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Depression among epileptic patients and its association with drug therapy in sub-Saharan Africa: A systematic review and meta-analysis

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  • Getenet Dessie
  • Henok Mulugeta
  • Cheru Tesema Leshargie
  • Fasil Wagnew
  • Sahai Burrowes

Abstract

Background: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa. Methods: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 to February 30, 2018, identified peer-reviewed, original research articles and doctoral dissertations using pre-defined quality and inclusion criteria. Relevant data were extracted and descriptive summaries of the studies presented in tabular form. The I2 statistic was used to assess heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias and the methodological quality of the included studies were assessed using the scale developed by Hoy and colleagues. The pooled prevalence of comorbidity at a 95% confidence interval (CI) was determined by applying a trim and fill analysis in a random-effects model. Results: Our search identified 167 studies, of which 14 original research articles and two doctoral dissertations reporting on case-control and cross-sectional studies were eligible for inclusion in the final analysis. The pooled estimate of prevalence of depression among patients with epilepsy was 32.71% (95% CI: 25.50–39.91%). Regional sub-group analysis found that the pooled prevalence in East Africa was 34.52% (95% CI: 23.53–45.51%) and 29.69% (95% CI: 22.7–36.68%) in Southern and West Africa. The odds of depression among epileptic patients receiving polytherapy were 2.65 higher than in those receiving monotherapy (95% CI: 1.49–4.71, I2 = 79.1%, p

Suggested Citation

  • Getenet Dessie & Henok Mulugeta & Cheru Tesema Leshargie & Fasil Wagnew & Sahai Burrowes, 2019. "Depression among epileptic patients and its association with drug therapy in sub-Saharan Africa: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    • Handle: RePEc:plo:pone00:0202613
    DOI: 10.1371/journal.pone.0202613
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Fidèle Sebera & Joao Ricardo Nickenig Vissoci & Josiane Umwiringirwa & Dirk E Teuwen & Paul E Boon & Peter Dedeken, 2020. "Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-16, June.

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