Prevalence and presentation of depressive illness in a primary health care setting in Kenya

Dhadphale, M; Cooper, G. D.; Cartwright-Taylor, Lesley

doi:10.1176/ajp.146.5.659

Cited by 16 publications

(3 citation statements)

References 14 publications

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“…The overall collaborative programme of work included a detailed situation appraisal of context, needs, resources, provision and outcomes using the mental health country profile [13,14,15], a focus group study of sixty traditional healers in Maseno, exploring their views of mental illness, aetiology and treatment [16], a study of attitudes of primary care staff about mental illness [17]; previous surveys of primary care [18]; adaptation of the WHO primary care guidelines for Kenya, and development of mental health policy and strategy [19]. This epidemiological survey is important to provide a baseline of mental health needs in the country.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

Jenkins

Njenga²,

Okonji

et al. 2012

IJERPH

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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.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

Jenkins

Njenga²,

Okonji

et al. 2012

IJERPH

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“…Reported prevalence rates of mental disorders range from 26% to 63% in district hospitals [14-16]; 20% [17] to 46% [18] in health centres; and 11% in the community [19]. …”

Section: Introductionmentioning

confidence: 99%

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Jenkins¹,

Othieno

Okeyo

et al. 2013

Int J Ment Health Syst

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Trial designA pragmatic cluster randomised controlled trial.MethodsParticipants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment.ResultsNumbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified.ConclusionThe training programme did not result in significantly improved recorded diagnostic rates of mental disorders in the routine clinic consultation register, but did have significant effects on patient outcomes in routine clinical practice.Trial registrationInternational Standard Randomised Controlled Trial Number Register ISRCTN53515024.

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“…At present, neither the prevalence nor the typical presentation of depression in Kenya is well-established. Depressed patients in African countries frequently present with somatic symptoms, perhaps because they believe it is the language the health care provider will understand, but can usually express their distress in psychological or emotional terms when asked in straightforward colloquial terms (Dhadphale, Cooper, & Cartwright-Taylor, 1989; Okello & Neema, 2007; Patel, 2001; Patel, Abas, Broadhead, Todd, & Reeler, 2001). A recent cross-sectional study of patients in general medical facilities in the Nairobi area found that although only 4.1% of patients were diagnosed with any form of mental disorder, 42% had symptoms of depression (Ndetei et al, 2009).…”

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confidence: 99%

Detecting Depression in Rural Primary Care Clinics in Central Kenya: Impact of a Brief Training Intervention

Alexander

Arnkoff

Glass

et al. 2013

International Perspectives in Psychology

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In developing countries, with minimal resources devoted to mental health, detection and treatment of mental illness necessarily falls to primary care providers, yet research has rarely focused on the experiences of private practitioners, especially in rural areas. This mixed-methods study investigated the diagnosis and treatment of depression by rural Kenyan primary care providers and assessed the impact of a brief training intervention on their comfort level and competence in recognizing depression. Participants were 44 providers practicing in private clinics in rural Kenya randomly assigned to intervention and wait-list control groups. Both groups completed pretest questionnaires eliciting diagnostic hypotheses based on live vignettes. The intervention group received brief training about screening for depression. Two months later, 23 participants returned to complete posttest questionnaires. Results demonstrated that brief training about depression and access to diagnostic instruments increased providers' comfort level with diagnosing depression; treatment preferences and barriers to care were also identified.

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Prevalence and presentation of depressive illness in a primary health care setting in Kenya

Cited by 16 publications

References 14 publications

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

Prevalence of Common Mental Disorders in a Rural District of Kenya, and Socio-Demographic Risk Factors

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Detecting Depression in Rural Primary Care Clinics in Central Kenya: Impact of a Brief Training Intervention

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