Abstract
BackgroundThe burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia.MethodsA search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran’s Q- statistic and the Higgs I2 test. A sensitivity analysis was also implemented. Publication bias was checked with Egger’s test and funnel plots visually.ResultsAmong 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%.ConclusionThe pooled magnitude of depression in prisoner’s population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
Highlights
The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it
This review and meta-analysis study obtained a pooled magnitude of depression in prisoner’s population in Ethiopia to be very high, 53.40%(95% confidence intervals (CI): 41.33, 65.46) and this pooled estimate was under the influence of considerable heterogeneity
Subgroup analysis showed that the pooled effect size for the depression prevalence was significantly in the southern region of the country than the pooled magnitude of depression in Oromia, southwest Ethiopia
Summary
The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. No pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia. Ethiopia has huge number of prisons both at the federal and regional levels. The federal prisons are used basically to handle serious crimes. Kality Prison; synonymously called Kilinto Prison is among the federal prisons and located in Addis Ababa and serves as the main prison of the country where the most severe form of crime that needs a long duration of sentences is handled there. Prisoners in Ethiopia are involved in skill-building activities while they are in prison which is essential for their future life as they are mostly in the productive age group
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