Pooled prevalence and associated factors of depression among high school students in Ethiopia

Depression among high school students is a public health concern in Ethiopia. Studies have indicated that estimates of the prevalence of depression and its predicting factors among high school students are inconsistent. A systematic review and meta-analysis are essential to determine the pooled prevalence of depression and associated factors among high school students to help health care managers design appropriate interventions. A wide-ranging search was used in international databases, such as PubMed, Scopus, Web of Science, EMBASE, Google Scholar, and Advanced Google. Observational studies (with cross-sectional study designs and case‒control, cohort and longitudinal studies) that reported the proportion of depression and associated factors in Ethiopia were included. In this study, unpublished and published primary studies were included. Two reviewers autonomously extracted all essential data elements using the Microsoft Excel worksheet and transferred them to Stata V.18 for analysis. The I2 statistic test was determine the presence of heterogeneity among included studies and Egger’s regression test and funnel plot checked the publication bias. In this review, a total of 10 primary studies with 6988 participants were included to estimate the combined prevalence. The pooled prevalence of depression among high school students in Ethiopia was 30% (26%, 34%). The subgroup analysis showed that the pooled prevalence of depression was higher in Tigray 35% (95% CI 33%, 38%) and a lower prevalence of depression was observed in Oromia 28% (95% CI 25%, 31%) and Amhara 28% (95% CI 18%, 37%). The results of the meta-analysis showed that being female (OR = 1.98; 95% CI 1.34, 2.61), alcohol use (OR = 2.59, 95% CI 1.64, 3.55), and parental neglect (OR = 2.64; 95% CI 1.86, 3.42) were significantly associated with depression among high school students in Ethiopia. In this study, the overall pooled prevalence of depression among high school students in Ethiopia was high. Being female, alcohol use and parental neglect were potential factors associated with depression among high school students in Ethiopia. Therefore, it is important to pay special attention and design interventions to address depression among high school students in Ethiopia. PROSPERO registration number: CRD42024543877.