The magnitude of co-morbid depression with post-traumatic stress disorder symptom in Africa, 2024 Systematic review and meta analysis

Objective: Depression is a significant public health concern arising from a complex interplay of environmental, psychological, biological, and social factors. Traumatic life experiences, such as war, disasters, accidents, and abuse, are prevalent in Africa and often lead to various mental health conditions. This review aims to assess the pooled burden of comorbid depression among individuals experiencing PTSD symptoms in Africa in 2024. Method: This study conducted a systematic review and meta-analysis, focusing on individuals diagnosed with both depression and post-traumatic stress disor der (PTSD). A comprehensive literature search was conducted across six major databases: PubMed, Scopus, Embase, PsycINFO, AJOL, and Google Scholar. Eligible studies published between 2008 and 2024 were included in the analysis. Statistical assumptions for random-effects models, heterogeneity, and publication bias were tested and met. Data extraction was performed using Microsoft Excel, with subsequent statistical analyses conducted using STATA-18 software. Result: This systematic review and meta-analysis integrated nineteen cross sectional studies from Africa, encompassing a total of 3,249 participants. The pooled prevalence estimate of comorbid depression among individuals exhibiting PTSD symptoms was 61% (95% CI: 49-72; I2 = 99.2%, P < 0.0001). A subgroup analysis based on study settings and sub-regions of the African continent revealed the highest prevalence of comorbid depression in refugee populations, reaching 75% (95% CI: 70-79, P < 0.0001). Regional subgroup analysis indicated a comorbid depression prevalence of 58% (95% CI: 51-65, P < 0.0001) in East Africa and 74% (95% CI: 52-97, P < 0.0001) in West Africa. Conclusion: This review indicates that more than half of respondents with PTSD in African populations also have comorbid depression, with the highest prevalence observed in refugee settings and West African countries. Comprehensive psychoso cial intervention guidelines are needed to effectively manage both conditions in clinical and humanitarian settings.