Living with psychosis in West and Southeast Africa: SUCCEED Africa's four-country situation analysis.

As part of the formative work of the SUCCEED Africa consortium, we followed a participatory process to identify existing gaps and resources needed for the development and implementation of a rights-based intervention for people with lived experience of psychosis in Malawi, Nigeria, Sierra Leone and Zimbabwe. In 2021, we conducted a desk review of published and grey literature on psychosis in the four SUCCEED countries. Using an adapted version of the PRIME situation analysis template, data were extracted across the five domains of the WHO Community-Based Rehabilitation (CBR) Matrix: health, education, livelihoods, social and empowerment.

Attitudes toward scale-up of an Intensive Combination Approach to Rollback the Epidemic in Nigerian adolescents (iCARE) intervention for youth in Nigeria: results of a mixed methods early-implementation study.

Background: Youth living with HIV (YLH) are disproportionately impacted by HIV with poor outcomes along the entire HIV care continuum. In a 2020-2022 pilot study, iCARE Nigeria, successfully tested a combination intervention incorporating mobile health technology and peer navigation to: 1) improve testing and linkage to HIV care for young men, especially young men who have sex with men (YMSM) and 2) improve medication adherence and treatment outcomes for YLH. The intervention was scaled up to 5 sites in 3 Nigerian cities.

Prevalence, Patterns and Correlates of Child and Adolescent Mental Disorders in Kumasi, Ghana: An Urban Community-Based Survey.

This study examined the prevalence and correlates of mental disorders among youth in Kumasi, Ghana, through a community-based cross-sectional survey. 672 urban participants aged 6-17 years were surveyed. Mental disorders were screened using Rutter's A2 Scale for Parent Assessment of Child Behaviour, with diagnoses confirmed by the Kiddie-Schedule for Affective Disorders and Schizophrenia.

A Stepped-Wedge, Cluster-Randomized, Multisite Study of Text Messaging Plus Peer Navigation to Improve Adherence and Viral Suppression Among Youth on Antiretroviral Therapy.

Background: To address the need for improved virologic suppression among youth living with HIV (YLH) on antiretroviral treatment (ART), we evaluated peer navigation plus TXTXT daily text message ART reminders.

Setting: YLH aged 15-24 years on ART for at least 3 months at 6 research sites in 4 Nigerian cities.

Methods: Using a stepped-wedge design, cluster 1 was nonrandomized, whereas clusters 2 and 3 were randomized to sequences of routine care (control period) and 48 weeks of the combination intervention (intervention period).

Debate: How much should nonspecialists be involved in mental health care when resources are limited? A perspective from low- and middle-income countries.

Millions of children and young people (CYP) in low- and middle-income countries (LMICs) have no access to mental health care. This huge treatment gap is primarily due to limited availability of trained mental health professionals. We propose task-sharing as a scalable strategy to expand access to child and adolescent mental health (CAMH) interventions in LMICs.

Effective community entry: reflections on community engagement in culturally sensitive research in southwestern Nigeria.

Effective community entry processes influence community participation and acceptance of public health interventions. Though there is a growing body of literature on the importance of community partnerships, there is a lack of pragmatic and practical documentation of the experiences involved in the community entry process as it relates to culturally sensitive topics such as child marriage which can help to support researchers working in this field. This article highlights key themes related to knowledge of the community, effective communication, cultural sensitivity, coproduction and giving feedback which help to build trust between the community members and the research team.

Making cities mental health friendly for adolescents and young adults.

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories.

Identifying potential catalysts to accelerate the achievement of Sustainable Development Goals (SDGs) among adolescents living in Nigeria.

Investing in adolescents in Africa holds great promise for the development of the continent. The steps involved in identifying factors linked to interventions that may accelerate the attainment of multiple SDGs for adolescents in Nigeria are described. Data from a survey to investigate the well-being of 1800 adolescents aged 10-19 years in Southwest Nigeria was analysed.

A postgraduate training programme in child and adolescent mental health in a lower-middle-income country: a partnership model from Nigeria.

This paper describes a postgraduate training programme in child and adolescent mental health (CAMH) in Nigeria. It explains the background, curriculum development, teaching, evaluation and outcomes. By its 10th year the programme had trained 166 CAMH professionals from 14 African countries.

