%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Bernard, Charlotte
%A Font, H.
%A Zotova, N.
%A Wools-Kaloustian, K.
%A Goodrich, S.
%A Kwobah, E. K.
%A Awoh, A. R.
%A Nkoo, G. C.
%A Nsonde, D. M.
%A Gandou, P.
%A Minga, A.
%A Tine, J. M.
%A Ndiaye, I.
%A Dabis, F.
%A Seydi, M.
%A de Rekeneire, N.
%A Yotebieng, M.
%A Jaquet, A.
%A IeDEA Cohort Collaboration,
%T Accuracy of alternative PHQ-9 scoring algorithms to screen for depression in people living with HIV in Sub-Saharan Africa
%D 2025
%L fdi:010092643
%G ENG
%J JAIDS
%@ 1525-4135
%K HIV ; depression ; screening tool ; PHQ-9 ; Sub-Saharan Africa
%K AFRIQUE SUBSAHARIENNE ; COTE D'IVOIRE ; SENEGAL ; CAMEROUN ; KENYA
%M ISI:001394811300009
%N 2
%P 143-149
%R 10.1097/qai.0000000000003551
%U https://www.documentation.ird.fr/hor/fdi:010092643
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-02/010092643.pdf
%V 98
%W Horizon (IRD)
%X Background:Screening for depression remains a priority for people living with HIV (PLWH) accessing care. The 9-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, C & ocirc;te 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), 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).Results:A total of 735 participants were included [54% women, median age 42 years (interquartile range 34-50)]. Depression was diagnosed by a psychiatrist in 95 (13%) participants. Alternative scoring sensitivities (0.59-0.74) were higher than that of the traditional score's (0.39). Compared to traditional scoring, AUC was significantly higher for PHQ-9 alternative scoring. Across settings, alternative scoring algorithms increased sensitivity and reduced variability.Conclusions:As a primary screening test, new scoring algorithms seemed to improve the PHQ-9 sensitivity in identifying depression and reducing heterogeneity across settings. This alternative might be considered to identify PLWH in need of referral for further diagnostic evaluations.
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