Mental health research in Botswana: a semi-systematic scoping review.

Mental and substance use disorders are a leading cause of disability worldwide. Despite this, there is a paucity of mental health research in low- and middle-income countries, especially in sub-Saharan Africa. We carried out a semi-systematic scoping review to determine the extent of mental health research in Botswana. Using a predetermined search strategy, we searched the databases Web of Science, PubMed, and EBSCOhost (Academic Search Complete, CINAHL with Full Text, MEDLINE, MEDLINE with Full Text, MLA International Bibliography, Open Dissertations) for articles written in English from inception to June 2020. We identified 58 studies for inclusion. The most researched subject was mental health aspects of HIV/AIDS, followed by research on neurotic and stress-related disorders. Most studies were cross-sectional and the earliest published study was from 1983. The majority of the studies were carried out by researchers affiliated to the University of Botswana, followed by academic institutions in the USA. There seems to be limited mental health research in Botswana, and there is a need to increase research capacity.

Cannabis Use Disorder Among First-Year Undergraduate Students in Gaborone, Botswana.

Cannabis use disorder (CUD) poses major clinical and public health concerns globally. It is a growing problem among the youth in Botswana, yet little research has been done on this subject. The present study hoped to address this gap in knowledge by determining the prevalence and associated factors of CUD among first-year university students in Botswana. A cross-sectional study was conducted among 410 first-year university undergraduates, using a modified version of the 37-item World Health Organization (WHO) drug questionnaire and DSM-5 criteria for CUD. The mean age of the respondents was 20.8 (SD = 1.5) years, and the male to female ratio was 1:1.1. Of the 401 students whose responses were analyzed, 37(9,2%) had used cannabis at least once in the last 12 months, but only 19 (4.7%) met the DSM-5 criteria for CUD. After binary regression analysis, difficulty in coping with the new environment/academic activities, receiving more than 150 USD monthly were positively associated with CUD, while regular participation in religious activities was negatively associated. CUD was found among the first-year undergraduates studied. Promoting protective activities such as religious activities and strengthening programs that teach students how to cope with academic stress and a new environment would be helpful.

HIV Prevalence Among Hospitalized Patients at the Main Psychiatric Referral Hospital in Botswana.

We examined HIV prevalence among patients 18-49 year olds admitted to a psychiatric hospital in Botswana in 2011 and 2012. The retrospective study analyzed females (F) and males (M) separately, comparing proportions with Chi square test and continuous variables with Wilcoxon rank-sum test, assessing significance at the 5% level. HIV seroprevalence among hospitalized psychiatric patients was much more common among females (53%) compared with males (19%) (p < 0.001). These women also appeared more vulnerable to infection compared with females in the general population (29%) (p < 0.017). Among both women and men, HIV-infection appeared most common among patients with organic mental disorders (F:68%, M:41%) and neurotic, stress related and somatoform disorders (F:68%, M:42%). The largest proportion of HIV infections co-occurred among patients diagnosed with schizophrenia, schizotypal and other psychotic disorders (F:48%; M:55%), mood (affective) disorders (F:21%; M:16%) and neurotic, stress-related and somatoform disorders (F:16%; M:20%). Interventions addressing both mental health and HIV among women and men require development.

Prescribing pattern of psychotropic medications in child psychiatric practice in a mental referral hospital in Botswana.

INTRODUCTION: There is a growing preference for psycho-pharmacological therapy over non-pharmacological care. The prescription pattern and the choice of psychotropic medications vary in different settings. Whilst newer agents and rational prescribing are favored in the more specialized settings, the pattern remains unclear in less specialized units, largely due to lack of data. The aims were to conduct a treatment audit in the only mental referral hospital in Botswana, which is a non-specialized child and adolescent care setting and see how it conforms to best practice. METHODS: A retrospective audit which involved the extraction of socio-demographic and clinical information from the records of patients who were ≤ 17 years and seen from January 1, 2012-July 31, 2016. RESULTS: A total of 238 files were used for this report. Mean age (SD) was 12.41 (4.1) years. Of the 120 (50.4%) patients who had pharmacological intervention, only 85(70.8%) had monotherapy. The most commonly prescribed psychotropic agents were antipsychotics (40%). Off-label use of antipsychotics and polypharmacy were 31.2% and 29.2% respectively. CONCLUSION: The level of conformity to standard practice in terms of psychotropic prescribing in our setting is consistent with the reports from developed countries where more specialized care ostensibly exists. Further studies will be necessary to determine the scope of psychotropic use.