Validating the Children's Depression Inventory in the context of Rwanda

被引:11
作者
Binagwaho, Agnes [1 ,2 ,3 ,4 ]
Fawzi, Mary C. Smith [2 ]
Agbonyitor, Mawuena [5 ]
Nsanzimana, Sabin [6 ]
Karema, Corine [6 ]
Remera, Eric [6 ]
Mutabazi, Vincent [6 ]
Shyirambere, Cyprien [7 ]
Cyamatare, Patrick [7 ]
Nutt, Cameron [8 ]
Wagner, Claire [9 ]
Condo, Jeanine [10 ]
Misago, Nancy [6 ]
Kayiteshonga, Yvonne [6 ]
机构
[1] Minist Hlth Rwanda, POB 84, Kigali, Rwanda
[2] Harvard Univ, Sch Med, Dept Global Hlth & Social Med, 641 Huntington Ave, Boston, MA 02115 USA
[3] Univ Global Hlth Equ, 260 Blvd Umuganda,POB 6955, Kigali, Rwanda
[4] Geisel Sch Med Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755 USA
[5] Univ Maryland, Sch Med, 685 W Baltimore St, Baltimore, MD 21201 USA
[6] Rwanda Biomed Ctr, POB 83, Kigali, Rwanda
[7] Univ Teaching Hosp Butare, Butare, Rwanda
[8] Partners Hlth, 641 Huntington Ave, Boston, MA 02115 USA
[9] Dana Farber Canc Inst, Ctr Global Canc Med, 450 Brookline Ave, Boston, MA 02115 USA
[10] Univ Rwanda, Sch Publ Hlth, POB 5229, Kigali, Rwanda
关键词
Rwanda; Children; Adolescents; Depression; Screening; HIV; Chronic disease; Validation; MENTAL-HEALTH; PSYCHIATRIC MORBIDITY; HIV; ADOLESCENTS; PREVALENCE; SYMPTOMS; VALIDITY; GENOCIDE; TRAUMA;
D O I
10.1186/s12887-016-0565-2
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Depression is often co-morbid with chronic conditions, and when combined with HIV it can increase progression and reduce survival. A brief and accurate screening tool for depression among children living with HIV is necessary to increase access to mental health care and improve HIV-related outcomes in the long-term. Methods: A validation study was conducted, comparing the Children's Depression Inventory (CDI) with a structured clinical assessment as the gold standard among children living with HIV ages 7-14 years in Rwanda. The response rate was 87 % and the analysis was performed among 100 study participants. Results: Twenty-five percent of children had a diagnosis of depression based on the clinical interview. Sensitivity of the CDI ranged from 44 to 76 % and specificity was 92 to 100 % for cut-off scores from 5 to 9. The area under the curve (AUC) for receiver operating characteristic analysis, an estimate of overall accuracy, was 0.87 (95 % confidence interval: 0.77-0.97). Conclusions: The significant prevalence of depression among children living with HIV in Rwanda reflects a critical need to advance mental health care in this population. Although overall accuracy of the CDI is reasonable in this context, further research needs to be done to develop a more sensitive measure of depression in this vulnerable population. Development of a highly sensitive screening measure will be a fundamental step towards improving access to mental health care among children living with HIV, potentially improving health outcomes and quality of life in the long-term as this vulnerable population transitions into adulthood.
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页数:7
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