Successful Implementation Strategies in iCARE Nigeria-A Pilot Intervention with Text Message Reminders and Peer Navigation for Youth Living with HIV.

To address poor outcomes among adolescents and young adults living with HIV (AYA-HIV), iCARE Nigeria successfully piloted two-way text message antiretroviral therapy (ART) reminders together with peer navigation. Study participants had significant improvement in ART adherence and viral suppression at 48 weeks. Understanding facto of this intervention.

Mixed methods implementation research to understand success of intensive combination approach to roll back the epidemic in Nigerian adolescents) (iCARE Nigeria) HIV testing uptake and linkage to care among young men focusing on young men who have sex with men in Ibadan.

Background: HIV seroprevalence in Nigeria is increasing among men who have sex with men (MSM) from 14% to 2007 to 23% in 2014, threatening progress towards ending the epidemic in the country. Expanding access to HIV testing and linkage to care for key populations, like young MSM (YMSM), is critical to end the HIV epidemic in Nigeria. The Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents (iCARE Nigeria) pilot intervention successfully implemented a combination of evidence-based interventions utilizing peer navigators and popular social media apps and platforms to reach young men at risk for HIV exposure, including YMSM.

A randomized stepped wedge trial of an intensive combination approach to roll back the HIV epidemic in Nigerian adolescents: iCARE Nigeria treatment support protocol.

Background: Nigeria is one of six countries with half the global burden of youth living with HIV. Interventions to date have been inadequate as AIDS-related deaths in Nigeria's youth have remained unchanged in recent years. The iCARE Nigeria HIV treatment support intervention, a combination of peer navigation and SMS text message medication reminders to promote viral suppression, demonstrated initial efficacy and feasibility in a pilot trial among youth living with HIV in Nigeria.

Lessons of Hope and Resilience: A Co-Produced Qualitative Study of the Experiences of Youth Living with Psychosis During the COVID-19 Pandemic in Nigeria.

Much of the emerging evidence on the impact of COVID-19 on people with psychosocial disabilities comes from high-income countries. This study sought to explore the perceptions and experiences of youths living with psychosis during the COVID-19 pandemic in Nigeria. Using a co-produced research process, a facility-based study was conducted among youth with confirmed diagnosis of a psychotic disorder.

A protocol for a controlled, pre-post intervention study to change attitudes toward child marriage in Southwestern Nigeria using targeted radio programming.

Background: Child marriage hinders progress toward population health and development goals. Cost effective interventions that address the root causes of child marriage are needed to speed progress toward ending the practice. Nigeria is home to the largest number of married girls in Africa and many of these girls are members of the Hausa ethnic group, making efforts to tackle this issue particularly urgent among this population.

Reprioritising global mental health: psychoses in sub-Saharan Africa.

Arthur Kleinman's 2009 Lancet commentary described global mental health as a "moral failure of humanity", asserting that priorities should be based not on the epidemiological and utilitarian economic arguments that tend to favour common mental health conditions like mild to moderate depression and anxiety, but rather on the human rights of those in the most vulnerable situations and the suffering that they experience. Yet more than a decade later, people with severe mental health conditions like psychoses are still being left behind. Here, we add to Kleinman's appeal a critical review of the literature on psychoses in sub-Saharan Africa, highlighting contradictions between local evidence and global narratives surrounding the burden of disease, the outcomes of schizophrenia, and the economic costs of mental health conditions.

Transforming access to care for serious mental disorders in slums (the TRANSFORM Project): rationale, design and protocol.

This paper introduces the TRANSFORM project, which aims to improve access to mental health services for people with serious and enduring mental disorders (SMDs - psychotic disorders and severe mood disorders, often with co-occurring substance misuse) living in urban slums in Dhaka (Bangladesh) and Ibadan (Nigeria). People living in slum communities have high rates of SMDs, limited access to mental health services and conditions of chronic hardship. Help is commonly sought from faith-based and traditional healers, but people with SMDs require medical treatment, support and follow-up.

Accelerating progress towards the sustainable development goals for adolescents in Ghana: a cross-sectional study.

Since the adoption of the sustainable development goals (SDGs) by the United Nations (UN), the search has been on to identify interventions that have effects on multiple SDG-targets simultaneously. Like other developing countries, Ghana has a youthful population and would require creative, urgent, youth-focused interventions to be able to attain the SDGs by 2030. This paper describes the application of the accelerator model on data from a sample of Ghanaian adolescents to identify potential accelerators towards selected SDG targets involving youth.

