Post-traumatic stress disorder in the Ethiopian population dwelling in war-affected communities: a systematic review and meta-analysis.

Background: Post-traumatic stress disorder (PTSD) is a significant mental health concern globally, particularly prevalent in populations exposed to war and conflict. This systematic review and meta-analysis aim to examine the prevalence and factors associated with PTSD among the Ethiopian population residing in war-affected communities. Methods: The review was reported according to the PRISMA guidelines. Related eligible published articles were searched in electronic online databases such as PubMed, Scopus, Web of Science, MEDLINE/PubMed, Scopus, Embase, Science Direct, Web of Science, Google Scholar, and Google, which reported the prevalence and risk factors of PTSD among people dwelling in the war-affected area until January 2024. The relevant data was extracted using a Microsoft Excel spreadsheet. The meta-analysis was conducted using STATA version 11. The estimated pooled prevalence and risk factors were estimated using a random effect model. The potential risk of publication bias was checked using a funnel plot and Egger's statistical test. Results: A total of nine published studies with 6107 participants were analyzed in this meta-analysis. The estimated pooled prevalence of PTSD among people living in war-affected areas was 48.4%, with a 95% CI (37.1, 59.8). This study found a higher prevalence of PTSD among women than men. Being female (OR= 2.2, 95% CI: 1.2, 4.3), witnessing a murder of a loved one (OR= 3.0, 95% CI: 1.2, 7.5), depression symptoms (OR= 2.8, 95% CI: 1.4, 5.6), and anxiety symptoms (OR= 3.4, 95% CI: 1.4, 8.0), a close family member killed or seriously injured (OR= 3.1, 95% CI: 1.2, 7.7), a moderate and high perceived threat to life (OR= 3.4, 95% CI: 1.3, 9.1), and poor social support (OR= 4.4, 95% CI: 1.1, 18.7) were associated with post-traumatic stress disorder. Conclusion: The result of this study shows the high prevalence rate of PTSD in people living in war-affected areas. disparities in PTSD prevalence, with women being at higher risk, and identified risk factors were witnessing the murder of a loved one, experiencing depression and anxiety, and perceived threat to life. Addressing PTSD in war-affected communities requires comprehensive interventions that consider both individual and contextual factors. Systematic review registration: www.crd.york.ac.uk/PROSPERO/, identifier CRD42024501384.

Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study.

Background: Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods: The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results: A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion: This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.

Psychiatric comorbidity in people with epilepsy in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Psychiatric comorbidity is a double burden among people with epilepsy. Since people with epilepsy are more vulnerable to psychiatric illnesses. So, the implementation of an appropriate intervention to minimize the double burden of comorbidity is very important. Therefore, this systematic review and meta-analysis aimed to assess the prevalence and associated factors of psychiatric comorbidity among people with epilepsy in Ethiopia. METHODS: This systematic review and meta-analysis followed the Preferred Reporting Item Review and Meta-analysis (PRISMA) guideline. Searching databases were PubMed, PsycINFO, Web of Science, Cochrane Library, Google Scholar, and HINARI.The quality of the included articles was assessed using the Newcastle-Ottawa Scale (NOS). The pooled meta-logistic regression was computed to estimate the pooled prevalence and the risk factors with a 95% CI. RESULTS: The pooled prevalence of psychiatric comorbidity in people with epilepsy was 34.69 % (95 % CI: 29.27, 40.10). Frequent seizures (POR = 2.94: 95 % CI: 1.08, 8.00) and a history of divorce (POR = 2.00: 95 % CI: 1.09, 3.81) were associated factors of psychiatric comorbidity in people with epilepsy. CONCLUSIONS: This systematic review and meta-analysis revealed that the pooled prevalence of psychiatric comorbidity among people with epilepsy was found to be higher compared with the general population. Therefore, among people with epilepsy, parallel psychiatric evaluation is very important along with neurological evaluation.

Prevalence of depression among students at Ethiopian universities and associated factors: A systematic review and meta-analysis.

