Manasi Kumar

Institute of Excellence in Health Equity

Outcomes of psychotherapies offered at KNH and Mathare hospitals

Background As set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV...

Dementia prevention in Africa is critically underexplored, despite the continent's high prevalence of modifiable risk factors. With a predominantly young and middle‐aged population, Africa presents a prime opportunity to implement evidence‐based strategies that could significantly reduce future dementia cases and mitigate its economic impact. The m...

This Viewpoint advocates for a targeting therapeutic intervention for the amelioration of loneliness and related mental health problems.

Objectives This study investigates the prevalence of the use of reusable menstrual materials in LMICs, examines differences in prevalence between countries and areas, and identifies individual and country-level factors associated with their use. Methods Data from Multiple Indicator Cluster surveys conducted between 2017 and 2020 in LMICs were used...

Background Adolescents comprise one-sixth of the world’s population, yet there is no clear understanding of the features that promote adolescent-friendly services (AFS). The lack of clarity and consistency around a definition presents a gap in health services. Methods The review was conducted following the Preferred Reporting Items for Systematic...

Planetary health influences mental health and a better management of climate, biodiversity and pollution has co-benefits of improving mental health outcomes. The recognition and treatment of mental health, however, has been marginalized within environmental and climate change sciences and a greater understanding of the complex underlying processes...

Purpose Globally, the number of children/adolescents exposed to HIV but uninfected (HIV-exposed uninfected, HEU) is growing. The HEU outcomes: population-evaluation and screening strategies study was designed to provide population-level evidence of the impact of HIV and recent antiretroviral therapy regimen exposure on neurodevelopmental, hearing a...

Background Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-base...

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important follow...

Introduction Depression, anxiety and behavioural disorders are the leading causes of illness and disability in adolescents. This study aims to evaluate the feasibility of integrating mental health services into a youth-led community-based intervention targeting out-of-school adolescents, residing in Kariobangi and Rhonda informal settlements in Ken...

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditio...

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 health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities³. Shaping the aspe...

This article presents processes for developing contextualized training procedures to better appreciate partnership, capacity-building experiences, and specific implementation challenges and opportunities for mental and public health teams. The program enrolled 469 out-of-school adolescents to participate in the integration of youth mental health in...

Background Since the Industrial Revolution, humanity has amassed great wealth and achieved unprecedented material prosperity. These advances have come, however, at great cost to the planet. They are guided by an economic model that focuses almost exclusively on short-term gain, while ignoring natural capital and human capital. They have relied on t...

In Kenya, approximately one in five girls aged 15–19 years old are pregnant or already a mother. Adolescent girls and young women experience significant mental health vulnerabilities during the pregnancy and postpartum periods, leading to poor antenatal and postnatal care attendance and inferior infant and maternal health outcomes. Pregnant adolesc...

Background Mental and substance use disorders are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with these. In low- and middle-income countries, such as Kenya, mental health is often given low priority, and resources for the prevention and treatment of mental and substance use disorders a...

This study focuses on nursing and medical students, assessing their knowledge, attitudes , and practices (KAP) regarding food safety. This non-random cross-sectional study was conducted between October and December 2022, with 1100 students (721 nursing and 379 medical) completing self-administered questionnaires. 949 (86.3%) of the respondents were...

This Viewpoint discusses the lack of research on the impact of climate events on mental health, climate change–related inequalities in low- and middle-income countries, and the immediate need to act now.

Background: Human activities have induced unprecedented global shifts in natural systems including the climate, the oceans, cryosphere and biosphere. The impacts of these changes on physical health are clear and are accelerating at an alarming rate. Climate change and its consequences, especially disruptive events like floods, droughts and heat wa...

Background Empirical evidence indicates that both HIV infection and stunting impede cognitive functions of school-going children. However, there is less evidence on how these two risk factors amplify each other’s negative effects. This study aimed to examine the direct effects of stunting on cognitive outcomes and the extent to which stunting (part...

The pregnancy rate in Kenya among adolescent girls is among the highest in the world. Adolescent girls experience increased risk of anxiety and depression during pregnancy and postpartum which can result in poor health outcomes for both mother and baby, and negatively influence their life course. Mental health is often given low priority in health...

Abstract Introduction Culturally validated neurocognitive measures for children in Low- and Middle-Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform development of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neurops...

Objectives There are inconsistencies in the South Africa HIV mortality data reported by IHME, UNAIDS and Statistics South Africa platforms. Between 2006-2016 these global datasets (IHME and UNAIDS) show that HIV-related mortalities were improving in South Africa, while Statistics South Africa argues the opposite. We explain the causes of this diffe...

BACKGROUND Mobile technology can support HIV care, but studies in youth living with HIV (YLWH) are limited. OBJECTIVE We developed a facilitated WhatsApp group intervention (named Vijana-SMART) for YLWH, grounded in social support theory and guided by YLWH’s design recommendations. This paper evaluates the intervention’s acceptability and pre-post...

Background Mobile technology can support HIV care, but studies in youth are limited. In 2014, youth receiving HIV care at several health care facilities in Nairobi, Kenya spontaneously formed peer support groups using the social media platform WhatsApp. Objective Inspired by youth-initiated groups, we aimed to evaluate the use of WhatsApp to deliv...

