Publications

International collaborators face challenges in the design and implementation of ethical biomedical research. Evaluating community understanding of research and processes like informed consent may enable researchers to better protect research participants in a particular setting; however, there exist few studies examining community perspectives in health research, particularly in resource-limited settings, or strategies for engaging the community in research processes. Our goal was to inform ethical research practice in a biomedical research setting in western Kenya and similar resource-limited settings.

Objective: To determine the prospective and retrospective consistency of diagnoses among readmitted psychiatric in-patients at the Moi Teaching and Referral Hospital in Eldoret, Kenya. Method: Admission and discharge diagnoses among a consecutive sample of 114 psychiatric in-patients readmitted at the Moi Teaching and Referral Hospital between August and December 2009 were compared. Results: The commonest diagnoses at admission were schizophrenia spectrum disorders (47.4{%}) and bipolar spectrum disorders (30.7{%}). Overall diagnostic stability as measured by prospective consistency in this study was 72.8{%}.The most stable diagnostic category was Major Depressive Disorder (100{%} prospective and retrospective consistency), followed by Bipolar Disorders (91.4{%} prospective consistency, 69.6{%} retrospective consistency) and Substance-related disorders (87.5{%} prospective consistency, 50{%} retrospective consistency). Schizophrenia-spectrum disorders had a prospective consistency of 75.9{%} and a retrospective consistency of 87.2{%}. 'Other Psychotic Disorders' (acute psychotic episode and psychotic disorder not otherwise specified) had the lowest diagnostic stability, with both prospective and retrospective consistency being 0{%}. Conclusion: Mood disorders and substance-related disorders have the highest diagnostic stability among readmitted psychiatric inpatients in a low-income country.