Prevalence of depression among students at Ethiopian universities and associated factors: A systematic review and meta-analysis

Background: Depression is the most common cause of disability in the world, which affects 350 million people. University students struggle to cope with stressors that are typical of higher education institutions as well as anxiety related to education. Although evidence indicates that they have a high prevalence of depression, no reviews have been done to determine the prevalence of depression among students at Ethiopian universities comprehensively. Methods: Without regard to time constraints, PubMed, Scopus, and EMBASE were investigated. A manual search for an article reference list was also conducted. The Meta XL software was used to extract relevant data, and the Stata-11 meta-prop package was used to analyze it. The Higgs I2 test was used to test for heterogeneity. Results: A search of the electronic and manual systems resulted in 940 articles. Data were extracted from ten studies included in this review involving a total number of 5207 university students. The pooled prevalence of depression was 28.13% (95% CI: 22.67, 33.59). In the sub-group analysis, the average prevalence was higher in studies having a lower sample size (28.42%) than studies with a higher sample; 27.70%, and studies that utilized other (PHQ-9, HADS); 30.67% higher than studies that used BDI-II; 26.07%. Being female (pooled AOR = 5.56) (95% CI: 1.51, 9.61), being a first-year (pooled AOR = 4.78) (95% CI: 2.21, 7.36), chewing khat (pooled AOR = 2.83) (95% CI: 2.32, 3.33), alcohol use (pooled AOR = 3.12 (95% CI:3.12, 4.01) and family history of mental illness (pooled AOR = 2.57 (95% CI:2.00, 3.15) were factors significantly associated with depression. Conclusion: This systematic review and meta-analysis revealed that more than one-fourth of students at Ethiopian universities had depression. More efforts need to be done to provide better mental healthcare to university students in Ethiopia.