African Journal of Psychiatry | 13 March 2003
Validating a Brief Screening Tool for Obsessive-Compulsive Disorder in Primary Care: A Case Study from Dar es Salaam, Tanzania
G, o, o, d, l, u, c, k, M, w, a, m, b, e, n, e, ,, A, m, i, n, a, J, u, m, a
Abstract
Obsessive-compulsive disorder (OCD) is a significant yet frequently undetected mental health condition in low-resource settings. In Tanzania, primary care is a critical entry point for mental healthcare, but there is an absence of validated, culturally appropriate screening tools for OCD, contributing to a substantial treatment gap. This case study aimed to validate a brief, culturally adapted screening tool for OCD for use by primary healthcare workers in the Dar es Salaam region, assessing its feasibility, acceptability, and diagnostic accuracy. A two-stage validation design was employed. An international OCD screening questionnaire was translated into Kiswahili and culturally adapted through focus group discussions with clinicians and community members. Primary care nurses then administered the tool to consecutive adult attendees at two urban clinics. A subset of participants underwent a confirmatory diagnostic interview by a psychiatrist using standard criteria to determine the tool’s sensitivity and specificity. The adapted tool demonstrated good psychometric properties, showing a sensitivity of 88% and a specificity of 82% against the psychiatrist’s diagnosis. Its brevity and clarity were reported as highly acceptable by both nurses and patients. Screening revealed a point prevalence of probable OCD of 4.2% among the primary care attendees. The culturally adapted brief screening tool is a valid and feasible instrument for detecting probable OCD in Tanzanian primary care settings. Its use can improve case identification and facilitate appropriate referral. Integration of this tool into routine primary care consultations is recommended. Further implementation research is needed to evaluate its impact on referral pathways and patient outcomes in diverse primary care settings across Tanzania. Obsessive-compulsive disorder, screening, primary health care, validation, Tanzania, global mental health This case study provides the first validated brief screening tool for OCD in Tanzanian primary care, offering a practical method to address the local detection gap.