Table 3 Treatment gaps by diagnosis—estimated treatment gaps (proportion of untreated disease) by diagnosis category for epilepsy/seizures, substance use, psychosis, and depression, based on estimated prevalence data extrapolated from other studies
MHU, district | Region/district population | Diagnosis | No. patients treated with diagnosis | Reference data used to estimate expected prevalence | Est. no. people with diagnosis in district | Coverage (no. seen/no. with diagnosis, %) | Treatment gap (100-Coverage) | ||
|---|---|---|---|---|---|---|---|---|---|
Author, date | Study type | Prevalence | |||||||
All | 7,396,000 | Epilepsy/seizures | 426 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 105,762.8 | 0.40 | 99.6 |
Alcohol and other substance use disorder | 83 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 38,459.2 | 0.22 | 99.8 | ||
Intellectual disability | 30 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 73,960 | 0.04 | 100.0 | ||
Psychotic disorder (including mania) | 171 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 84,314.4 | 0.20 | 99.8 | ||
Moderate-severe emotional disorder/depression | 84 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 271,433.2 | 0.03 | 100.0 | ||
34 Military Hosp., Western Ar. Urban | 1,055,964 | Epilepsy/seizures | 0 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 15,100.3 | 0.00 | 100.0 |
Alcohol and other substance use disorder | 29 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 5491.0 | 0.53 | 99.5 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 10,559.6 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 15 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 12,038.0 | 0.12 | 99.9 | ||
Moderate-severe emotional disorder/depression | 7 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 38,753.9 | 0.02 | 100.0 | ||
Total | 51 | Â | Â | Â | 81,942.8 | 0.06 | 99.9 | ||
Bo Gov. Hosp., Bo | 575,478 | Epilepsy/seizures | 315 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 8229.3 | 3.83 | 96.2 |
Alcohol and other substance use disorder | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2992.5 | 0.03 | 100.0 | ||
Intellectual disability | 2 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 5754.8 | 0.03 | 100.0 | ||
Psychotic disorder (including mania) | 15 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 6560.4 | 0.23 | 99.8 | ||
Moderate-severe emotional disorder/depression | 4 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 21,120.0 | 0.02 | 100.0 | ||
Total | 337 | Â | Â | Â | 44,657.1 | 0.75 | 99.2 | ||
Bonthe Gov. Hosp., Bonthe | 200,781 | Epilepsy/seizures | 39 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 2871.2 | 1.36 | 98.6 |
Alcohol and other substance use disorder | 3 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 1044.1 | 0.29 | 99.7 | ||
Intellectual disability | 3 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 2007.8 | 0.15 | 99.9 | ||
Psychotic disorder (including mania) | 9 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 2288.9 | 0.39 | 99.6 | ||
Moderate-severe emotional disorder/depression | 5 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 7368.7 | 0.07 | 99.9 | ||
Total | 59 | Â | Â | Â | 15,580.6 | 0.38 | 99.6 | ||
Connaught Hosp., Western Ar. Urban | 1,055,964 | Epilepsy/seizures | 11 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 15,100.3 | 0.07 | 99.9 |
Alcohol and other substance use disorder | 8 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 5491.0 | 0.15 | 99.9 | ||
Intellectual disability | 11 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 10,559.6 | 0.10 | 99.9 | ||
Psychotic disorder (including mania) | 49 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 12,038.0 | 0.41 | 99.6 | ||
Moderate-severe emotional disorder/depression | 24 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 38,753.9 | 0.06 | 99.9 | ||
Total | 103 | Â | Â | Â | 81,942.8 | 0.13 | 99.9 | ||
Sierra Leone China Friendship Hosp., Western Ar. Rural | 444,270 | Epilepsy/seizures | 6 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 6353.1 | 0.09 | 99.9 |
Alcohol and other substance use disorder | 3 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2310.2 | 0.13 | 99.9 | ||
Intellectual disability | 1 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 4442.7 | 0.02 | 100.0 | ||
Psychotic disorder (including mania) | 11 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 5064.7 | 0.22 | 99.8 | ||
Moderate-severe emotional disorder/depression | 3 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 16,304.7 | 0.02 | 100.0 | ||
Total | 24 | Â | Â | Â | 34,475.4 | 0.07 | 99.9 | ||
Kambia Gov. Hosp., Kambia | 345,474 | Epilepsy/seizures | 1 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 4940.3 | 0.02 | 100.0 |
Alcohol and other substance use disorder | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 1796.5 | 0.06 | 99.9 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 3454.7 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 2 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 3938.4 | 0.05 | 99.9 | ||
Moderate-severe emotional disorder/depression | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 12,678.9 | 0.01 | 100.0 | ||
Total | 5 | Â | Â | Â | 26,808.8 | 0.02 | 100.0 | ||
Kailahun Gov. Hosp., Kailahun | 526,379 | Epilepsy/seizures | 18 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 7527.2 | 0.24 | 99.8 |
Alcohol and other substance use disorder | 23 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2737.2 | 0.84 | 99.2 | ||
Intellectual disability | 2 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 5263.8 | 0.04 | 100.0 | ||
