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Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis

INTRODUCTION: Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and...

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Autores principales: Dadi, Abel Fekadu, Akalu, Temesgen Yihunie, Baraki, Adhanom Gebreegziabher, Wolde, Haileab Fekadu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188237/
https://www.ncbi.nlm.nih.gov/pubmed/32343736
http://dx.doi.org/10.1371/journal.pone.0231940
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author Dadi, Abel Fekadu
Akalu, Temesgen Yihunie
Baraki, Adhanom Gebreegziabher
Wolde, Haileab Fekadu
author_facet Dadi, Abel Fekadu
Akalu, Temesgen Yihunie
Baraki, Adhanom Gebreegziabher
Wolde, Haileab Fekadu
author_sort Dadi, Abel Fekadu
collection PubMed
description INTRODUCTION: Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. METHODS: We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I(2) statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). RESULTS: Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. CONCLUSION: While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.
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spelling pubmed-71882372020-05-06 Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis Dadi, Abel Fekadu Akalu, Temesgen Yihunie Baraki, Adhanom Gebreegziabher Wolde, Haileab Fekadu PLoS One Research Article INTRODUCTION: Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. METHODS: We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I(2) statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). RESULTS: Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. CONCLUSION: While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND. Public Library of Science 2020-04-28 /pmc/articles/PMC7188237/ /pubmed/32343736 http://dx.doi.org/10.1371/journal.pone.0231940 Text en © 2020 Dadi et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dadi, Abel Fekadu
Akalu, Temesgen Yihunie
Baraki, Adhanom Gebreegziabher
Wolde, Haileab Fekadu
Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title_full Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title_fullStr Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title_full_unstemmed Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title_short Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis
title_sort epidemiology of postnatal depression and its associated factors in africa: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188237/
https://www.ncbi.nlm.nih.gov/pubmed/32343736
http://dx.doi.org/10.1371/journal.pone.0231940
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