The study provides a comprehensive synthesis of existing research on post-traumatic stress disorder (PTSD) and associated risk factors among IDPs in African countries.
Articles were included in the review if they reported the quantitative outcome of the prevalence of PTSD and associated factors among IDPs in Africa based on a cross-sectional study. Only studies published in peer-reviewed journals before 11 June 2023 were included. The quality of articles was assessed using the Joanna Briggs Institute (JBI) quality appraisal tools for analytical cross-sectional studies, and only articles with low and moderate biases were reviewed.
A total of 14 studies covering 7,590 participants met the inclusion criteria for the review. The studies were conducted in Ethiopia (three studies), Nigeria (five studies), Kenya, Somalia, Sudan, South Sudan, Uganda, and the Democratic Republic of Congo (DRC).
Main findings:
- The pooled prevalence of PTSD among IDPs in Africa was 51 percent, with the lowest prevalence found in Sudan at 15 percent and the highest prevalence found in Nigeria at 94 percent. In-country subgroup analysis revealed a pooled prevalence of 62 percent in Nigeria and 54 percent in Ethiopia.
- There was a higher prevalence rate among positive screening cases compared to clinically confirmed cases. The pooled prevalence was 31 percent for clinically confirmed cases of PTSD and 55 percent for positive screening cases of PTSD.
- Females were at higher risk of PTSD than men. In four studies, female IDPs had a twofold higher risk of developing PTSD compared to male IDPs.
- Being divorced, separated, or widowed was associated with PTSD. The pooled results of three studies revealed that individuals who were no longer married (divorced, separated, widowed, or forcefully separated) were 1.93 times more likely to develop PTSD compared to those who were married or single.
- Unemployment was associated with PTSD. The pooled findings of two studies showed that the likelihood of PTSD was 1.9 times higher for unemployed IDPs compared to employed IDPs.
- Injuries, ill-health without medical treatment, and depression are associated with PTSD. Pooled results from two studies revealed that the likelihood of PTSD was 1.9 times higher for injured IDPs than for uninjured ones. The combined findings of two studies revealed that the likelihood of PTSD was 1.9 times higher for IDPs with poor health who did not receive medical care than for those who did receive medical care. The pooled result from four studies revealed that people with depression had a three-fold increased risk of developing PTSD compared to people without depression.
- The number of traumatic events and the frequency of displacement are risk factors for PTSD. Pooled results from two studies revealed that the likelihood of PTSD was higher in IDPs who had experienced four or more traumatic events, 3.2 times higher for those who had experienced eight to 11 traumatic events, and 5.4 times higher for those who had experienced 12 or more traumatic events compared to those who had experienced zero to three traumatic events. There is also a substantial correlation between PTSD and a higher frequency of displacement, with those displaced more than once having a two-fold increased risk of developing PTSD.
The findings highlight the high prevalence of PTSD among IDPs in Africa. The identification of significant risk factors, including female sex, marital status, number of traumatic events, ill health without medical care, depression, and frequency of displacement, provides valuable insights for targeted interventions. The authors recommend interventions and tailored mental health programs to prevent PTSD among IDPs, focusing on the identified risk factors.