Background: This study aimed to estimate the prevalence of suicidal behaviors, i.e. suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) among adolescents with a focus on parental and peer support in eight South-East Asian countries including Bangladesh, Bhutan, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand. Method:...

Violence against children-which includes maltreatment (including physical, sexual, psychological and emotional violence, and neglect), bullying (including cyberbullying), youth violence (including physical assault with or without weapons), intimate partner violence (including exposure to domestic violence and direct involvement in teen dating viole...

Background Understanding mental health treatment preferences of adolescents and youth is particularly important for interventions to be acceptable and successful. Person-centered care mandates empowering individuals to take charge of their own health rather than being passive recipients of services. Methods We conducted a discrete choice experimen...

Background: Intentional Self-Harm (ISH) contributes to a significant disease burden globally. Despite the urgent need for effective treatment, health care workers lack adequate training on ISH. Evidently, there is a correlation between attitude and practice that could determine ISH treatment outcomes. Objective: To explore the knowledge, attitudes...

Background: Interventions targeting combined sexual and reproductive health, Human Immunodeficiency Virus (HIV) management and mental health care in sub-Saharan Africa (SSA) are few. There is a need to address common determinants of poor mental, psychosocial and sexual and reproductive health and rights (SRHR) through multimodal and multipronged i...

Background Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-res...

HIV stigma remains a barrier in achieving optimal HIV treatment. We studied the prevalence and predictors of HIV stigma among adolescents and youth with HIV (AYWHIV) ages 15-24 years in Western Kenya. Of 1011 AYWHIV, 69% were female with a median age of 18 years. Most (59%) attended adolescent clinic days, and 40% attended support groups. One-quart...

There are gaps in evidence regarding mental and sexual outcomes and associated interventions for women with Female Genital Mutilation/Cutting (FGM/C) living in Africa. This study employed a narrative synthesis to collate evidence on mental and sexual health outcomes. A systematic search of bibliographic databases and websites was performed using ap...

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narrative...

Objective: We estimated the effects of HIV stigma on mental health and treatment outcomes for youth with HIV (YWHIV). Design: Secondary analysis of data for YWHIV ages 15-24 years in Western Kenya. Methods: Participants completed a longitudinal survey (baseline, month 6 and 12) assessing socio-demographics, antiretroviral therapy (ART) adheren...

Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustaina...

Background Peripartum adolescents experience significant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents’ responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addre...

Introduction There is paucity of culturally adapted tools for assessing depression and anxiety in children and adolescents in low-and middle-income countries. This hinders early detection, provision of appropriate and culturally acceptable interventions. In a partnership with the University of Nairobi, Nairobi County, Kenyatta National Hospital, an...

Background: Literature highlights that adolescent mental health problems are amenable to treatment, specifically psychological interventions. Unfortunately, there is a dearth of evidence on the services available for their management, especially in low-middle-income contexts. Aims & Objectives: This study aimed to highlight psychological interventi...

Background Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolesc...

Aim Adolescents in low-and-middle-income countries (LMICs) are facing numerous developmental, sexual and reproductive health (SRH) challenges including exposure to multidimensional violence. Gender-based violence (GBV) specifically intimate partner violence (IPV) are both highly prevalent in LMICs and are strongly linked with poor SRH outcomes. How...

Purpose Our study aimed to validate culturally adapted English and Swahili versions of the Patient Health Questionnaire–9 (PHQ-9) for use with adolescents in Kenya. Criterion validity was determined with clinician-administered diagnostic interviews using the Kiddie Schedule of Affective Disorders and Schizophrenia. Methods A total of 250 adolescen...

Introduction Adolescent and youth mental health problems are increasingly becoming an area of concern in global health. Young people in sub-Saharan Africa experience significant adversities and systemic challenges despite technological advancements and demographic transition that the region is experiencing. We examined the nexus between experiences...

IMPORTANCE Adolescents and young people have been historically understudied populations, and previous studies indicate that during epidemics, these populations, especially in low- and middle-income countries (LMICs), are at high risk of developing mental disturbances. OBJECTIVE To identify the existing evidence regarding the association of mental h...

Background: The aim of this paper was to explore clinicians’ perspectives on the provision of psychotherapy to adolescents referred for care in a public health facility, with a focus on identifying both facilitators and barriers to the treatment process. Method: The study was conducted at the Youth Clinic of the Mental Health Department at Kenyatta...

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehens...

In South Africa, men were traditionally eligible to receive government pensions at 65 years. However, that eligibility criterion was changed in 2008 to allow men to receive a pension payout at 60 years. This study is designed to quantify the impact of the 2008 pension reform on mental health outcomes (depression and traumatic stress) and deaths amo...

Introduction. Culturally validated neurocognitive measures for children in Low- and Middle-Income Countries are important in the timely and correct identification of neurocognitive impairments. Such measures can inform development of interventions for children exposed to additional vulnerabilities like HIV infection. The Battery for Neuropsychologi...

Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20–25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution t...

BACKGROUND Mobile Health (mHealth), the use of mobile technology in health care, is increasingly being used for mental health service delivery even in Low-Middle-Income countries (LMICs) to scale-up treatment, and a variety of evidence supports their potentials in different populations OBJECTIVE In this study, we utilise a theoretical lens to expl...