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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

From: The burden of mental disorder in Sierra Leone: a retrospective observational evaluation of programmatic data from the roll out of decentralised nurse-led mental health units

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     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     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     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     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     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     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     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     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     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     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     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     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     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     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     41,239.4 0.00 100.0