The electro-convulsive therapy story of Africa, a systematic review
Bibliographic record
Abstract
Over the years, the use of Electroconvulsive therapy (ECT) has gained increasing acceptance as a viable treatment for managing treatment-resistant mental health conditions, and it is known to deliver more rapid therapeutic benefits than most treatment modalities in psychiatry. However, the practice of ECT exhibits significant variability both within and between countries. This review aimed to shed light on the status of ECT in the African context and its implications for mental health care in the region. In July 2023, databases (Ovid, PubMed, Web of Science, etc.) were searched for articles about ECT in Africa, following the PRISMA guidelines. Eligible studies reporting ECT practices in Africa and those about knowledge, attitudes, and perceptions were excluded. A total of 25 articles met the study criteria. The reviewed studies revealed that unmodified ECT continues to be used in some African countries due to resource limitations, while bilateral ECT is widely practiced across the continent. The primary diagnostic indications for ECT in Africa included severe depression and affective disorders. ECT usage and regulation vary significantly throughout Africa. The studies, primarily observational, detailed numerous challenges in employing the method, particularly concerning resource utilization in healthcare facilities. The review highlights the necessity for adaptable standards and local protocols to enhance ECT practices throughout Africa. It emphasizes the importance of conducting more evidence-based research to develop region-specific guidelines that ensure the safe and effective use of ECT. Policymakers and healthcare practitioners should prioritize resource allocation, training, and standardization to improve ECT delivery and outcomes on the continent.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".