Prevalence of depression among students at Ethiopian universities and associated factors: A systematic review and meta-analysis

Abstract

Background Depression is the most common cause of disability in the world, which affects 350 million people. University students struggle to cope with stressors that are typical of higher education institutions as well as anxiety related to education. Although evidence indicates that they have a high prevalence of depression, no reviews have been done to determine the prevalence of depression among students at Ethiopian universities comprehensively. Methods Without regard to time constraints, PubMed, Scopus, and EMBASE were investigated. A manual search for an article reference list was also conducted. The Meta XL software was used to extract relevant data, and the Stata-11 meta-prop package was used to analyze it. The Higgs I2 test was used to test for heterogeneity. Results A search of the electronic and manual systems resulted in 940 articles. Data were extracted from ten studies included in this review involving a total number of 5207 university students. The pooled prevalence of depression was 28.13% (95% CI: 22.67, 33.59). In the sub-group analysis, the average prevalence was higher in studies having a lower sample size (28.42%) than studies with a higher sample; 27.70%, and studies that utilized other (PHQ-9, HADS); 30.67% higher than studies that used BDI-II; 26.07%. Being female (pooled AOR = 5.56) (95% CI: 1.51, 9.61), being a first-year (pooled AOR = 4.78) (95% CI: 2.21, 7.36), chewing khat (pooled AOR = 2.83) (95% CI: 2.32, 3.33), alcohol use (pooled AOR = 3.12 (95% CI:3.12, 4.01) and family history of mental illness (pooled AOR = 2.57 (95% CI:2.00, 3.15) were factors significantly associated with depression. Conclusion This systematic review and meta-analysis revealed that more than one-fourth of students at Ethiopian universities had depression. More efforts need to be done to provide better mental healthcare to university students in Ethiopia.

Prevalence of depression and its associated factors among Ethiopian students: a systematic review and meta-analysis

“…Accordingly, being female was 2.8 times more likely to have depression compared with male sex. This finding was consistent with other studies conducted in Ethiopia, 81 Cameroon, 74 Saudi Arabia 78 and Brazil. 84 This might be due to the fact that females are more prone to depression due to gender-related vulnerability to psychosocial stressors and they are also more sensitive to stress.…”

“…The result of this systematic review and meta-analysis was higher than the findings of other studies conducted in Ethiopia 28.13%, 81 Spain 18.4%, 82 Australia 21.8% 26 and the USA 23%. 31 It was also higher than the systematic review and meta-analysis that was conducted in China, with a pooled prevalence of 28.4%.…”

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

“…The physical factors that were associated with higher depression prevalence in both cohorts had a higher relative risk in the 2021 cohort, implying that the ongoing pandemic has worsened the negative impact of the pre-existing health conditions on mental health outcomes [ 18 ]. The behavioural factors that were associated with higher depression prevalence in the 2020 cohort had a weaker relative risk in the 2021 cohort, which could be attributed to a coping and adaptive mechanism in response to the acute stress following the outbreak of the pandemic [ 2 , 5 ]. Despite the limitations of using two cross-sectional samples, this study adds to the existing literature by demonstrating that sociodemographic and physical risk factors have a more lasting and accumulated influence on depression among university entrants during the pandemic, while behavioural risk factors have a more immediate and transient influence at the onset of the pandemic.…”

“…The diversity and complexity of depressive experiences and outcomes depend on various factors. Some of these factors are sociodemographic, such as age, gender, ethnicity, study level, and residency status [ 5 , 6 ]. Sociodemographic characteristics may affect the level of exposure, vulnerability, and resilience to depressive triggers and stressors.…”

“…Sociodemographic characteristics may affect the level of exposure, vulnerability, and resilience to depressive triggers and stressors. Behavioural factors, such as alcohol and tobacco use, [ 2 , 5 ] may indicate maladaptive coping strategies, impaired emotion regulation, or increased rumination, which are all associated with higher depression risk. Additionally, physical factors such as multimorbidity, family history of depression, and obesity could also contribute to depression [ 7 – 9 ].…”