Psychotic disorder (including mania) | 2 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 6000.7 | 0.03 | 100.0 | ||
Moderate-severe emotional disorder/depression | 5 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 19,318.1 | 0.03 | 100.0 | ||
Total | 50 | Â | Â | Â | 40,847.0 | 0.12 | 99.9 | ||
Kenema Gov. Hosp., Kenema | 609,891 | Epilepsy/seizures | 0 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 8721.4 | 0.00 | 100.0 |
Alcohol and other substance use disorder | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 3171.4 | 0.03 | 100.0 | ||
Intellectual disability | 1 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 6098.9 | 0.02 | 100.0 | ||
Psychotic disorder (including mania) | 4 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 6952.8 | 0.06 | 99.9 | ||
Moderate-severe emotional disorder/depression | 6 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 22,383.0 | 0.03 | 100.0 | ||
Total | 12 | Â | Â | Â | 47,327.5 | 0.03 | 100.0 | ||
Kabala Gov. Hosp., Koinadugu | 409,372 | Epilepsy/seizures | 4 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 5854.0 | 0.07 | 99.9 |
Alcohol and other substance use disorder | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2128.7 | 0.00 | 100.0 | ||
Intellectual disability | 3 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 4093.7 | 0.07 | 99.9 | ||
Psychotic disorder (including mania) | 26 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 4666.8 | 0.56 | 99.4 | ||
Moderate-severe emotional disorder/depression | 22 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 15,024.0 | 0.15 | 99.9 | ||
Total | 55 | Â | Â | Â | 31,767.3 | 0.17 | 99.8 | ||
Koidu Gov. Hosp., Kono | 506,100 | Epilepsy/seizures | 27 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 7237.2 | 0.37 | 99.6 |
Alcohol and other substance use disorder | 7 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2631.7 | 0.27 | 99.7 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 5061.0 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 18 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 5769.5 | 0.31 | 99.7 | ||
Moderate-severe emotional disorder/depression | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 18,573.9 | 0.00 | 100.0 | ||
Total | 52 | Â | Â | Â | 39,273.4 | 0.13 | 99.9 | ||
Makeni Gov. Hosp., Bombali | 606,544 | Epilepsy/seizures | 4 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 8673.6 | 0.05 | 100.0 |
Alcohol and other substance use disorder | 6 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 3154.0 | 0.19 | 99.8 | ||
Intellectual disability | 2 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 6065.4 | 0.03 | 100.0 | ||
Psychotic disorder (including mania) | 16 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 6914.6 | 0.23 | 99.8 | ||
Moderate-severe emotional disorder/depression | 4 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 22,260.2 | 0.02 | 100.0 | ||
Total | 32 | Â | Â | Â | 47,067.8 | 0.07 | 99.9 | ||
Moyamba Gov. Hosp., Moyamba | 318,588 | Epilepsy/seizures | 1 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 4555.8 | 0.02 | 100.0 |
Alcohol and other substance use disorder | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 1656.7 | 0.06 | 99.9 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 3185.9 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 3 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 3631.9 | 0.08 | 99.9 | ||
Moderate-severe emotional disorder/depression | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 11,692.2 | 0.01 | 100.0 | ||
Total | 6 | Â | Â | Â | 24,722.4 | 0.02 | 100.0 | ||
Ola During Children’s Hosp., Western Ar. Urban | 1,055,964 | Epilepsy/seizures | 0 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 15,100.3 | 0.00 | 100.0 |
Alcohol and other substance use disorder | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 5491.0 | 0.00 | 100.0 | ||
Intellectual disability | 5 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 10,559.6 | 0.05 | 100.0 | ||
Psychotic disorder (including mania) | 1 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 12,038.0 | 0.01 | 100.0 | ||
Moderate-severe emotional disorder/depression | 2 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 38,753.9 | 0.01 | 100.0 | ||
Total | 8 | Â | Â | Â | 81,942.8 | 0.01 | 100.0 | ||
Pujehun Gov. Hosp., Pujehun | 346,461 | Epilepsy/seizures | 0 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 4954.4 | 0.00 | 100.0 |
Alcohol and other substance use disorder | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 1801.6 | 0.00 | 100.0 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 3464.6 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 3949.7 | 0.00 | 100.0 | ||
Moderate-severe emotional disorder/depression | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 12,715.1 | 0.00 | 100.0 | ||
Total | 0 | Â | Â | Â | 26,885.4 | 0.00 | 100.0 | ||
Magburaka Gov. Hosp., Tonkolili | 531,435 | Epilepsy/seizures | 0 | Ba-Diop A et al., 2014 | Meta analysis | 0.0143 | 7599.5 | 0.00 | 100.0 |
Alcohol and other substance use disorder | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0052 | 2763.5 | 0.00 | 100.0 | ||
Intellectual disability | 0 | Alemu W et al., 2012 | 2002 Sierra Leone needs assessment post-civil war | 0.01 | 5314.4 | 0.00 | 100.0 | ||
Psychotic disorder (including mania) | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0114 | 6058.4 | 0.00 | 100.0 | ||
Moderate-severe emotional disorder/depression | 0 | Charlston FJ et al., 2014 | Estimates for West sub-Saharan Africa region | 0.0367 | 19,503.7 | 0.00 | 100.0 | ||
Total | 0 | Â | Â | Â | 41,239.4 | 0.00 | 100.0 | ||