Burns Jonathan K, Ntlantsana Vuyokazi, Mkhombo Tsatsawani, Paruk Saeeda, Thela Lindokuhle, Juby Vidette, Duba Busisiwe, Sbiya Musa, Wambua G Nduku, Naidu Thirusha, Cohen Alex, du Plessis Stefan, Hoek Hans W, Kirkbride James B, Morgan Craig, Roberts Tessa, Susser Ezra, Swartz Leslie, Tanser Frank, Tomita Andrew, Veling Wim, Chiliza Bonginkosi
University of KwaZulu-Natal, Durban, South Africa.
University of Exeter, Exeter, UK.
Soc Psychiatry Psychiatr Epidemiol. 2025 Oct 31. doi: 10.1007/s00127-025-03011-1.
Relatively little epidemiological evidence on psychosis from diverse settings in the Global South exists, where many people with untreated psychosis seek help outside of formal health service settings. Here, we report a preliminary mapping study of formal and informal community resources within a catchment area in South Africa that established an infrastructure that could be used to detect a representative sample of individuals with untreated psychosis.
PSYMAP-ZN is a 3-year study of incidence, clinical presentation and associated risk factors for untreated psychosis in Msunduzi Municipality in South Africa. We conducted a preliminary mapping study of the region in which we aimed to document all potential providers of care (gatekeepers) in both formal (health services) and informal (folk) sectors, with the purpose of enrolling them in a collaborative case surveillance system. We drew on official sources, local knowledge from key stakeholders and utilised snowballing techniques.
We established a surveillance system which included (a) all secondary mental health and primary care services (b) the majority of informal providers (including traditional health practitioners, religious institutions) and (c) a wide range of key informants.
Expanding the global knowledge base on psychosis to diverse settings in the Global South requires a surveillance and case-detection method that includes (in addition to formal health settings) informal settings and local key informant knowledge in the community. This preliminary 'mapping' process established a platform for the ongoing PSYMAP study of untreated psychosis in South Africa.
在全球南方的不同地区，关于精神病的流行病学证据相对较少，许多未治疗的精神病患者在正规医疗服务机构之外寻求帮助。在此，我们报告一项在南非一个集水区内对正规和非正规社区资源进行的初步测绘研究，该研究建立了一个可用于检测未治疗精神病患者代表性样本的基础设施。
PSYMAP-ZN是一项为期3年的关于南非姆孙杜齐市未治疗精神病的发病率、临床表现及相关危险因素的研究。我们对该地区进行了初步测绘研究，旨在记录正规（医疗服务）和非正规（民间）部门所有潜在的护理提供者（把关人），以便将他们纳入一个协作病例监测系统。我们利用了官方资料来源、关键利益相关者的当地知识，并采用了滚雪球技术。
我们建立了一个监测系统，该系统包括（a）所有二级心理健康和初级保健服务机构，（b）大多数非正规提供者（包括传统治疗师、宗教机构），以及（c）广泛的关键信息提供者。
要将关于精神病的全球知识库扩展到全球南方的不同地区，需要一种监测和病例检测方法，该方法除了包括正规医疗机构外，还应包括非正规机构以及社区中的当地关键信息提供者的知识。这个初步的“测绘”过程为正在进行的关于南非未治疗精神病的PSYMAP研究建立了一个平台。
