Magnitude of depression and associated factors among patients with tuberculosis in sub-Saharan Africa: A systematic review and meta-analysis.

Abstract

• This systematic review and meta-analysis reported the prevalence of depression and risk factors among tuberculosis patients in Sub-Saharan Africa. • This review revealed that more than one-third of tuberculosis patients in sub-Saharan countries had comorbid depression • Multi drug resistant tuberculosis treatment, intensive phase of the treatment and having a comorbid chronic illness were associated factors of depression. • Routine screening and integrated management of comorbid depression among patients with Tuberculosis are important to be considered by clinicians. : Depression in tuberculosis patients escalates the risk of adverse health outcomes. Despite its serious complications, limited evidence regarding the magnitude of comorbidity and determinants of depression among patients with tuberculosis is available in Africa. : This systematic review and meta-analysis was followed Preferred Reporting Items for Systematic Review and Meta-Analysis 2009 guideline. International databases such as were searched. Meta-analysis was conducted using STATA version 14 software. Quality of studies was assessed by using the Newcastle-Ottawa Scale criteria. The random effects model was used to estimate the pooled prevalence of depression at 95% confidence interval level. : This review includes a total of 19 articles with 4391 participants. The pooled prevalence of depression among patients with tuberculosis was 39.42%. Comorbid chronic illnesses, multi-drug resistance treatment, and being on intensive phase of treatment were significant factors associated with depression in patients with tuberculosis. : This systematic review and meta-analysis revealed that more than one-third of patients with tuberculosis in sub-Saharan countries had comorbid depression. Usual screening and integrating the management of depression in patients with tuberculosis by clinicians is critical in reducing its effect. Researchers might study furtherly the emotional consequence of tuberculosis by considering affecting factors. : Selection bias was observed as we were only able to review English-language studies. We got studies only from nine countries among 54 countries of the region, and some of the studies used small sample size, could reduce the representativeness of the findings. The prevalence estimation of this systematic review and meta-analysis was also influenced by studies variation in tool preferences to measure depression among tuberculosis patients.