BACKGROUND: Depression is the most common cause of disability in the world, which affects 350 million people. University students struggle to cope with stressors that are typical of higher education institutions as well as anxiety related to education. Although evidence indicates that they have a high prevalence of depression, no reviews have been done to determine the prevalence of depression among students at Ethiopian universities comprehensively. METHODS: Without regard to time constraints, PubMed, Scopus, and EMBASE were investigated. A manual search for an article reference list was also conducted. The Meta XL software was used to extract relevant data, and the Stata-11 meta-prop package was used to analyze it. The Higgs I2 test was used to test for heterogeneity. RESULTS: A search of the electronic and manual systems resulted in 940 articles. Data were extracted from ten studies included in this review involving a total number of 5207 university students. The pooled prevalence of depression was 28.13% (95% CI: 22.67, 33.59). In the sub-group analysis, the average prevalence was higher in studies having a lower sample size (28.42%) than studies with a higher sample; 27.70%, and studies that utilized other (PHQ-9, HADS); 30.67% higher than studies that used BDI-II; 26.07%. Being female (pooled AOR = 5.56) (95% CI: 1.51, 9.61), being a first-year (pooled AOR = 4.78) (95% CI: 2.21, 7.36), chewing khat (pooled AOR = 2.83) (95% CI: 2.32, 3.33), alcohol use (pooled AOR = 3.12 (95% CI:3.12, 4.01) and family history of mental illness (pooled AOR = 2.57 (95% CI:2.00, 3.15) were factors significantly associated with depression. CONCLUSION: This systematic review and meta-analysis revealed that more than one-fourth of students at Ethiopian universities had depression. More efforts need to be done to provide better mental healthcare to university students in Ethiopia.

Substance use and associated factors among high school students in Northwest Ethiopia.

Introduction: substance abuse is the use of a drug that affects both the function and the structure of the brain by altering the activity neurotransmitters of particular pathways in the central nervous system that affect the mood, perception, and consciousness of the person. Methods: a cross-sectional study design was employed among 422 high school students. Study participants were selected by simple random sampling from all five high school students. A self-reported questionnaire was used that included alcohol, smoking, and substance involvement screening test, Oslo-3 social support, and other instruments. Data were checked, coded, and entered into Epi-Data version 4.6.2 then exported to the statistical package for social sciences version 20 for analysis. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with substance use. Adjusted odds ratios with 95% confidence intervals were determined and predictors with a p-value of <0.05 were counted as significantly associated. Results: a total of 406 students have participated with an overall response rate of 96.2% (n=406). Of the participants 235 were female and 171 were male. The mean age was 17.51 with a standard deviation of ±1.42. The prevalence of substance use among study participants was 52.5%. Being male aOR: 1.77, 95% CI 1.11-2.77, family history of substance use aOR: 3.07, 95% CI 1.57-6.01, and having close friends´ pressure aOR: 5.77, 95% CI 2.39-13.89 were significantly associated with substances use among high school students. Conclusion: the prevalence of substance use among high school students was high. Being male, family history of substance use, and having peer pressures were strongly associated with substance use.

Social phobia of Ethiopian students: meta-analysis and systematic review.

BACKGROUND: Social anxiety disorder is defined as the fear of social situations, incorporating situations that involve contact with strangers. People highly fear embarrassing themselves which includes situations like social gatherings, oral presentations, and meeting new people. People with social phobia have nonspecific fears of practicing vague or, performing specific tasks like eating or speaking in front of others. In people with social anxiety disorder, worry can arise from both the circumstance itself and embarrassment from others, for students, social phobia is an overwhelming fear of speaking in front of others or giving presentations in class. The prevalence of social phobia among different studies in Ethiopia was inconsistent and inconclusive therefore, this study showed the cumulative burden of social phobia among students in Ethiopia. METHOD: Observational studies published on social phobia and associated factors among students in Ethiopia were included in this study based on the criteria after independent selection by two authors. Data were extracted by Microsoft Excel spreadsheet to be exported to Stata version 11 for further analysis. The random-effect model was used to estimate the pooled effect size of social phobia and its effect on the previous studies with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. Sub-group analysis and sensitivity analysis were done. RESULT: A total of 2878 study participants from seven studies were included in this meta-analysis and systematic review. The pooled prevalence of social phobia among students in Ethiopia was 26.81% with a 95% CI (22.31-31.30). The pooled effect size of social phobia in Oromia, Amhara, and SNNPs regions was 24.76%, 24.76%, and 29.47%, respectively. According to the subgroup analysis, university, and college/high school students were 28.05% and 25.34% respectively. Being female [AOR = 2.11 (95% CI 1.72-2.60)], having poor social support [AOR = 2.38 (95% CI 1.54-3.70)], substance use [AOR = 2.25 (95% CI 1.54-3.30)], single parent [AOR = 5.18 (95% CI 3.30-8.12)], and rural residence [AOR = 2.29 (95% CI 1.91-2.75)] were significantly associated in this meta-analysis in Ethiopia. CONCLUSION: The pooled prevalence of social phobia in this meta-analysis and systematic review was high (26.81%) among students therefore, the educational bureau needs to work on decreasing the burden of social phobia to raise the academic achievement and creativity of the students. In therapeutic advice like exposure to presentations, family members take the responsibility for the students' therapy and expose them to various social interactions.

