@article{fdi:010092643,
  title = {{A}ccuracy of alternative {PHQ}-9 scoring algorithms to screen for depression in people living with {HIV} in {S}ub-{S}aharan {A}frica},
  author = {{B}ernard, {C}harlotte and {F}ont, {H}. and {Z}otova, {N}. and {W}ools-{K}aloustian, {K}. and {G}oodrich, {S}. and {K}wobah, {E}. {K}. and {A}woh, {A}. {R}. and {N}koo, {G}. {C}. and {N}sonde, {D}. {M}. and {G}andou, {P}. and {M}inga, {A}. and {T}ine, {J}. {M}. and {N}diaye, {I}. and {D}abis, {F}. and {S}eydi, {M}. and de {R}ekeneire, {N}. and {Y}otebieng, {M}. and {J}aquet, {A}. and {I}e{DEA} {C}ohort {C}ollaboration,},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground:{S}creening for depression remains a priority for people living with {HIV} ({PLWH}) accessing care. {T}he 9-item {P}atient {H}ealth {Q}uestionnaire ({PHQ}-9) is a widely used depression screening tool, but has limited accuracy when applied across various cultural contexts. {W}e aimed to evaluate the performance of alternative {PHQ}-9 scoring algorithms in sub-{S}aharan {A}frican {PLWH}.{S}etting:{F}ive {HIV} programs in {C}ameroon, {C} & ocirc;te d'{I}voire, {K}enya, {S}enegal, and the {R}epublic of {C}ongo.{M}ethods:{A}dult {PLWH} were screened for depression during the 2018-2022 period. {D}iagnosis confirmation was done by psychiatrist blinded clinical evaluation (gold standard). {D}iagnostic performances, including sensitivity and area under the curve ({AUC}) of the traditional {PHQ}-9 scoring (positive screening - score >= 10), were compared to alternative scoring algorithms including (1) the presence of >= 1 mood symptom ({PHQ}-9 items 1 and 2) combined with >= 2 other symptoms listed in the {PHQ}-9, and (2) a simplified recoding of each 4-response item into 2 categories (absence/presence).{R}esults:{A} total of 735 participants were included [54% women, median age 42 years (interquartile range 34-50)]. {D}epression was diagnosed by a psychiatrist in 95 (13%) participants. {A}lternative scoring sensitivities (0.59-0.74) were higher than that of the traditional score's (0.39). {C}ompared to traditional scoring, {AUC} was significantly higher for {PHQ}-9 alternative scoring. {A}cross settings, alternative scoring algorithms increased sensitivity and reduced variability.{C}onclusions:{A}s a primary screening test, new scoring algorithms seemed to improve the {PHQ}-9 sensitivity in identifying depression and reducing heterogeneity across settings. {T}his alternative might be considered to identify {PLWH} in need of referral for further diagnostic evaluations.},
  keywords = {{HIV} ; depression ; screening tool ; {PHQ}-9 ; {S}ub-{S}aharan {A}frica ; {AFRIQUE} {SUBSAHARIENNE} ; {COTE} {D}'{IVOIRE} ; {SENEGAL} ; {CAMEROUN} ; {KENYA}},
  booktitle = {},
  journal = {{JAIDS}},
  volume = {98},
  numero = {2},
  pages = {143--149},
  ISSN = {1525-4135},
  year = {2025},
  DOI = {10.1097/qai.0000000000003551},
  URL = {https://www.documentation.ird.fr/hor/fdi:010092643},
}