Validation of the Child Depression Screening Tool in three African settings: Rwanda, Senegal and South Africa.

The unavailability of reliable, easy-to-use depression screening tools adapted for Sub-Saharan African children is a significant barrier to the treatment of childhood depression. We thus adapted the Child Depression Screening Tool (CDST) to the South African (SA), Senegalese (S) and Rwandan (R) contexts, as a tool to screen for depression in children suffering from chronic illnesses, trauma and difficulties related to COVID-19, family and community hardships. A DSM-5-based diagnostic interview and the CDST screening measure were administered to 1,001 participants aged between 7 and 16 years. The prevalence of depression ranged between 9.5 and 16.8%. It was more prevalent in youth with chronic illness and those exposed to adverse life events. Older age (R and SA), female sex (S), dislike of school (R and SA) and cannabis use (SA) were also associated with worse depression. Receiver operating characteristic analysis showed satisfactory performance (79-89%) and that sensitivity and specificity were optimized at a CDST cut-point of 5.0. The CDST is a valid tool to screen for depression in the settings assessed. If found to be suitable in other countries and settings, it may offer a clinically sound, sustainable path towards the identification of child depression in Africa.