Prevalence and associated factors of depression, anxiety, and stress among high school students in, Northwest Ethiopia, 2021.

BACKGROUND: Many studies have revealed that students' performance in school, is affected by symptoms of depression, anxiety, and stress, which may impair their academic achievement, and lead to school dropout. However, to date, no studies have evaluated these three disorders among high school students in Africa. Therefore, in this study, we aimed to assess the prevalence of depression, anxiety, stress, and their associated factors among high school students in Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted. A simple random sampling technique was used to select 849 participants from six high schools in Northwest Ethiopia. A self-administered Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was used to collect the data. Data were analyzed using SPSS Version 25.0 software to identify factors associated with DAS, and bi-variable and multi-variable analyses were performed. RESULTS: The prevalence of depression, anxiety, and stress was 41.4, 66.7, and 52.2% respectively. Being female (AOR = 1.304, 95% CI = 1.006-1.849), higher risky khat chewers (AOR = 5.595, 95% CI = 2.357-11.132), having social phobia (AOR = 1.416, 95% CI = 1.045-1.919) were associated with depression. Being higher risky cigarette smokers (AOR = 4.777, 95% CI = 1.407-7304), having a history of chronic medical illness (AOR = 2.099, 95% CI = 1.045-4.218), and having a family history of mental illness (AOR = 1.777, 95% CI = 1.028-3.073) associated with anxiety. Stress was associated with high-risk alcohol drinkers (AOR = 1.828, 95% CI = 1.012-3.303), rural residency (AOR = 1.395, 95%CI = 1.010-1.925), and low social support (AOR 1.7391, 95% CI = 1.203-2.515). CONCLUSION: The burden of DAS among high school students was found to be high. Female sex, chewing khat, and having social phobia are associated with depression. Conversely, smoking cigarettes, having a chronic medical illness, and having a family history of mental illness are all linked to anxiety. Being a highly risky alcoholic drinker, having poor social support, and being a rural resident are positively associated with stress. Therefore, extending mental health services to all high schools, and strengthening the existing counseling services, are recommended.

Sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest, Ethiopia.

Background: Poor sleep quality is common among nurses. This problem possibly results in negative emotional and psychological consequences in nurses which secondary affect their work performances. However, in Ethiopia, there is a paucity of information about poor sleep quality and associated factors among nurses. This study aimed to assess the prevalence of poor sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 542 nurses who worked at University of Gondar (UOG), Tibebe Ghion, Felege Hiwot Comprehensive Specialized Hospitals, Ethiopia, who were incorporated into the study through a simple random sampling technique from 1 May to 2 June 2021. The Pittsburgh sleep quality index (PSQI) with a cut score of above 5 was used to assess sleep quality using a structured self-administered questionnaire. Other tools used are Depression Anxiety Stress Scales (DASS-21), Shift Work sleep disorders (SWSD), and Oslo-3 social support scales. Epi-Data version 3.1 was used for data entry and SPSS version 25 was used for data analysis. A multivariable logistic regression analysis was performed to identify variables that have a significant association with poor sleep quality among nurse professionals. The degree of association was assessed using an odds ratio (OR) with a 95% confidence interval (CI) at a two-tailed p-value of <0.05. Results: A total of 510 nurses were included in the study with a response rate of 94%. The study showed that the overall prevalence of poor sleep quality among nurses was 75.5% (95% CI (71.8, 79.1). Being female (AOR = 1.72:95% CI = 1.19, 2.28), depressive symptoms (AOR = 2.24:95% CI = 1.24, 3.85), anxiety symptoms (AOR = 2.12: 95% CI = 1.23, 3.62), stress (AOR = 2.85: 95% CI = 1.67, 4.82) and current alcohol drinking (AOR = 1.84 :95% CI = 1.27, 3.13) were significantly associated with poor sleep quality. Conclusion: The overall prevalence of poor sleep quality among nurses was high. Being female, depressive symptoms, anxiety symptoms, stress, and current alcohol drinking had been significantly associated with poor sleep quality. Therefore, it is essential to institute effective intervention strategies emphasizing contributing factors to poor sleep quality.