Article Text
Abstract
Background Screening women for postnatal depression (PND) provides an opportunity to reach undetected cases and enhance pregnancy outcomes. In Zimbabwe, no validation of depression screening tools has been done on postnatal women in rural settings.
Objectives This study aims to determine criterion validity of the Edinburgh Postnatal Depression Scale (EPDS), the Patient Health Questionnaire (PHQ-9) and the Center for Epidemiological Studies-Depression (CES-D) scale using the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria as the reference standard.
Methods Women (n=462) attending postnatal care at 7 or 42 days at two rural district hospitals in Zimbabwe will be assessed for depressive symptoms using the EPDS, PHQ-9 and CES-D. The women will be interviewed by a clinical psychologist using DSM-5 criteria. Sensitivities, specificities, positive predictive values, negative predictive values and test efficiencies will be calculated for each of the three tools. The area under the receiver operating curve will quantify the overall ability of the three tests to discriminate between those mothers with PND and those without.
Discussion Findings from this study will add to the body of knowledge on PND among women in resource-limited settings. Identifying women with PND will enable healthcare providers to link them with care, which will ultimately improve maternal and child health outcomes. Furthermore, this study will provide evidence on which screening tool would be best for screening PND in rural settings of Zimbabwe.
- epds
- phq-9
- ces-d
- zimbabwe
- criterion validation
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Footnotes
Contributors JJ conceived the study. Both JJ and MJC wrote the first and subsequent drafts of the manuscript. Both authors read and approved the final manuscript.
Funding This study is supported by the University of KwaZulu-Natal College of Health Sciences PhD scholarship fund awarded to JJ for the year 2017.
Disclaimer The funders of the scholarship had no role in the design of the study, collection, analysis, interpretation of data and in writing the manuscript.
Competing interests None declared.
Patient consent Not required.
Ethics approval The permission to proceed has been granted by the Zimbabwean Ministry of Health and Child Care at national, provincial, district and health facility levels. The research protocols have been reviewed and approved by the institutional review boards of the University of KwaZulu-Natal UKZN Biomedical Research Ethics Committee (BE598/16), the Joint Research Ethics Committee for the University of Zimbabwe, College of Health Sciences and the Parirenyatwa Group of Hospitals (JREC/30/17) and the Medical Research Council of Zimbabwe (MRCZ/A/2161). Medical Research Council of Zimbabwe.
Provenance and peer review Not commissioned; externally peer reviewed.