Prevalence and Correlates of Major Depressive Disorder among Human Immunodeficiency Virus Infected Adults in Sub-Saharan Africa: A Systematic Review and Meta-analysis

Abstract

Introduction: Although major depressive disorder (MDD) is the commonest psychiatric complication of HIV infection, its prevalence and correlates are not fully evaluated in Sub-Saharan Africa (SSA). Methods: PsychInfo, Medline and Google scholar were among the data bases searched for relevant publications up to December 2013. Assessments of study quality, heterogeneity test (I2 statistics) and sensitivity analysis were performed. We used random-effects model (REM) meta-analysis to derive pooled estimates of MDD in SSA. Statistically significant p-value in both Egger’s and Begg’s tests denote publication bias. Results: The prevalence (95% confidence interval [CI]) of MDD among HIV infected subjects was 17.3% (11.65-22.97). Symptomatic patients with Acquired immune deficiency syndrome (AIDS) had significantly higher prevalence than asymptomatic patients (17.5% and 8.3% respectively, P = .036). Odds Ratio [OR] (95% CI) of correlates of MDD were: HIV infection = 3.1 (1.97-4.17), female gender = 1.71 (1.09-2.32), Tuberculosis (TB) = 2.34 (1.0-5.63), food insecurity = 2.89 (1.40-5.89), higher income = 0.68 (0.45-1.0) and high social support = 0.75 (0.60-0.90). Conclusion: HIV infection is associated with development of MDD and AIDS patients are mostly afflicted. Preventing disease progression and improving the social welfare of patients are interventions needed to reduce the burden of MDD among HIV-infected subjects in SSA.