Author
Mwanza Banda
Bio: Mwanza Banda is an academic researcher from University of Zambia. The author has contributed to research in topics: Acquired immunodeficiency syndrome (AIDS) & Mental health. The author has an hindex of 3, co-authored 3 publications receiving 234 citations.
Papers
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TL;DR: The research programme undertakes an analysis of existing mental health policies in four African countries, and will carry out and evaluate interventions to assist in the development and implementation of mental Health policies in those countries, over a five-year period.
Abstract: The purpose of the research programme introduced in this article is to provide new knowledge regarding comprehensive multisectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme undertakes an analysis of existing mental health policies in four African countries (Ghana, South Africa, Uganda, Zambia), and will carry out and evaluate interventions to assist in the development and implementation of mental health policies in those countries, over a five-year period. The four countries in which the programme is being conducted represent a variety of scenarios in mental health policy development and implementation.
155 citations
TL;DR: Gender significantly influenced the performance on NP tests with females performing more poorly compared to males, and larger studies that will accommodate gender differences and age are necessary to generate appropriate norms in Zambia in order to better assess the prevalence of HAND in the developing country setting.
Abstract: Zambia has substantially been affected by the HIV/AIDS epidemic with prevalence rates at 14% in a population estimated at 12 million. Yet, the extent of HIV-associated neurocognitive disorders (HAND) in this population remains to be clearly understood. A series of culturally appropriate neuropsychological (NP) assessments [International HIV Dementia Scale (IHDS), Color Trails Test 1 and 2, Grooved pegboard Test, and Time Gait Test] were used to test the effects of HIV on NP performance of HIV seropositive and seronegative individuals. Twenty-two percent HIV positive individuals ARV naive met the criteria for IHDS-defined NP impairment. Gender significantly influenced the performance on NP tests with females performing more poorly compared to males. Larger studies that will accommodate gender differences and age are necessary to generate appropriate norms in Zambia in order to better assess the prevalence of HAND in the developing country setting.
48 citations
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University of North Carolina at Chapel Hill1, University of Zimbabwe2, University of California, San Diego3, Washington University in St. Louis4, Cheikh Anta Diop University5, Medical Research Council6, University of Nebraska Medical Center7, University of Yaoundé I8, Temple University9, Addis Ababa University10, University of Nebraska–Lincoln11, Johns Hopkins University12, Makerere University13, University of Missouri14, University of Cape Town15, University of California, San Francisco16, Michigan State University17, Case Western Reserve University18, Harvard University19, University of Pennsylvania20, University of Maryland, Baltimore21, National Institutes of Health22
TL;DR: In 2009, the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention was held in Cape Town, South Africa, and was affiliated with the National Institute of Mental Health (NIMH) as discussed by the authors.
Abstract: In July 2009, the Center for Mental Health Research on AIDS at the National Institute of Mental Health organized and supported the meeting “NeuroAIDS in Africa.” This meeting was held in Cape Town, South Africa, and was affiliated with the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention. Presentations began with an overview of the epidemiology of HIV in sub-Saharan Africa, the molecular epidemiology of HIV, HIV-associated neurocognitive disorders (HANDs), and HAND treatment. These introductory talks were followed by presentations on HAND research and clinical care in Botswana, Cameroon, Ethiopia, The Gambia, Kenya, Malawi, Nigeria, Senegal, South Africa, Uganda, and Zambia. Topics discussed included best practices for assessing neurocognitive disorders, patterns of central nervous system (CNS) involvement in the region, subtype-associated risk for HAND, pediatric HIV assessments and neurodevelopment, HIV-associated CNS opportunistic infections and immune reconstitution syndrome, the evolving changes in treatment implementation, and various opportunities and strategies for NeuroAIDS research and capacity building in the region.
41 citations
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TL;DR: It is argued that a basic, evidence-based package of services for core mental disorders should be scaled up, and that protection of the human rights of people with mental disorders and their families should be strengthened.
704 citations
TL;DR: It is found that the mental health effect of poverty alleviation interventions was inconclusive, although some conditional cash transfer and asset promotion programmes had mental health benefits and mental health interventions were associated with improved economic outcomes in all studies.
