jane
通讯作者：
Gunn, Jane