低收入国家埃塞俄比亚接受抗逆转录病毒治疗患者的抑郁症状及其决定因素：一项系统评价和荟萃分析

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.

作者信息

Necho Mogesie, Belete Asmare, Tsehay Mekonnen

机构信息

Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

Int J Ment Health Syst. 2021 Jan 6;15(1):3. doi: 10.1186/s13033-020-00430-2.

BACKGROUND

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.

METHODS

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 I test were also done. Besides, the Eggers test and symmetry in the funnel plot were used to detect the presence/absence of publication bias.

RESULT

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.

CONCLUSION

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.

背景

感染艾滋病毒/艾滋病的人群中存在抑郁症可能导致不坚持服用抗逆转录病毒药物。这还会导致进一步的合并症和机会性疾病，进而降低患者的生活质量。因此，本研究的目的是确定艾滋病毒患者中抑郁症的合并患病率及其相关因素。

方法

对PubMed、Scopus和EMBASE中的相关文章进行了调查。使用Meta-XL 5.3版本提取数据，并使用具有随机效应模型的STATA-11 Meta-prop软件包对抑郁症及其相关因素进行量化。进行敏感性和亚组分析以探索异质性来源。还进行了Cochran's Q统计量和Higgs I检验。此外，使用Egger检验和漏斗图的对称性来检测是否存在发表偏倚。

结果

在这项荟萃分析中，我们纳入了21篇评估10090名参与者的文章。艾滋病毒/艾滋病患者中抑郁症的平均患病率为35.8%（95%置信区间28.29，43.25）。奥罗米亚地区抑郁症状的平均估计患病率为59.4%，埃塞俄比亚南部为29.25%。此外，分别用贝克抑郁量表和医院焦虑抑郁量表测量的抑郁症平均患病率为45.6%和26.2%。此外，样本量≤400名参与者的研究中抑郁症患病率为47.7%，样本量>400名参与者的研究中为28.5%。感知到的艾滋病毒耻辱感的合并调整优势比（AOR）为3.75（95%置信区间2.34，5.16），社会支持差的合并调整优势比为6.22（95%置信区间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%置信区间1.00，5.05）、5.5（95%置信区间1.97，10.03）和5.43（95%置信区间1.60，9.28）。