Seizure disorder, mental retardation and psychoses are more prevalent in rural than urban areas in Mozambique. There is an urgent requirement for advocacy to enhance understanding of mental disorders, as well as investment in mental-health services in rural areas which can work together with traditional medical practitioners, according to an article in The Lancet, this week’s edition.
Dr Vikram Patel and Dr Helen Weiss, London School of Hygiene and Tropical Medicine, UK, and team looked at 2,739 households in Mozambique – 943 in Cuamba (a rural town) and 1,796 in Maputo City. In each household, one person was asked to identify any members of his/her household who had symptoms of mental retardation, psychosis and seizure disorder – they were also asked to identify the causes of the disorders, what treatment the person was currently receiving, and the person’s current state.
Prevalence was shown to be higher in rural settings, compared to urban settings, said the researchers:
Urban Areas
— Prevalence of psychoses – 1•6%
— Prevalence of mental retardation – 1•3 %
— Prevalence of seizure disorders – 1•6%
Rural Areas
— Prevalence of psychoses – 4•4%
— Prevalence of mental retardation – 1•9%
— Prevalence of seizure disorders – 4•0%
When asked what they thought had caused the psychoses, the most common answer household informants gave was supernatural causes. Approximately three-quarters of cases managed to consult a traditional practitioner. The researchers also found that approximately half of all the people with these disorders suffered from poor general health.
“These findings imply that mental-health policies in sub-Saharan Africa should focus on advocacy activities to raise awareness about severe mental and neurological disorders; investment in mental-health resources in community care settings, especially in rural areas; and close co-operation with traditional medical practitioners to promote recognition and appropriate management of people with severe mental and neurological disorders,” the authors concluded.
“The results of this study should provide authorities in Mozambique, at whose behest the study was done, with a basis for planning health services…epidemiological and health-services research to determine the burden of mental illness are urgently needed in developing countries. The integration of mental health services into primary-care systems might be the only way to cope with that burden worldwide,”wrote Dr Julio Arboleda-Flórez, Ontario, Canada, in an accompanying Comment.
Written by: Christian Nordqvist