埃塞俄比亚艾滋病毒/艾滋病感染者中常见精神障碍的患病率及其与感知耻辱和社会支持的关联：一项系统评价和荟萃分析

Prevalence of common mental disorder and its association with perceived stigma and social support among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.

作者信息

Duko Bereket, Belayhun Yitagesu, Bedaso Asres

机构信息

School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.

Australian Centre for Precision Health, Unit of Clinical & Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.

出版信息

Int J Ment Health Syst. 2024 Jul 8;18(1):25. doi: 10.1186/s13033-024-00641-x.

DOI:10.1186/s13033-024-00641-x

PMID:38978036

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11232219/

Abstract

BACKGROUND

When common mental disorders (CMD) co-occur with HIV/AIDS, they can complicate patient diagnosis, help-seeking behaviors, quality of life, treatment outcomes, and drug adherence. Thus, estimating the pooled prevalence of CMD and its association with perceived stigma and social support among people living with HIV/AIDS (PLWHA) in Ethiopia could potentially support policymakers and health professionals to understand the disease burden and set a solution to improve the mental well-being of PLWHA.

METHODS

Popular databases such as PubMed, SCOPUS, EMBASE, and Psych-INFO as well as Google Scholar, AJOL, CINAHL, PILOTS and Web of Science were searched for the relevant articles conducted in Ethiopia. We included cross-sectional, case-control, and cohort studies in the review. The Comprehensive Meta-Analysis software version 3.0 was used to pool the results of the included studies. The Q- and I-statistics were used to assess the heterogeneity between the included studies. We employed a random-effects meta-analysis model to estimate the pooled prevalence of CMD and to account for heterogeneity among the included studies. We also conducted a leave-one-out analyses, and stratified meta-analyses by gender (male and female).

RESULTS

The studies included in this systematic review and meta-analysis were published between 2009 and 2021, recruiting a total of 5625 participants. The pooled estimated prevalence of CMD among PLWHA in Ethiopia was 26.1% (95% CI 18.1-36.0). The pooled estimated prevalence of CMD was significantly higher among females, at 39.5% (95% CI 21.2-39.0), compared to males, 26.9% (95% CI 15.6-31.7). Moreover, the pooled estimated prevalence of CMD in PLWHA ranged from 23.5 to 28.9% in the leave-one-out sensitivity analysis, indicating that the removal of any single study did not significantly affect the pooled estimate. The pooled effects (AOR) of Perceived HIV stigma and poor perceived social support on common mental disorder were 2.91, 95% CI (1.35-6.29) and 5.56, 95% CI (1.89-16.39), respectively.

CONCLUSION

People living with HIV/AIDS (PLWHA) who received poor social support and those with HIV-related perceived stigma were found to have strong association with CMD. Therefore, it is advisable that all PLWHA attending ART clinic should be screened for CMD, social support and HIV-related perceived stigma.

摘要

背景

当常见精神障碍（CMD）与艾滋病毒/艾滋病同时发生时，会使患者诊断、寻求帮助行为、生活质量、治疗结果和药物依从性变得复杂。因此，估计埃塞俄比亚艾滋病毒/艾滋病感染者（PLWHA）中CMD的合并患病率及其与感知耻辱和社会支持的关联，可能有助于政策制定者和卫生专业人员了解疾病负担，并制定改善PLWHA心理健康的解决方案。

方法

在PubMed、SCOPUS、EMBASE和Psych-INFO等流行数据库以及谷歌学术、AJOL、CINAHL、PILOTS和科学网中搜索在埃塞俄比亚进行的相关文章。我们纳入了综述中的横断面研究、病例对照研究和队列研究。使用综合元分析软件版本3.0汇总纳入研究的结果。Q统计量和I统计量用于评估纳入研究之间的异质性。我们采用随机效应元分析模型来估计CMD的合并患病率，并考虑纳入研究之间的异质性。我们还进行了逐一剔除分析，并按性别（男性和女性）进行分层元分析。

结果

该系统评价和元分析纳入的研究发表于2009年至2021年之间，共招募了5625名参与者。埃塞俄比亚PLWHA中CMD的合并估计患病率为26.1%（95%CI 18.1 - 36.0）。女性中CMD的合并估计患病率显著高于男性，分别为39.5%（95%CI 21.2 - 39.0）和26.9%（95%CI 15.6 - 31.7）。此外，在逐一剔除敏感性分析中，PLWHA中CMD的合并估计患病率在23.5%至28.9%之间，这表明剔除任何一项研究对合并估计值没有显著影响。感知到的艾滋病毒耻辱感和较差的感知社会支持对常见精神障碍的合并效应（AOR）分别为2.91，95%CI（1.35 - 6.29）和5.56，95%CI（1.89 - 16.39）。