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

BMC Pediatrics

Research Article

Claire Wagner¹  Mary C. Smith Fawzi²  Agnes Binagwaho³  Cameron Nutt⁴  Yvonne Kayiteshonga⁵  Corine Karema⁵  Vincent Mutabazi⁵  Eric Remera⁵  Nancy Misago⁵  Sabin Nsanzimana⁵  Jeanine Condo⁶  Patrick Cyamatare⁷  Cyprien Shyirambere⁷  Mawuena Agbonyitor⁸ 

[1] Dana-Farber Cancer Institute Center for Global Cancer Medicine, 450 Brookline Avenue, 02115, Boston, MA, USA;Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, 02115, Boston, MA, USA;Ministry of Health of Rwanda, P.O. Box 84, Kigali, Rwanda;Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, 02115, Boston, MA, USA;University of Global Health Equity, P.O. Box 6955, 260 Blvd de l’Umuganda, Kigali, Rwanda;Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, 03755, Hanover, NH, USA;Partners In Health, 641 Huntington Avenue, 02115, Boston, MA, USA;Rwanda Biomedical Center, P.O. Box 83, Kigali, Rwanda;School of Public Health, University of Rwanda, P.O. Box 5229, Kigali, Rwanda;University Teaching Hospital of Butare, Butare, Rwanda;University of Maryland School of Medicine, 685 W Baltimore St., 21201, Baltimore, MD, USA;

关键词: Rwanda;    Children;    Adolescents;    Depression;    Screening;    HIV;    Chronic disease;    Validation;   

DOI  :  10.1186/s12887-016-0565-2

 received in 2014-09-09, accepted in 2016-02-16,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDepression 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.MethodsA 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.ResultsTwenty-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).ConclusionsThe 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.

【 授权许可】

CC BY   
© Binagwaho et al. 2016