Prevalence and associated factors of depression among breast cancer patients in Sub-Saharan Africa: A systematic review and meta-analysis

Author:

Mohammed Anissa1ORCID,Melak Dagnachew1,Demeke Bayou Fekade1ORCID,Yasin Husniya1,Zerga Aregash Abebayehu2ORCID,Wagaye Birhanu2,Yeshanew Ayele Fanos2,Hussien Asfaw Ahmed2,Kebede Natnael3ORCID,Mekonen Asnakew Molla4,Mihiretu Mengistu Mera4ORCID,Tsega Yawkal4,Addisu Elsabeth5,Cherie Niguss5ORCID,Birhane Tesfaye5,Endris Hussien6,Abegaz Zinet5ORCID,Endawkie Abel1

Affiliation:

1. Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

2. Department of Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

3. Department of Health Promotion, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

4. Department of Health System and Management, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

5. Department of Reproductive Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia

6. Department of Anaesthesia and Critical Care, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia

Abstract

Introduction: Even though breast cancer incidence is lower in Sub-Saharan Africa, its mortality is higher in these countries. However, the impact does not end with diagnosis and treatment; rather many patients struggle with depression which is very common among these patients. This systematic review and meta-analysis helps to provide valuable insights into the overall prevalence of depression and associated factors among breast cancer patients in Sub-Saharan Africa. Method: We searched several databases, including MEDLINE, Embase, Scopus, Hinary, CINHAL and Google Scholar to retrieve relevant literatures from inception up to 15 June 2023. All observational studies, published in English at any time were included, while, letters to editor, review articles, commentaries, interventional and qualitative studies, and, abstracts presented in conferences or seminars were excluded. The results of this systematic review and meta-analysis have been written based on the PRISMA 2020 checklist and the protocol have been registered in PROSPERO database (CRD42023428910). Result: We have included nine articles with 2226 study participants. The result showed that, the pooled prevalence of depression among breast cancer patients in Sub-Saharan Africa was 45.6% (95% CI: 30%–61%) with significant heterogeneity I2 = 98.9%, (Cochrane) Q < 0.0001. There was no single study effect and publication bias but substantial heterogeneity was observed. In addition, there has been a publication bias with eggers test ( p < 0.0033). However, there were no studies imputed after trim and fill analysis. From the factors, breast cancer patients who had poor financial support were 1.47 (95% CI: 1.02–2.13) times more at risk of developing depression than their counterparts. Conclusion: The prevalence of depression among breast cancer patients in Sub-Saharan Africa countries were higher than other regions. Thus, Emphasis should be given on developing financial assistance programs designed to cover the medical costs and improving the health care infrastructure.

Publisher

SAGE Publications

Reference46 articles.

1. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

2. Breast cancer in sub-Saharan Africa: The current state and uncertain future

3. Ethiopia – Global Cancer Observatory. International agency for research on cancer, The Global cancer observatory, https://gco.iarc.fr/today/data/factsheets/populations/231-ethiopia-fact-sheets.pdf (2021, accessed 06 July 2023).

4. A review of psychological impact of breast cancer in women below 50 years old

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