Suvira Ramlall

University of KwaZulu-Natal | ukzn · Department of Psychiatry

This study investigates the association between serum mature brain-derived neurotrophic factor (mBDNF), its precursor proBDNF, and neurocognitive function in ART-naïve adults with HIV in sub-Saharan Africa, exploring the distinct roles of these neurotrophic factors in cognitive health. This cross-sectional analysis utilized stored baseline serum sa...

Introduction Relapse among individuals with serious mental illnesses in resource-limited contexts, including South Africa, is a significant concern. To date, the risks for relapse among this population is well documented, but little is known about prevention strategies to reduce its occurrence in these resource-limited settings. Therefore, this qua...

Background Despite antiretroviral therapy (ART), HIV-associated neurocognitive impairment persists. We investigate the association between serum levels of mature Brain-Derived Neurotrophic Factor (mBDNF), precursor BDNF (proBDNF) and neurocognitive changes over time among adults living with HIV in sub-Saharan Africa, seeking to elucidate the interp...

Background Clozapine is the only Food and Drug Administration (FDA) and National Institute for Care and Excellence (NICE) approved drug for treatment-resistant schizophrenia (TRS). Its potentially life-threatening haematological side effects of neutropaenia and agranulocytosis mandate rigorous monitoring of neutrophil counts, presenting unique, Thi...

Inpowerment: Building Mental & Emotional Resilience, provides a lucid approach to understanding and navigating mental and emotional health challenges, together with pragmatic self-help techniques for overcoming them. It is both an approachable workbook, that encourages the reader to take an active role in their own journey of self-growth, and an em...

Background: There is a deficit of psychiatrists in South Africa, and to our knowledge, there is no situational analysis of training posts for psychiatrists in the country. Aim: To compare the number of specialists and subspecialists in training and training posts available in 2008 and 2018. Setting: South African medical schools with departments of...

Background: There is a deficit of psychiatrists in South Africa, and to our knowledge, there is no situational analysis of training posts for psychiatrists in the country.Aim: To compare the number of specialists and subspecialists in training and training posts available in 2008 and 2018.Setting: South African medical schools with departments of p...

While the ethics of involuntary admission for psychiatric inpatient care is widely contested, the practice is legally permissible across most jurisdictions. In many countries, laws governing the use of involuntary admission set out core criteria under which involuntary admission is permitted; these parameters broadly related to either risk of harm...

Background: South Africa had over 4 million cases of coronavirus disease 2019 (COVID-19) infections and more than 1 million COVID-19-related deaths. Despite the devastating psychological impact of the COVID-19 pandemic, there is little qualitative, critical evaluation of government mental health services in this resource-limited setting. Aim: The...

As a direct consequence of the Covid-19 pandemic, due to being exposed to chronic and multiple sources of psychological stress, healthcare workers constitute a vulnerable population. Despite the potential impact of Covid-19 on their psychological and physical health, insufficient attention has been given to their mental well-being. The primary obje...

Increased screen time (ST) in children is quickly becoming a public health concern as children are now reliant on technology for social interaction and educational development. The eye-health community has paid considerable attention to this in the recent literature, documenting it as digital eye strain. Continual close eye work and a lack of outdo...

Despite lower incidences of HIV-associated dementia due to antiretroviral therapy, neuropsychological impairment (NPI) remains a persistent challenge in sub-Saharan Africa. Improving cognitive reserve (CR) can mitigate NPI, but there are few investigations on neuropsychological (NP) performance, and its association with CR in newly diagnosed ART-na...

HIV-associated neurocognitive impairment remains a challenge even in the era of antiretroviral therapy (ART). Over 90% of people living with HIV are in low- and middle-income countries. Hence, it is not surprising that such countries bear a considerable burden of comorbidities like HIV-associated neurocognitive impairment despite an overall increas...

Low and middle-income countries (LMICs) are the epicenter of the HIV epidemic. The scale-up of antiretroviral therapy (ART) has reduced mortality, but HIV-associated neurocognitive impairment (HANI) remains prevalent, which impacts functional performance, medication adherence, and quality of life. We aimed to evaluate the effect of ART on neurocogn...

Introduction Residential care settings have shown high social isolation rates with incumbent risks necessitating measurement to formulate health promotion policies. Objective To measure social isolation levels in older persons living in a lower socio-economic residential care setting in South Africa. Method A cross sectional survey with older per...

