Disorders In Ethiopia Research Articles

Detecting perinatal common mental disorders in Ethiopia: Validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale

Background The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries. Methods Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study ( n = 101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone ( n = 119). Results EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting ‘cases’ of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women. Limitations Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size. Conclusions EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD.

A descriptive analysis of admissions to Amanuel Psychiatric Hospital in Ethiopia

Background: The care of patients with severe mental disorder in Ethiopia remains centralized in the capital city. Objective: To assess pattern of psychiatric admission and its implication for service provision. Methods: A descriptive analysis of one-year admission data was undertaken from the only psychiatric hospital in Ethiopia. Results: The annual age-sex standardized admission rate was 4 per 100 000 (n=1564). Two-thirds of the patients came from Addis Ababa and the immediate surrounding areas. Nearly three-quarters were men, and aged 30 years or younger. Schizophrenia and bipolar disorder were the top two discharge diagnoses. The median length of hospital stay (LOS) was 63 days. Diagnosis of schizophrenia and place of residence, i.e. living outside of Addis Ababa independently predicted LOS above the median. Conclusion: Admission data demonstrated a huge mental health unmet need in Ethiopia. Providing adequate resources for modernization and well-supervised decentralization may be vital steps in the quest for accessible and equitable psychiatric care.The Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 173-178

Utility of the concept of minor depressive disorder: Evidence from a large rural community sample in a developing country setting

Background Evidence on the utility of the minor depressive disorder diagnostic construct in rural communities and developing countries is scarce. Aim To assess the utility and validity of definitive minor depressive disorder in Ethiopia by determining its impact and sociodemographic correlates. Methods Assessment of 68,378 adults, aged 15–49 years, living in a largely rural district in Ethiopia using the Composite International Diagnostic Interview. Results The lifetime prevalence of minor depressive disorder was 2.2% (95% CI = 2.1%, 2.3%). Age, marital status, education and unemployment independently predicted minor depressive disorder. Over 80% of cases used health services, 55.1% experienced persistent thoughts of death and 14.6% attempted suicide. Limitation Findings are based on lifetime estimates. Conclusions Minor depressive disorder is an important public health problem in rural Ethiopia, as shown by the associated high health service use and risk behaviour. Sociodemographic correlates suggest aetiological continuity with major depression. Thus our findings extend the clinical and public health utility of this diagnostic construct to rural community and developing country settings.

Child labor and childhood behavioral and mental health problems in Ethiopia

Background : According to ILO estimates, at least 180 million children aged 5 to 14 years are currently engaged in fulltime work in the developing countries. However, very little information exists about childhood behavioral and mental disorders in Ethiopia. Objective : The objectives of this study are to estimate the prevalence and describe the nature of behavioral and mental health problems, as well as child abuse, nutritional problems, gross physical illness and injury among child laborers aged 8 to 15 years in Ethiopia. However, only the behavioral and mental health problems of the study population are examined here. Methods : A cross-sectional survey of children aged 8 to 15 years, and who were engaged in fulltime work in different formal and informal sectors non-laborers, was conducted in four major towns of Ethiopia. The screening instrument known as Reported Questionnaire on Children (RQC) and a diagnostic instrument known as the Diagnostic Interview for Children and Adolescents ( DICA) were used to detect symptoms and signs of behavioral and mental problems in the children. br> Results : A total of 2000 child laborers and 400 non-laborers were interviewed using RQC to screen for probable cases of behavioral and mental problems. Of these, 50% of the laborers and 42% of the non-laborers were males. The mean age of the laborers was 13.8 ±1.8 years while that of the non-laborers was 12.2 ±2.1 years. More females (76.8%) were found to have been engaged in domestic labor than males. The RQC interview screened 9.4% (n=226) of the children as probable cases of mental/ behavioral disorders, (14.0% non-laborers and 8.5% laborers). The second stage DICA interview gave an overall prevalence of 5.5% (4.9% in laborers and 8.8% in non-laborers). Conclusion : The prevalence of childhood behavioral and mental disorders in this study is within the range reported in previews studies conducted on children of the same age group. However, the lower prevalence of childhood disorders in the child laborers compared to that of the non-laborers found in the current study is probably due to selection bias or healthy workers effect. Thus, further study is recommended to explain this unexpected finding. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 119-126

