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撒哈拉以南非洲地区艾滋病毒阳性女性的产前抑郁症及其预测因素；系统评价与荟萃分析

Antenatal depression and its predictors among HIV positive women in Sub-Saharan Africa; a systematic review and meta-analysis.

作者信息

Abebe Gossa Fetene, Alie Melsew Setegn, Adugna Amanuel, Asemelash Daniel, Tesfaye Tamirat, Girma Desalegn, Asres Abyot

机构信息

Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan, Ethiopia.

School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia.

出版信息

Front Psychiatry. 2024 Jun 11;15:1385323. doi: 10.3389/fpsyt.2024.1385323. eCollection 2024.

DOI:10.3389/fpsyt.2024.1385323
PMID:38919635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11196764/
Abstract

BACKGROUND

Antenatal depression in Human Immunodeficiency Virus (HIV) positive pregnant women can have significant adverse effects on both the mother and newborns, yet it is often overlooked in pregnancy care in Sub-Saharan Africa (SSA). Despite this, there is limited data on the combined prevalence of antenatal depression and its predictors among HIV-positive women in the region.

OBJECTIVE

To assess the pooled prevalence of antenatal depression and its associated factors among HIV-positive women in SSA.

METHODS

All primary cross-sectional studies published before 1 January/2024, were included. We conducted searches in relevant databases; PubMed, HINARI, Web of Science, PsycINFO, Psychiatry Online, ScienceDirect, and Google Scholar. The Joanna Briggs Institute checklist was used to critically appraise the selected studies. To assess heterogeneity among the studies, we utilized the I test. Publication bias was evaluated using a funnel plot and Egger's test. The forest plot was used to present the combined proportion of antenatal depression and odds ratio, along with a 95% confidence interval.

RESULTS

The pooled prevalence of antenatal depression among HIV-positive women in Sub-Saharan Africa was found to be 30.6% (95% CI, 19.8%-41.3%). Factors significantly associated with antenatal depression among HIV-positive women in SSA included being unmarried (AOR: 3.09, 95% CI: 1.57 - 6.07), having a previous history of depression (AOR: 2.97, 95% CI: 1.79 - 4.91), experiencing intimate partner violence (IPV) (AOR: 2.11, 95% CI: 1.44 - 3.09), and experiencing stigma (AOR: 1.36, 95% CI: 1.05 - 1.76).

CONCLUSION

High prevalence of antenatal depression among HIV-positive women in SSA underscores the need for prioritizing identification and management. Interventions addressing factors like IPV and stigma, along with training for healthcare providers in recognizing symptoms and providing support, are recommended.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024508236.

摘要

背景

人类免疫缺陷病毒（HIV）阳性孕妇的产前抑郁会对母亲和新生儿产生重大不利影响，但在撒哈拉以南非洲（SSA）的孕期护理中，这一问题常常被忽视。尽管如此，该地区HIV阳性女性中产前抑郁的合并患病率及其预测因素的数据有限。

目的

评估SSA地区HIV阳性女性中产前抑郁的合并患病率及其相关因素。

方法

纳入所有在2024年1月1日前发表的原发性横断面研究。我们在相关数据库中进行了检索；包括PubMed、HINARI、科学网、PsycINFO、《精神病学在线》、ScienceDirect和谷歌学术。使用乔安娜·布里格斯研究所清单对所选研究进行严格评估。为了评估研究之间的异质性，我们使用了I检验。使用漏斗图和埃格检验评估发表偏倚。森林图用于呈现产前抑郁的合并比例和比值比，以及95%置信区间。

结果

撒哈拉以南非洲HIV阳性女性中产前抑郁的合并患病率为30.6%（95%CI，19.8%-41.3%）。SSA地区HIV阳性女性中与产前抑郁显著相关的因素包括未婚（调整后比值比：3.09，95%CI：1.57-6.07）、有抑郁症病史（调整后比值比：2.97，95%CI：1.79-4.91）、经历亲密伴侣暴力（IPV）（调整后比值比：2.11,95%CI：1.44-3.09）以及遭受耻辱感（调整后比值比：1.36，95%CI：1.05-1.76）。

结论

SSA地区HIV阳性女性中产前抑郁的高患病率凸显了优先进行识别和管理的必要性。建议采取干预措施解决IPV和耻辱感等因素，并对医疗保健提供者进行识别症状和提供支持方面的培训。

系统评价注册

https://www.crd.york.ac.uk/PROSPERO/，标识符CRD42024508236。

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