Post‐Stroke Depression and Determinants in Ethiopia; A Systematic Review and Meta‐Analysis

Abstract

ABSTRACT Introduction Post stroke depression is a critical barrier to recovery and rehabilitation, contributing to a higher risk of severe disability, cognitive and functional decline, greater dependence on daily activities, and poor adherence to treatment. Additionally, post‐stroke depression is a leading cause of death globally. The prevalence of PSD varies significantly depending on the type of study and screening methods used. However, it remains poorly understood and inadequately explored in many parts of the world, especially in developing countries. To identify the key determinants of PSD, conducting a systematic review and meta‐analysis is crucial and relevant to current clinical practices. Methods In conducting this review, the International Preferred Reporting Items for Systematic Reviews and Meta‐Analyses checklist was used. This review focused on studies examining the prevalence of post‐stroke depression and its determinants in Ethiopia. Two authors conducted electronic searches in PubMed, Google Scholar, Science Direct, and African Journals Online Library, with the search period extending until April 8, 2024. Data were extracted using Microsoft Excel and exported to STATA version 11 software for analysis. Heterogeneity of studies was assessed by Cochran's Q test and I2 statistics. Results The analysis included the final eight studies. The pooled prevalence of post stroke depression was 40.9% (95% CI: 26.52–55.28, p < 0.001). The analysis revealed significant heterogeneity among the included studies (I2 = 91.1%, p < 0.001). Being female (OR 3.51, 95% CI: 1.87–6.58), being illiterate (OR 2.02, 95% CI: 1.29–3.17), and being over 40 years old (OR = 1.59, 95% CI: 1.09, 2.32) were determinants of post stroke depression. Conclusions According to the current review, post stroke depression is highly prevalent in Ethiopia. Being female, being illiterate and being over 40 years old were factors associated with post stroke depression. Therefore, attention should be given to strengthening social support; health professionals should focus on reducing disability/physical dependency and depression, as these are vital factors for improving quality of life.