Accuracy of alternative PHQ-9 scoring algorithms to screen for depression in people living with HIV in Sub-Saharan Africa.

Autor:	Bernard C; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France., Font H; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France., Zotova N; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Wools-Kaloustian K; Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America., Goodrich S; Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States of America., Kwobah EK; Department of Mental Health,Moi Teaching and Referral Hospital and Moi University,Eldoret,Kenya., Awoh AR; Clinical Research Education and Consultancy,Yaoundé,Cameroon., Nko'o Mbongo'o GC; Department of Psychiatry,Jamot Hospital,Yaoundé,Cameroon.; Faculty of Medicine and Pharmaceutical Sciences of Dschang,Dschang,Cameroon., Nsonde DM; Centre de Traitement Ambulatoire,Brazzaville,Republic of Congo., Gandou P; Centre de Traitement Ambulatoire,Brazzaville,Republic of Congo., Minga A; Centre médical de suivi des donneurs de sang (CNTS-CI), Abidjan, Côte d'Ivoire., Tine JM; Service de maladies infectieuses et tropicales, CHNU de Fann, Dakar, Senegal., Ndiaye I; Service de psychiatrie, CHNU de Fann, Dakar, Senegal., Dabis F; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France., Seydi M; Service de maladies infectieuses et tropicales, CHNU de Fann, Dakar, Senegal., de Rekeneire N; Institut Pasteur du Cambodge,Phnom Penh,Cambodia., Yotebieng M; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA., Jaquet A; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 Oct 24. Date of Electronic Publication: 2024 Oct 24.
DOI:	10.1097/QAI.0000000000003551
Abstrakt:	Background: Screening for depression remains a priority for people living with HIV (PLWH) accessing care. The nine-item Patient Health Questionnaire (PHQ-9) is a widely used depression screening tool, but has limited accuracy when applied across various cultural contexts. We aimed to evaluate the performance of alternative PHQ-9 scoring algorithms in sub-Saharan African PLWH. Setting: five HIV programs in Cameroon, Côte d'Ivoire, Kenya, Senegal and the Republic of Congo. Methods: Adult PLWH were screened for depression during the 2018-2022 period. Diagnosis confirmation was done by psychiatrist blinded clinical evaluation (gold standard). Diagnostic performances, including sensitivity, and area under the curve (AUC)) of the traditional PHQ-9 scoring (positive screening - score≥10) was compared to alternative scoring algorithms including: i) the presence of ≥1 mood symptom (PHQ-9 items 1&2) combined with ≥2 other symptoms listed in the PHQ-9, and ii) a simplified recoding of each 4-response item into two categories (absence/presence). Results: A total of 735 participants were included (54% female, median age 42 years [IQR 34-50]). Depression was diagnosed by a psychiatrist in 95(13%) participants. Alternative scoring sensitivities (0.59 to 0.74) were higher than that of the traditional score's (0.39). Compared to traditional scoring, AUC were significantly higher for PHQ-9 alternative scoring. Across settings, alternative scoring algorithms increased sensitivity and reduced variability. Conclusion: As a primary screening test, new scoring algorithms appeared to improve the PHQ-9 sensitivity in identifying depression and reduce heterogeneity across settings. This alternative might be considered to identify PLWH in need of referral for further diagnostic evaluations. Competing Interests: The authors report no conflicts of interest related to this work. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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