Background: Cognitive reserve (CR), the brain's capacity to resist pathology, plays an essential role in preserving cognitive health of people living with HIV. CR differs by HIV clinical stage, but there are few studies on CR profiles of newly diagnosed ART-naïve HIV-positive individuals to inform early intervention in sub-Saharan Africa. Method:...

Stigma is an important social determinant of health-seeking behavior; however, the nature and extent of its association with depression among people living with multidrug-resistant tuberculosis (MDR-TB) are not well-understood. We enrolled 200 microbiologically confirmed MDR-TB inpatients at a TB specialist hospital in KwaZulu-Natal Province, an ar...

Background: Coronary artery bypass graft (CABG) surgery has been found to be associated with post-operative cognitive decline. Despite the large and growing numbers being conducted in South Africa, the associated or ensuing cognitive symptoms or impairment have received little research attention. Aim: The aim of this pilot study was to describe th...

Objectives Optimising medication adherence is one of the essential factors in reversing the tide of a TB‐HIV syndemic in sub‐Saharan Africa, especially South Africa. Impairment in key neurocognitive domains may impair patients’ ability to maintain adherence to treatment, but the level of cognition and its relationship to HIV status has not been exa...

National and institutional policies to escalate the production of doctorates have raised concerns about the quality of PhDs in South Africa. This study evaluates examiner reports of doctorates by thesis and publication in clinical medicine to ascertain the criteria that examiners used to define a successful doctoral thesis. A qualitative hermeneuti...

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remains prevalent in the anti-retroviral (ART) era. While there is a complex interplay of many factors in the neuropathogenesis of HAND, decreased neurotrophic synthesis has been shown to contribute to synaptic degeneration which is a hallmark of HAND neuropathology. Brain...

Background: Depression, anxiety and stress (DAS) have been shown to be co-morbid with dyspepsia. Local data on the factors associated with these co-morbidities could inform the role of psychiatric intervention in affected patients. Aim: The aim of this study was to describe the frequency of undiagnosed DAS and their associated protective and risk...

Although neurocognitive impairment (NCI) is a well-recognized challenge in human immunodeficiency virus (HIV), there is little evidence regarding it among individuals with multiple drug-resistant tuberculosis (MDR-TB) within HIV endemic sub-Saharan Africa. The extent of NCI risk, particularly HIV-associated neurocognitive disorders (HAND) risk, was...

Purpose Household food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidem...

Panel data from the South African National Income Dynamics Study, a nationally representative sample of households (years 2008, 2010 and 2012), were used to examine the longitudinal association between religious involvement and depression risk. Approximately 89.6–91.8% identified themselves as religiously affiliated, while 88.0–90.3% perceived reli...

Objective: To examine the association of depressive symptoms and contributing psychosocial factors during hospitalisation and 1-month post discharge in patients with acute myocardial infarction (MI). Methods and results: The study population comprised consecutive patients from a multi-ethnic background, admitted June 2015 - November 2015 to the Co...

As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of eInterventions for older people and specifically in having a...

Background: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an...

Background: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an...

The requirement of ‘research completion’ as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health st...

The requirement of ‘research completion’ as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health st...

The requirement of ‘research completion’ as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health st...

Historically, mental afflictions have been ascribed to supernatural causes with corresponding treatment rituals. Psychotherapy has long been described as the treatment of the “mind”, with the mind–body dualism creating much conflict and confusion about the legitimacy of mental and emotional suffering in an era of managed care demanding evidence-bas...

The word “psyche” refers to “the soul, spirit or the mind” and therapy is the process of healing, of making whole. Thus, psychotherapy pertains to healing of the soul/self or the mind. Historically, therapists have shied away from exploring the spiritual dimension of clients for fear of the controversies and sensitivities associated with religion a...

Background: The majority of studies on spirituality demonstrate its positive association with mental health. Despite the increasing number of studies, there remains a dearth of studies emanating from African countries looking at the relationship between mental illness, quality of life and measures of spirituality. The present study evaluates the ro...

p> Background. Neuropsychological tests can successfully distinguish between healthy elderly persons and those with clinically significant cognitive impairment. Objectives. A battery of neuropsychological tests was evaluated for their discrimination validity of cognitive impairment in a group of elderly persons in Durban, South Africa. Method....

Background. Neuropsychological tests can successfully distinguish between healthy elderly persons and those with clinically significant cognitive impairment. Objectives. A battery of neuropsychological tests was evaluated for their discrimination validity of cognitive impairment in a group of elderly persons in Durban, South Africa. Method. A sampl...

