Background: The COVID-19 pandemic is a worldwide epidemic declared by the world health organization as a public health emergency of concern and consequently inducing huge mental health and psychological reactions. Aims: This study is aimed to summarize the existing data regarding anxiety, depression, and psychological distress during the covid-19 pandemic among the wider population so that effective intervention strategies will be initiated. Methods: Pieces of literature that assessed anxiety, depression, and psychological distress among the general population during the COVID pandemic period were systematically gathered. Data extraction in Microsoft excel was done by two independent reviewers using predefined criteria. The analysis was done using a stata-11 and random effect model. A sub-group and sensitivity analysis was done. Besides, the funnel plot and eggers publication bias test was tested. Results: Sixteen studies that assessed 78,225 participants were included. Nine studies were included in the meta-analysis for anxiety prevalence. The average prevalence of anxiety was found to be 38.12%. A sub-group analysis showed that anxiety was 33.33% in China and 47.70% in other countries (Italy, Turkey, and India). Anxiety prevalence in studies measured with the DASS-21 scale, GAD-7 scale, and other tools (SAS, HADS, and 5-point Likert scale) was 23.4%, 40.73%, and 44.47% respectively. The prevalence of anxiety in studies that assessed a sample size above 2,000 participants was 40.33%. The average prevalence of depression among included studies was 34.31% and a sub-group analysis showed that depression was higher in China (36.32%) than in other countries (28.3%). Moreover, six studies reported psychological distress and the average prevalence was 37.54%. Conclusion: This study revealed that anxiety, depression, and psychological distress are potential public mental health problems of the global community that suggests the need for early recognition and initiation of interventions during the COVID-19 pandemic period.

IntroductionContraception discontinuation is a major public health issue that leads to unwanted pregnancies and unsafe abortions. Therefore, this systematic review and meta-analysis aimed to estimate discontinuation of contraceptives and its determinants in Ethiopia.MethodsPubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed.ResultsOut of 654 studies assessed, 20 met our criteria and were included in the study. The total number of study participants was 8,780. The pooled prevalence of discontinuation of long acting reversible contraceptive use was 36.94% (95% CI: 28.547–45.326). According to sub-group analysis, Amhara region (45%) and institution-based studies (47.9%) had the highest prevalence. The most common reason for contraceptive discontinuation was negative side effect (42.3%).Women experienced side effects (AOR = 2.833:95% CI:2.005–4.003), didn't receive counseling on side effects (AOR = 2.417; 95% CI: 1.591–3.672), didn't appoint follow up (AOR = 2.820; 95% CI: 2.048–3.881), dissatisfied with the given service (AOR = 5.156; 95% CI: 3.644–7.296), and a desire to be pregnant (AOR = 2.366; 95% CI: 1.760–3.182) were predictors of discontinuation of contraceptives.ConclusionIn Ethiopia, the pooled prevalence of long acting contraceptive discontinuation was high. Side effects, not being informed about side effects, dissatisfaction with the provided service, no insertion follow-up, and a desire to become pregnant were all associated factors. Healthcare professionals should focus on the client's reproductive goals, proper management of side effects, counseling, and post-insertion visits.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347860, identifier CRD42022347860.

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