四个低收入和中等收入国家地区可能的抑郁症和可能的酒精使用障碍的治疗接触覆盖率：PRIME横断面社区调查
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.
作者信息
Rathod Sujit D, De Silva Mary J, Ssebunnya Joshua, Breuer Erica, Murhar Vaibhav, Luitel Nagendra P, Medhin Girmay, Kigozi Fred, Shidhaye Rahul, Fekadu Abebaw, Jordans Mark, Patel Vikram, Tomlinson Mark, Lund Crick
机构信息
Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Butabika National Referral and Teaching Hospital, Makerere University, Kampala, Uganda.
出版信息
PLoS One. 2016 Sep 15;11(9):e0162038. doi: 10.1371/journal.pone.0162038. eCollection 2016.
CONTEXT
A 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.
OBJECTIVE
To 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.
METHODS
Population-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.
SETTING
Sodo District, Ethiopia; Sehore District, India; Chitwan District, Nepal; and Kamuli District, Uganda.
PARTICIPANTS
8036 adults residing in these districts between May 2013 and May 2014.
MAIN OUTCOME MEASURES
Treatment contact coverage was defined as having sought care from a specialist, generalist, or other health care provider for symptoms related to depression or AUD.
RESULTS
The 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%.
CONCLUSIONS
Our 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.
背景
目前正在形成一个有力的证据基础，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，大多数LMIC环境中这些疾病的服务覆盖范围仍然未知。
目的
描述一项重复横断面调查的方法，以确定四个LMIC地区可能患有抑郁症和可能患有AUD的治疗接触覆盖率的变化，并呈现关于治疗接触覆盖率的基线调查结果。
方法
基于人群的横断面调查，采用结构化问卷，其中包括经过验证的筛查工具以识别可能的病例。我们将接触覆盖率定义为在过去12个月内寻求专业帮助的病例比例。
地点
埃塞俄比亚的索多区；印度的塞霍尔区；尼泊尔的奇特旺区；乌干达的卡穆利区。
参与者
2013年5月至2014年5月期间居住在这些地区的8036名成年人。
主要观察指标
治疗接触覆盖率定义为因与抑郁症或AUD相关的症状而寻求专科医生、全科医生或其他医疗服务提供者的治疗。
结果
在过去12个月内筛查出抑郁症呈阳性的成年人比例在尼泊尔为11.2%，在印度为29.7%，过去12个月的治疗接触覆盖率在尼泊尔为8.1%，在印度为23.5%。在埃塞俄比亚，可能患有抑郁症的终生接触覆盖率为23.7%。在过去12个月内筛查出AUD呈阳性的成年人比例在乌干达为1.7%，在埃塞俄比亚为13.9%，过去12个月的治疗接触覆盖率在印度为2.8%，在尼泊尔为5.1%。在埃塞俄比亚，可能患有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，并为其做出了贡献，该证据基础表明LMIC中抑郁症和AUD的治疗接触覆盖率较低。计划中的后续调查将用于估计与地区级精神卫生保健计划实施相吻合的接触覆盖率变化。
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