Beyond clannishness and colonialism: understanding political disorder in Ethiopia's Somali Region, 1991–2004

This article proposes an alternative interpretation of political disorder in Ethiopia's Somali Regional State since the rise to power of the Ethiopian People's Revolutionary Democratic Front (EPRDF) in 1991. Some observers have perceived contemporary politics in the former Ogaden as an example of ‘internal colonisation’ by highland Ethiopians. Others attribute political instability to the ‘nomadic culture’ inherent in the Somali clan structure and the ineptness of its political leaders. This study argues that neither of these two politicised narratives grasps the contradictory interactions between the federal Ethiopian government and its Somali periphery, nor the recursive relations between state and society. With reference to the literature on neo-patrimonialism, I elucidate political disorder in the Somali Region by empirically describing hybrid political domination, institutional instability, and patronage relations, showing how neo-patrimonial rule translates into contested statehood in the region and political devices ranging from military coercion to subtle co-optation. Rather than unilateral domination, a complex web of power and manipulation between parts of the federal and regional authorities animates political disorder in Ethiopia's Somali Region.

Performance evaluation of topical formulations of the crude extracts of <i>L. adoensis</i> and <i>O. rochetiana</i>

Lippia adoensis and Olinia rochetiana are traditionally used in the form of topical applications for the treatment of various skin disorders in Ethiopia. In view of their traditional uses and proven antimicrobial activities, the crude extracts of the two botanicals were incorporated into various formulation bases having different degrees of hydrophilicity and/or lipophilicity. The performances of the resulting topical formulations were then evaluated using agar well diffusion technique. The results indicated that water miscible (hydrophilic) formulations are superior in performance to water immiscible (hydrophobic) ones. The most lipophilic ointment (petrolatum ointment) showed virtually no activity indicating that the active compound(s) of the herbal drugs could not be released from this formulation. Some formulations of the herbal drugs showed relatively comparable activities with different topical antiseptic products locally available in the market. L. adoensis in sodium laurate monostearin cream base showed a zone of inhibition of 25 ± 0.9 against S. aureus, which is even better than that of gentamycin (21 ± 1.0) against the same organism. Similarly, O. rochetiana, in the same base, showed a zone of inhibition of 65 ± 2.5 against T. menthagrophytes, which is by far better than any of the topical antifungal agents tested. From among the marketed topical antifungal agents clotrimazole gave the maximum zone of inhibition (47 ± 2.5. The traditional claims attributed to these herbal drugs by the local people for the treatment of topical skin disorders is partly justified by the different degrees of antimicrobial activities exhibited by topical formulations of these botanicals against the selected strains of bacteria and fungi which are known to be common causative agents for different types of skin infections. Keywords: Lippia adoensis, Olinia rochetiana, topical formulations, performance evaluation, antimicrobial activity Ethiopian Pharmaceutical Journal, vol. 22 (2004): 15-26

Traditional treatment of mental and psychosomatic disorders in Ethiopia

In traditional Ethiopia, there are three major cultural influences that are operating: Traditional African, Coptic and Islamic. Irrespective of the religious affiliation, people share very much the same ideas on human nature and the world. Regarding mental disorders, but also many somatic disorders, the commonly shared belief is that they are caused by spirits or by other evil forces. Generally, there is no clear-cut division between physical and mental disorders and accordingly there is a clear interaction between physical and spiritual healing, for example when spiritual formulas have to be ingested or when herbal remedies have to be gathered with proper spiritual ceremonies. There are several different indigenous institutions for dealing with mentally disturbed people. In the Coptic Church, there are monks and priests that are specialized in healing practices often using holy water sites. In the traditional African context, there are different kinds of spiritual healers who are in direct contact with the spiritual world, from which they get information and directives for the treatment. In the Muslim culture, there are also spiritual leaders who are praying and preparing charms with writings on paper or skin of words of Allah, but who also practice healing with herbs and surgery.