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Meta-Analysis
. 2025 Apr 25;25(1):1547.
doi: 10.1186/s12889-025-22685-5.

Exploring the occurence and risk factors of post-stroke depression among stroke survivors in Africa: a comprehensive systematic review and meta-analysis

Techilo Tinsae  1 , Wondale Getinet  2 , Setegn Fentahun  2 , Shegaye Shumet  2 , Girmaw Medifu  2 , Fantahun Andualem  2 , Girum Nakie  2 , Tesfaye Segon  3 , Selam Koye  2 , Gebresilassie Tadesse  2 , Gidey Rtbey  2
Affiliations
Meta-Analysis

Exploring the occurence and risk factors of post-stroke depression among stroke survivors in Africa: a comprehensive systematic review and meta-analysis

Techilo Tinsae et al. BMC Public Health. .

Abstract

Background: Post-stroke depression is a significant health concern, especially in developing countries. The high prevalence, incidence, and complexity of depression among stroke survivors pose a substantial occurence on vulnerable individuals. This study aimed to investigate the prevalence, incidence, and risk factors of post-stroke depression among stroke survivors in Africa.

Methods: PubMed, WHO Global Index Medicus, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, HINARI, and Google were the sources of data searching. Literature reporting the prevalence, incidence and risk factors of post-stroke depression in Africa was included. The quality of each study was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). Data were extracted using a Microsoft Excel spreadsheet, and data analysis was performed using STATA version 11. Heterogeneity between studies was checked using the I2 statistical test. Publication bias was checked using Egger's statistical test and funnel plot.

Results: A total of twenty-two relevant studies with 3175 stroke patients were included in this systematic review and meta-analysis. The overall estimated pooled prevalence and incidence of depression among stroke survivors in Africa were found to be 42.5% (95% CI = 26.9, 58.1) and 33.2% (95% CI = 23.3, 43.0), respectively. The subgroup analysis further revealed that Nigeria had the highest prevalence of depression at 47.6% (95% CI: 15.1, 80.1), followed by Ethiopia at 44.4% (95% CI: 28.2, 60.6). This study did not identify any factors that were positively associated with post-stroke depression.

Conclusion: The prevalence and incidence of depression among stroke survivors are notably high. Despite the high occurence, this study did not identify specific risk factors positively associated with post-stroke depression. Consequently, addressing post-stroke depression through integrated care models, routine screening, and targeted interventions is crucial for enhancing the quality of life and rehabilitation outcomes for stroke survivors in Africa.

Keywords: Depression; Incidence and stroke depression; Post-stroke; Post-stroke depression; Prevalence; Stroke.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not Applicable. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart showing the selection process of eligible studies for this review, 2020
Fig. 2
Fig. 2
Forest Plot describing the pooled prevalence of depression among stroke survivors in Africa with a 95% CI
Fig. 3
Fig. 3
Funnel plot with a pseudo-95% confidence interval that investigated the heterogeneity of the pooled prevalence of depression among stroke survivors in Africa
Fig. 4
Fig. 4
The sensitivity analysis of the pooled estimated prevalence of depression among stroke survivors in Africa
Fig. 5
Fig. 5
Forest Plot describes the sub-group analysis of the prevalence of depression among stroke survivors based on the country in Africa with a 95% CI
Fig. 6
Fig. 6
Forest Plot describing the pooled incidence of depression among post-stroke survival in Africa with a 95% CI
Fig. 7
Fig. 7
Funnel plot with a pseudo-95% confidence interval that investigated the heterogeneity of the pooled incidence of post-stroke depression in Africa
Fig. 8
Fig. 8
The sensitivity analysis of the pooled estimated incidence of depression among stroke survivors in Africa
Fig. 9
Fig. 9
Factors associated with post-stroke depression in East Africa with a 95% CI
See this image and copyright information in PMC

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