Treatment Contact Coverage for Probable Depressive and Probable Alcohol Use Disorders in Four Low- and Middle-Income Country Districts: The PRIME Cross-Sectional Community Surveys
Treatment Contact Coverage for Probable Depressive and Probable Alcohol Use Disorders in Four Low- and Middle-Income Country Districts: The PRIME Cross-Sectional Community Surveys
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DOI：
10.1371/journal.pone.0162038
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发表时间：
2016-09-15
期刊：
影响因子：
3.7
通讯作者：
Lund, Crick
中科院分区：
文献类型：
--
作者：
Rathod, Sujit D.;De Silva, Mary J.;Lund, Crick
一个强大的证据基础正在出现，表明在低收入和中等收入国家（LMIC）提供的抑郁症和酒精使用障碍（AUD）治疗可能是有效的。然而，在大多数LMIC settings.Objective.Objectives描述重复横断面调查的方法，以确定可能的抑郁症和可能的AUD在四个LMIC地区的治疗接触覆盖率的变化，并提出关于治疗接触覆盖率的基线调查结果。其中包括经验证的筛查工具，以确定可能的病例。我们将接触覆盖率定义为过去12个月内寻求专业帮助的病例比例。和Kamuli区，乌干达，2013年5月至2014年5月期间居住在这些地区的8036名成年人主要结果测量治疗接触覆盖率定义为寻求专科医生，通才，或其他卫生保健提供者的抑郁症或AUD的症状。ResultsThe抑郁症筛查阳性的成年人在过去12个月的比例从尼泊尔的11.2%到印度的29.7%不等，在过去12个月的治疗接触覆盖率从尼泊尔的8.1%到印度的23.5%不等。在埃塞俄比亚，终身接触可能抑郁症的覆盖率为23.7%。过去12个月AUD筛查阳性的成年人比例从乌干达的1.7%到埃塞俄比亚的13.9%不等，过去12个月的治疗接触覆盖率从印度的2.8%到尼泊尔的5.1%不等。在埃塞俄比亚，可能的AUD的终生接触覆盖率为13.1%。结论我们的研究结果与有限的证据基础一致，并有助于有限的证据基础，这表明LMIC中抑郁症和AUD的治疗接触覆盖率较低。计划的后续调查将用于估计与地区一级精神卫生保健计划的实施相吻合的接触覆盖率的变化。
ContextA robust evidence base is now emerging that indicates that treatment for depression and alcohol use disorders (AUD) delivered in low and middle-income countries (LMIC) can be effective. However, the coverage of services for these conditions in most LMIC settings remains unknown.ObjectiveTo describe the methods of a repeat cross-sectional survey to determine changes in treatment contact coverage for probable depression and for probable AUD in four LMIC districts, and to present the baseline findings regarding treatment contact coverage.MethodsPopulation-based cross-sectional surveys with structured questionnaires, which included validated screening tools to identify probable cases. We defined contact coverage as being the proportion of cases who sought professional help in the past 12 months.SettingSodo District, Ethiopia; Sehore District, India; Chitwan District, Nepal; and Kamuli District, UgandaParticipants8036 adults residing in these districts between May 2013 and May 2014Main Outcome MeasuresTreatment contact coverage was defined as having sought care from a specialist, generalist, or other health care provider for symptoms related to depression or AUD.ResultsThe proportion of adults who screened positive for depression over the past 12 months ranged from 11.2% in Nepal to 29.7% in India and treatment contact coverage over the past 12 months ranged between 8.1% in Nepal to 23.5% in India. In Ethiopia, lifetime contact coverage for probable depression was 23.7%. The proportion of adults who screened positive for AUD over the past 12 months ranged from 1.7% in Uganda to 13.9% in Ethiopia and treatment contact coverage over the past 12 months ranged from 2.8% in India to 5.1% in Nepal. In Ethiopia, lifetime contact coverage for probable AUD was 13.1%.ConclusionsOur findings are consistent with and contribute to the limited evidence base which indicates low treatment contact coverage for depression and for AUD in LMIC. The planned follow up surveys will be used to estimate the change in contact coverage coinciding with the implementation of district-level mental health care plans.