To describe the demographic, clinical and risk profile of Mild Cognitive Impairment and dementia in a sample of elderly South Africans within a residential setting. One hundred and forty participants residing in a group of residential homes for the elderly were assessed by psychiatrists and assigned diagnoses of dementia or Mild Cognitive Impairmen...

The aim of this study was to report on the prevalence of cognitive impairment, and to assess the performance and utility of subjective, objective and informant screening tools in a heterogeneous community sample. A sample of 302 elderly participants (>60 years) living in residential homes in a large city in South Africa were screened for the presen...

p> List of abstracts and authors: 1. Bipolar disorder not otherwise specified -overdiagnosed or underdiagnosed? E Allers 2. The prognosis of major depression untreated and treated: Does the data reflect the true picture of the prognosis of this very common disorder? E Allers 3. Can we prolong our patients' life expectancy? Providing a bette...

Background: The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal age-related cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. Methods: A sample of...

Objective: To describe the demographic, clinical and risk profile of Mild Cognitive Impairment and dementia in a sample of elderly South Africans within a residential setting. Method: One hundred and forty participants residing in a group of residential homes for the elderly were assessed by psychiatrists and assigned diagnoses of dementia or Mild...

The Mental Health Care Act 17 of 2002 (MHCA) was promulgated in 2004. It has been hailed as one of the most progressive pieces of mental health legislation. A true measure of its merit is the degree to which it has transformed mental health services and in particular improved the quality of care. This paper will describe the impact of the Act on me...

In the current mental health environment in South Africa, the development of a relevant mental health research agenda poses several challenges. This paper provides a brief overview of the current state of published research in mental health and, using a translation research framework, makes recommendations for five strategic directions to be consid...

South Africa has a shortage of facilities and psychiatrists to assess adjudicative competence of prisoners awaiting assessment under sections 77 to 79 of the Criminal Procedures Act of 1977. Various solutions have been proposed by the Department of Health. The recent linking of a Magistrate's court and a prison by videoconferencing offers the oppor...

Psychiatry registrars form the backbone of specialized psychiatric service provision in South Africa. Medical schools are centralized while clinical services need to be widespread and accessible. Video-conferencing has the potential to link registrars at satellite hospitals with academic centers. The study thus evaluated of the use of videoconferen...

In 2009, the Departments of Psychiatry and Telehealth of the University of KwaZulu-Natal (UKZN) initiated a three year project to develop telepsychiatry services in KwaZulu-Natal. This paper describes the challenges and opportunities of this project. This was a collaborative, in situ health service project and an action research framework was adopt...

The access of rural Mental Health Care Users in South Africa to specialist psychiatrists and quality mental health care is currently sub-optimal. Health professionals and planners working in psychiatry lack a well-defined and feasible outreach model to facilitate the delivery of services to remote and rural areas. In response to this challenge, a t...

Telepsychiatry, the practice of psychiatry over distance using information and communication technologies is, after teleradiology, the most practiced form of telemedicine in the world. As with any new technology, clinical service, or intervention in medicine, it is prudent to have guidelines for the safe and efficacious use of the technology in cli...

p> List of abstracts and authors: 1. Antipsychotics in anxiety disorders Christer Allgulander 2. Anxiety in somatic disorders Christer Allgulander 3. Community rehabilitation of the schizophrenic patient Orlando Alonso Betancourt, Maricela Morales Herrera 4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care...

The South African Mental Health Care Act (the Act) No. 17 of 2002 stipulated that regional and district hospitals be designated to admit, observe and treat mental health care users (MHCUs) for 72 hours before they are transferred to a psychiatric hospital. Medical managers in 49 'designated' hospitals in KwaZulu-Natal (KZN) were surveyed on infrast...

p> Background: KwaZulu-Natal had no dedicated in-patient adolescent psychiatric service during the study period and adolescents were admitted to general psychiatric wards. Aim of Study: This is a descriptive review of adolescents admitted with psychotic symptoms to a psychiatric hospital. It aims to describe their demographic profile, associated...

During most of the latter part of the last century, South Africa has followed international trends in the training of psychiatrists. Training programmes have become increasingly focused on the neurobiological aspects of psychiatric disorders with less attention being paid to psychotherapy. This is consistent with developments in psychiatric researc...