From surviving to thriving: integrating mental health care into HIV, community, and family services for adolescents living with HIV.

Adolescents are a crucial generation, with the potential to bring future social and economic success for themselves and their countries. More than 90% of adolescents living with HIV reside in sub-Saharan Africa, where their mental health is set against a background of poverty, familial stress, service gaps, and an HIV epidemic that is now intertwined with the COVID-19 pandemic. In this Series paper, we review systematic reviews, randomised trials, and cohort studies of adolescents living with and affected by HIV.

Evaluation of the iCARE Nigeria Pilot Intervention Using Social Media and Peer Navigation to Promote HIV Testing and Linkage to Care Among High-Risk Young Men: A Nonrandomized Controlled Trial.

Importance: Nigeria has the fourth-largest HIV epidemic globally, yet high levels of social stigma inhibit HIV testing among Nigerian youths and young men who have sex with men (MSM).

Objective: To report pilot data from iCARE Nigeria (Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents), a combination intervention using social media and peer navigation to promote HIV testing and linkage to care among high-risk youths and young men (hereinafter referred to as young men), including predominantly young MSM.

Design, Setting, And Participants: This nonrandomized controlled study assessed an organizational and community-level 12-month, preintervention-postintervention pilot trial of a combination intervention designed to increase HIV testing uptake, increase the rate of identified seropositive cases, and improve linkage to care among young men, including MSM, using social media outreach and peer navigation.

Escaping social rejection, gaining total capital: the complex psychological experience of female genital mutilation/cutting (FGM/C) among the Izzi in Southeast Nigeria.

Background: While the deleterious effects of FGM/C on physical health are well documented, the psychological experience of this harmful practice is a neglected area of research, which limits global mental health actions. As FGM/C was a traditional practice in some areas of Nigeria, the study aimed to understand the psychological experience of FGM/C in context.

Methods: This qualitative study was completed in urban and rural Izzi communities in Southeast Nigeria where FGM/C was widely practiced.

Adaptation of evidence-based approaches to promote HIV testing and treatment engagement among high-risk Nigerian youth.

Background: Nigeria has the second highest number of people living with HIV (PLWH) globally, and evidence-based approaches are needed to achieve national goals to identify, treat, and reduce new infections. Youth between the ages of 15-24, including young men who have sex with men (YMSM), are disproportionately impacted by the Nigerian HIV epidemic. The purpose of this study was to inform adaptation of evidence-based peer navigation and mHealth approaches (social media outreach to promote HIV testing; short messaging service text message reminders to promote HIV treatment engagement) to the local context within iCARE Nigeria, a multi-phase study designed to investigate combination interventions to promote HIV testing and care engagement among youth in Nigeria.

A controlled trial of Cognitive Behavioural Therapy-based strategies for insomnia among in-school adolescents in southern Nigeria.

Background: Sleep difficulties are highly prevalent among adolescents, and are associated with significant impairments. The effectiveness and acceptability of Cognitive Behavioural Therapy-based (CBT-based) treatment for insomnia in adolescents is established for High Income Countries, but unknown for African settings. Thus, the aim of this study was to assess the effect of CBT-based intervention among in-school adolescents with sleep difficulties in Southern Nigeria.

Effect of Text Messaging Plus Peer Navigation on Viral Suppression Among Youth With HIV in the iCARE Nigeria Pilot Study.

Background: Consistent with the global trend, youth with HIV (YWH) in Nigeria have high rates of viral nonsuppression. Hence, novel interventions are needed.

Setting: Infectious Diseases Institute, College of Medicine, University of Ibadan, Nigeria.

Effect of a Brief Supportive and Educational Intervention on the Psychological Well-Being of Mothers with Babies in Neonatal Wards of a Tertiary Hospital in Ibadan, Nigeria.

Objective: To assess the effect of a supportive educational intervention on the psychological wellbeing of mothers whose babies were admitted to Neonatal Care Unit (NCU) in Nigeria.

Methods: Controlled trial involving 41 mothers whose babies were consecutively admitted into two NCUs (21 in the intervention group and 19 controls). The intervention group received two group-based sessions which included psychological coping strategies, and familiarity with NCU environment, equipment, personnel and procedures.