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Jermaine Dambi, MS, PhD

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GHES LMIC Fellow 2019-2020

FELLOWSHIP SITE: University of Zimbabwe
U.S. INSTITUTION: Stanford University

Project Title: An evaluation of the feasibility, acceptability, and practicality of Digital Screening of probable Common mental health Disorders in a busy HIV care clinic in Harare, Zimbabwe: the DiSC0-D Feasibility Study.

The Sub-Saharan region has the world greatest burden of HIV/AIDS. Unfortunately, common mental health disorders (CMDs) are endemic in people living with HIV/AIDS (PLWHA). For instance, the prevalence of depression is thrice in PLWHA, and is often undiagnosed. Poor mental health is regrettably associated with; poor treatment adherence, maladaptive/risky behaviours, and increased mortality. Consequently, integration of mental health services in routine HIV care is a public health priority. Routine mental health surveillance in PLWHA underscores the need for simple/brief screening tools to facilitate early; screening, diagnosis and referral for treatment. Developed in Zimbabwe, the Shona Symptoms Questionnaire (SSQ) is a simple binary (Yes or No) screening tool with 14 items. It can be self-completed within 2-3 minutes and paper-based version has been extensively used in studies profiling the mental health of Zimbabwean PLWHA.

However, evidence from an on-going systematic review shows that there is room for the improvement of the psychometric properties of the SSQ. Further, evidence from a recent study piloting a mental health screening program by Zimbabwean nurses and community health workers revealed that in its present state, the SSQ might not be feasible for integration in a busy clinic given its length. Given these potential limitations, it is essential to refine the psychometric properties of the SSQ to increase its clinical and research utility further. Concurrently, there is also an increased propensity towards the use of modern technologies such as tablet-based screening of mental health outcomes. Routine digital screening offers the opportunity for the closure of the huge mental health treatment gap in PLWHA. The proposed study therefore aims to:

  1. calibrate and validate a shorter version of the SSQ

  2. pilot a tablet-based CMDs surveillance program in a busy HIV care clinic in Harare, Zimbabwe