Abstract

Background: Depression is one of the major mental health disorders and predicted as a second disease burden in the globe by the year 2020, but it is neglected mental disorders among HIV patients in Sub-Sahara Africa. Depression in HIV patients lead to poor engagement to care and poor health outcomes. There are various studies conducted on the prevalence and factors associated with depression among HIV patients. However, there is limited study which shows the national estimate of depression and the association of stigma and depression among Adult HIV/AIDS in Ethiopia. Therefore, this review is conducted to assess the pooled prevalence of depression and the association of stigma and depression among Adult HIV/AIDS in Ethiopia.

Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies conducted in Ethiopia. To access primary studies, MEDLINE through PubMed, Google Scholar, HINARI, CINAHL and African Journals Online, and University library (repository) were used as a source. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. Observational studies that report on prevalence of depression and odds ratio to see the association of stigma and depression among HIV infected adults were searched systematically. Data were extracted by using Microsoft excel sheet. Stata/se version 14 was used for analysis. Variability between the studies was assessed by using forest plot and I-squared heterogencity test. Subgroup and sensitivity analysis was done when I² >50. Small studies publication bias was checked subjectively through funnel plot and objectively through egger’s test. The pooled estimate prevalence and odds ratio with 95% CI were computed using random effect model of analysis.

Result: a Total of 1779 articles were identified, of which, 17 studies were eligible for full review. Eleven articles were used for analysis. Of the 11 articles only four articles used to estimate the pooled odds ratio. The pooled prevalence of depression was 19.95 %( 95% CI: 6.31%, 33.59). Whereas, the pooled effect size of depression among stigmatized patient was 2.52(95% CI: 1.9, 3.34).

Conclusion:

The pooled prevalence of depression among HIV/AIDS patients in Ethiopia was found to be high and stigma was significantly associated with depression. Programs offering support to PLWHA in Ethiopia should screen for stigma and depression in order to provide comprehensive support to at risk patients.

Keywords: Depression, Ethiopia, HIV infected patients, Meta-analysis, Stigma, systematic review