Depressive symptoms and their determinants in patients who are on antiretroviral therapy in the case of a low-income country, Ethiopia: a systematic review and meta-analysis.
Depressive symptoms and their determinants in patients who are on antiretroviral therapy in the case of a low-income country, Ethiopia: a systematic review and meta-analysis.
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DOI：
10.1186/s13033-020-00430-2
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发表时间：
2021-01-06
影响因子：
3.6
通讯作者：
Tsehay M
中科院分区：
文献类型：
--
作者：
Necho M;Belete A;Tsehay M
艾滋病毒/艾滋病感染者出现抑郁症可能导致不坚持抗逆转录病毒药物治疗。它还会导致进一步的合并症和机会性疾病，从而降低患者的生活质量。因此，本研究的目的是确定HIV患者中抑郁症的总体患病率及其相关因素。研究了PubMed、Scopus和EMBASE中的相关文章。采用Meta-XL version 5.3提取数据，采用STATA-11 Meta-prop软件包和随机效应模型量化抑郁及其相关因素。进行敏感性和亚组分析以探索异质性的来源。还进行了科克伦q统计量和希格斯I2检验。此外，使用Eggers检验和漏斗图的对称性来检测是否存在发表偏倚。在这项荟萃分析中，我们纳入了21篇文章，评估了10090名参与者。艾滋病毒/艾滋病患者中抑郁症的平均患病率为35.8% （95% CI 28.29, 43.25）。在奥罗米亚地区，抑郁症状的平均估计患病率为59.4%，在埃塞俄比亚南部为29.25%。贝克抑郁量表和医院焦虑抑郁量表的平均抑郁患病率分别为45.6%和26.2%。此外，在样本量≤400名参与者的研究中，抑郁症的患病率为47.7%，而在样本量为400名参与者的研究中，抑郁症的患病率为28.5%。感知艾滋病毒耻辱的合并调整优势比（AOR）为3.75 (95% CI 2.34, 5.16)，社会支持差的合并调整优势比为6.22 （95% CI 2.96, 9.47）。此外，药物依从性差、机会性感染和艾滋病晚期的平均优势比分别为3.03 （95% CI 1.00, 5.05）、5.5 （95% CI 1.97, 10.03）和5.43 （95% CI 1.60, 9.28）。艾滋病毒/艾滋病感染者中抑郁症的总体患病率很高。与HIV污名感、社会支持差、机会性感染、艾滋病晚期、药物依从性差等因素相关。应重视抑郁症及其相关因素的常规筛查和管理。
The presence of depression in people living with HIV/AIDS could lead to non-adherence to antiretroviral medications. It also leads to further comorbid and opportunistic illness and then lowering the patient's quality of life. The objective of this study was therefore to determine the pooled prevalence of depression and its related factors in HIV patients. Relevant articles in PubMed, Scopus, and EMBASE were investigated. The Meta-XL version 5.3 was used to extract data and STATA-11 Meta-prop packages with the Random effect model was used to quantify depression and its related factors. Sensitivity and subgroup analysis were performed to explore sources of heterogeneity. The Cochran’s Q-statistic and the Higgs I2 test were also done. Besides, the Eggers test and symmetry in the funnel plot were used to detect the presence/absence of publication bias. In this meta-analysis, we included 21 articles that assessed 10,090 participants. The average prevalence of depression among people with HIV/AIDS was 35.8% (95% CI 28.29, 43.25). The average estimated prevalence of depressive symptoms was 59.4% in the Oromia region and 29.25% in southern Ethiopia. Besides, the average prevalence of depression was 45.6% and 26.2% as measured with Beck’s depression inventory and Hospital anxiety and depression scale respectively. Moreover, the prevalence of depression was 47.7% in studies that used a sample size ≤ of 400 participants and 28.5% in studies that used a sample size of > 400 participants. The pooled adjusted odds ratio (AOR) of perceived HIV stigma was 3.75 (95% CI 2.34, 5.16) and that of poor social support was 6.22 (95% CI 2.96, 9.47). Moreover, the average odds ratio of poor medication adherence, opportunistic infection, and advanced stages of AIDS were 3.03 (95% CI 1.00, 5.05), 5.5 (95% CI 1.97, 10.03), and 5.43 (95% CI 1.60, 9.28) respectively. The pooled prevalence of depression among individuals living with HIV/AIDS was high. Factors such as perceived HIV stigma, poor social support, opportunistic infection, advanced AIDS stage, and poor medication adherence were related to it. Routine screening and management of depression and its related factors should be given due consideration.
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