654 citations
TL;DR: A number of potential strategies for CAMH promotion which focus on building capacity in children and adolescents, in parents and families, in the school and health systems, and in the wider community are described, including structural interventions.
Abstract: Children and adolescents in low and middle income countries (LAMIC) constitute 35-50% of the population. Although the population in many such countries is predominantly rural, rapid urbanisation and social change is under way, with an increase in urban poverty and unemployment, which are risk factors for poor child and adolescent mental health (CAMH). There is a vast gap between CAMH needs (as measured through burden of disease estimates) and the availability of CAMH resources. The role of CAMH promotion and prevention can thus not be overestimated. However, the evidence base for affordable and effective interventions for promotion and prevention in LAMIC is limited. In this review, we briefly review the public health importance of CAM disorders in LAMIC and the specific issues related to risk and protective factors for these disorders. We describe a number of potential strategies for CAMH promotion which focus on building capacity in children and adolescents, in parents and families, in the school and health systems, and in the wider community, including structural interventions. Building capacity in CAMH must also focus on the detection and treatment of disorders for which the evidence base is somewhat stronger, and on wider public health strategies for prevention and promotion. In particular, capacity needs to be built across the health system, with particular foci on low-cost, universally available and accessible resources, and on empowerment of families and children. We also consider the role of formal teaching and training programmes, and the role for specialists in CAMH promotion.
380 citations
TL;DR: A profile of the current mental health policy, legislation and services in Uganda was provided to provide an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services.
Abstract: The Ugandan government recognizes mental health as a serious public health and development concern, and has of recent implemented a number of reforms aimed at strengthening the country's mental health system. The aim of this study was to provide a profile of the current mental health policy, legislation and services in Uganda. A survey was conducted of public sector mental health policy and legislation, and service resources and utilisation in Uganda, in the year 2005, using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS) Version 2.2. Uganda's draft mental health policy encompasses many positive reforms, including decentralization and integration of mental health services into Primary Health Care (PHC). The mental health legislation is however outdated and offensive. Services are still significantly underfunded (with only 1% of the health expenditure going to mental health), and skewed towards urban areas. Per 100,000 population, there were 1.83 beds in mental hospitals, 1.4 beds in community based psychiatric inpatient units, and 0.42 beds in forensic facilities. The total personnel working in mental health facilities were 310 (1.13 per 100,000 population). Only 0.8% of the medical doctors and 4% of the nurses had specialized in psychiatry. Although there have been important developments in Uganda's mental health policy and services, there remains a number of shortcomings, especially in terms of resources and service delivery. There is an urgent need for more research on the current burden of mental disorders and the functioning of mental health programs and services in Uganda.
233 citations
TL;DR: Prevention and treatment of HAND requires strategies aimed at suppressing CNS HIV replication and effects of systemic and CNS inflammation in aging and substance-abusing HIV populations, which must be accompanied by evaluation of potential ART neurotoxicity.
Abstract: The present review discusses current concepts of HIV-associated neurocognitive disorders (HAND) in the era of antiretroviral therapy (ART). As the HIV epidemic enters its fourth decade (the second decade of ART) research must address evolving factors in HAND pathogenesis. These include persistent systemic and central nervous system (CNS) inflammation aging in the HIV-infected brain HIV subtype (clade) distribution concomitant use of drugs of abuse and potential neurotoxicity of ART drugs. RECENT FINDINGS: Although the severest form of HAND HIV-associated dementia (HAD) is now rare due to ART the persistence of milder functionally important HAND forms persist in up to half of HIV-infected individuals. HAND prevalence may be higher in areas of Africa where different HIV subtypes predominate and ART regimens that are more effective in suppressing CNS HIV replication can improve neurological outcomes. HAND are correlated with persistent systemic and CNS inflammation and enhanced neuronal injury due to stimulant abuse (cocaine and methamphetamine) aging and possibly ART drugs themselves. SUMMARY: Prevention and treatment of HAND requires strategies aimed at suppressing CNS HIV replication and effects of systemic and CNS inflammation in aging and substance-abusing HIV populations. Use of improved CNS-penetrating ART must be accompanied by evaluation of potential ART neurotoxicity.
221 citations