Conclusions: The final screening protocol is highly sensitive and could reduce burden on ART clinicians by 30{ca7ad0b74511a57bb2016f24c729dd7716d5352e92d2275aa1f91fb22c36b0a7}. The uptake and acceptance of the handheld tool to support implementation of the protocol was high. Further examination of the data reveals several important questions to include in future referral algorithms to improve sensitivity and specificity. Based on these results, we identify a refined algorithm to explore in future evaluations. (Source: International Journal of Medical Informatics).