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Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper

Author

Listed:
  • Charlotte Hanlon
  • Tessa Roberts
  • Eleni Misganaw
  • Ashok Malla
  • Alex Cohen
  • Teshome Shibre
  • Wubalem Fekadu
  • Solomon Teferra
  • Derege Kebede
  • Adiyam Mulushoa
  • Zerihun Girma
  • Mekonnen Tsehay
  • Dessalegn Kiross
  • Crick Lund
  • Abebaw Fekadu
  • Craig Morgan
  • Atalay Alem

Abstract

Background: Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery. Methods: The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations.

Suggested Citation

  • Charlotte Hanlon & Tessa Roberts & Eleni Misganaw & Ashok Malla & Alex Cohen & Teshome Shibre & Wubalem Fekadu & Solomon Teferra & Derege Kebede & Adiyam Mulushoa & Zerihun Girma & Mekonnen Tsehay & D, 2024. "Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper," PLOS ONE, Public Library of Science, vol. 19(5), pages 1-24, May.
    • Handle: RePEc:plo:pone00:0293232
    DOI: 10.1371/journal.pone.0293232
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    References listed on IDEAS

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    1. Lauren C Ng & Anne Stevenson & Sreeja S Kalapurakkel & Charlotte Hanlon & Soraya Seedat & Boniface Harerimana & Bonginkosi Chiliza & Karestan C Koenen, 2020. "National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis," PLOS Medicine, Public Library of Science, vol. 17(5), pages 1-30, May.
    2. Wang, P.S. & Demler, O. & Kessler, R.C., 2002. "Adequacy of treatment for serious mental illness in the United States," American Journal of Public Health, American Public Health Association, vol. 92(1), pages 92-98.
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