Prevalence, Predictors, and Outcomes of Depression in Persons With Type 2 Diabetes Mellitus in Africa: A Systematic Review and Meta-analysis

Abstract Depression is a debilitating comorbidity in individuals with type 2 diabetes mellitus (T2DM), severely impacting disease management and outcomes. This review aimed to synthesize quantitative evidence regarding the prevalence, predictors, and outcomes of depression among persons with T2DM in Africa. Relevant studies were identified from searches on PubMed, PsycINFO, Embase, Global Health, Scopus, and Web of Science from their inception to April 27, 2024. Data on depression prevalence were aggregated through random-effect meta-analysis, whereas accounting for variation using subgroup analysis. Narrative synthesis was conducted to textually summarize the predictors and outcomes of depression. A total of 42 articles involving 14,401 participants with T2DM were included in this review. The pooled prevalence of depression was 37.9% (95% confidence interval = 31.2–45.1). Subgroup analysis based on gender revealed a higher prevalence of depression in females than in males (37.9% vs. 33.2%). Predictors of depression included sociodemographic factors, clinical and diabetes-related factors, psychosocial factors, and care behaviors. Depression was associated with low engagement in self-care, diminished quality of life and psychological well-being, poor glycemic control, and diabetes-related complications. The prevalence of depression is considerably high among persons with T2DM in Africa and is associated with negative health outcomes. This underscores the pressing need for integrated mental health and diabetes care in the region. PROSPERO registration: CRD42024541709.