The validation exercise was carried out as a cross-sectional study at the largest clinic in the suburb of Mbare near the central business district of Harare, Zimbabwe.Īdults aged 18 and above attending the clinic were enrolled over a two-week period in June 2016. It is a self-report measure that is widely used in western contexts and has been found to have very good psychometric properties in various settings. The Posttraumatic Stress Disorder Checklist (PCL) was developed at the National Center for PTSD. The most appropriate current screening tool which based on DSM-5 is the Posttraumatic Stress Disorder Checklist (PCL-5) which has not been validated in Africa. For Zimbabwe, efforts have been made to validate screening tools for common mental disorders such as depression and anxiety for use in primary health care settings but none have been validated for PTSD therefore this study seeks to address this deficit. In general, too little is known about the prevalence of PTSD and PTSD related to HIV infection and its impact on health outcomes such as, health seeking behavior, treatment adherence and quality of life in sub-Saharan Africa. DSM-IV American Psychiatric Association, 1994). Receiving a life-threatening diagnosis meets the threshold for consideration as a traumatic event for the development of PTSD and was included in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV (4th ed. The use of different PTSD assessment tools as well as the diversity with which traumatic events have been defined have contributed to varying outcomes in studies of PTSD. Receiving an HIV-diagnosis was experienced as a traumatic index event for 36.4% in a population of recently diagnosed persons. The incidence of HIV-related PTSD in a cross-sectional study in the Western Cape, South Africa, was found to be at 40%. In South Africa, PLWH have been found to have high prevalence of persisting psychiatric disorders with PTSD rates at follow-up of 20% being associated with a longer duration of infection and low baseline functionality. Women are reported to be at greater risk of developing symptoms of PTSD with cumulative effects of multiple traumas being common and associated with worse psychiatric and other chronic medical comorbidity. Furthermore, lack of education, interpersonal violence (IPV), and exposure to weather phenomena due to climate change can contribute to poor mental health outcomes including stress related disorders. Political and economic instability, including poverty and disparity with its consequences of food scarcity and lack of access to medical care are some of the stressors. Stressors, both acute and chronic, that people in LMIC are exposed to often occur on a daily basis. The negative experience of being HIV positive is cumulative with PLWH exposed to multiple HIV-related stressors and losses which can lead to PTSD symptomatology. In sub-Saharan Africa, people living with HIV (PLWH) have a high rate of post-traumatic stress disorder (PTSD). ![]() There is need to explore ways of integrating screening tools for PTSD in interventions delivered by lay health workers in low and middle-income countries (LMIC). The PCL-5 performed well in this population with a high prevalence of HIV. The Shona version of the PCL-5 demonstrated good internal consistency (Cronbach’s alpha = 0.92). PTSD was diagnosed in 40 (19.6%) participants using the gold standard procedure. Of these, 91 (44.6%) were HIV positive, 100 (49%) were HIV negative, while 13 (6.4%) did not know their HIV status. ResultĪ total of 204 participants were assessed. Study participants were then interviewed independently using the Clinician Administered PTSD Scale (CAPS-5) as the gold standard by one of five doctors with training in mental health. After obtaining written consent, trained research assistants administered the tool to eligible participants. MethodĪdults aged 18 and above attending the clinic were enrolled over a two-week period in June 2016. ![]() We validated the Shona version of the PTSD Checklist for DSM-5 (PCL-5) in a primary health care clinic in Harare, Zimbabwe. ![]() ![]() There is a dearth of validated tools measuring posttraumatic stress disorder (PTSD) in low and middle-income countries in sub-Saharan Africa.
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