{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:37:27Z","timestamp":1791261447878,"version":"4.1.0"},"reference-count":116,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec id=\"S2056472425108181_as1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108181_as2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108181_as3\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception to 15 February 2024. The keywords used in the search were \u2018depression\/anxiety\/PTSD\u2019, \u2018healthcare workers\u2019, \u2018SSA\u2019 and their variations.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108181_as4\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Sixty-nine studies met our inclusion criteria, most of which (<jats:italic>n<\/jats:italic> = 55, 79.7%) focused on the burden of these disorders during the COVID-19 pandemic. Across studies, wide-ranging prevalence estimates of depressive (2.1\u201375.7%), anxiety (4.8\u201396.5%) and PTSD symptoms (11.7\u201378.3%) were reported. These disorders appear to have been heightened during the COVID-19 pandemic. Several sociodemographic, health-related, COVID-19-related and work-related factors were reported to either increase or lower the risk of these disorders among HCWs from SSA.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108181_as5\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>The burden of depression, anxiety and PTSD among HCWs from SSA is high and appears to have been worsened by the COVID-19 pandemic. The correlates of these disorders among HCWs from this region are multifactorial. A multi-component intervention could contribute to addressing the burden of mental disorders among HCWs from this region.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10818","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T02:20:41Z","timestamp":1757298041000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and factors associated with depression, anxiety and post-traumatic stress disorder among healthcare workers from sub-Saharan Africa: systematic review"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3156-5787","authenticated-orcid":false,"given":"Ezra Kipngetich","family":"Too","sequence":"first","affiliation":[{"name":"Aga Khan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peninah","family":"Wachira","sequence":"additional","affiliation":[{"name":"University of Antwerp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Njenga","sequence":"additional","affiliation":[{"name":"Aga Khan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina Adhiambo","family":"Odero","sequence":"additional","affiliation":[{"name":"Aga Khan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Ndirangu-Mugo","sequence":"additional","affiliation":[{"name":"Aga Khan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Abubakar","sequence":"additional","affiliation":[{"name":"Aga Khan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"S2056472425108181_ref79","doi-asserted-by":"publisher","DOI":"10.1016\/j.amp.2020.08.012"},{"key":"S2056472425108181_ref92","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"S2056472425108181_ref38","doi-asserted-by":"publisher","DOI":"10.4102\/phcfm.v13i1.2823"},{"key":"S2056472425108181_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104002"},{"key":"S2056472425108181_ref35","first-page":"1222","article-title":"Post-traumatic stress disorder among the staff of a mental health hospital: prevalence and risk factors","volume":"24","author":"Olashore","year":"2018","journal-title":"S Afr J Psychiatr"},{"key":"S2056472425108181_ref65","doi-asserted-by":"publisher","DOI":"10.47104\/ebnrojs3.v5i3.294"},{"key":"S2056472425108181_ref3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246454"},{"key":"S2056472425108181_ref105","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156939"},{"key":"S2056472425108181_ref27","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.559819"},{"key":"S2056472425108181_ref31","first-page":"63","article-title":"Depression and burnout among health extension workers in Ethiopia: a cross-sectional study","volume":"33","author":"Birhane","year":"2023","journal-title":"Ethiop J Health Sci"},{"key":"S2056472425108181_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06358-8"},{"key":"S2056472425108181_ref101","volume-title":"PCL-C for DSM-IV","author":"Weathers","year":"1991"},{"key":"S2056472425108181_ref77","doi-asserted-by":"publisher","DOI":"10.25259\/JPATS_38_2021"},{"key":"S2056472425108181_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.08.013"},{"key":"S2056472425108181_ref109","doi-asserted-by":"publisher","DOI":"10.1002\/1348-9585.12175"},{"key":"S2056472425108181_ref43","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-050316"},{"key":"S2056472425108181_ref115","doi-asserted-by":"publisher","DOI":"10.1097\/NUR.0b013e3182503ef0"},{"key":"S2056472425108181_ref28","first-page":"16","article-title":"Associations among depression, leisure-time and occupational physical activity of health care providers in a Nigerian tertiary hospital setting","volume":"9","author":"Aliyu","year":"2017","journal-title":"Afr J Physiother Rehabil Sci"},{"key":"S2056472425108181_ref53","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S282822"},{"key":"S2056472425108181_ref58","first-page":"29","article-title":"Post-traumatic stress symptoms in mental healthcare workers during the COVID-19 outbreak","volume":"2098","author":"Human","year":"2023","journal-title":"S Afr J Psychiatr"},{"key":"S2056472425108181_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09322-z"},{"key":"S2056472425108181_ref87","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(94)00075-U"},{"key":"S2056472425108181_ref6","doi-asserted-by":"publisher","DOI":"10.1037\/tra0001362"},{"key":"S2056472425108181_ref100","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"S2056472425108181_ref52","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243022"},{"key":"S2056472425108181_ref85","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273052"},{"key":"S2056472425108181_ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239753"},{"key":"S2056472425108181_ref45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266570"},{"key":"S2056472425108181_ref93","volume-title":"Anxiety Self-Rating Scale","author":"Komor","year":"1999"},{"key":"S2056472425108181_ref23","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-1621"},{"key":"S2056472425108181_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-022-00998-z"},{"key":"S2056472425108181_ref40","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S291446"},{"key":"S2056472425108181_ref61","first-page":"e114746","article-title":"An investigation of associations and incidence of anxiety, depression, perceived vulnerability to diseases, and fear of COVID-19 among Nigerian health care workers","volume":"10","author":"Ariyo","year":"2021","journal-title":"Arch Pediatr Infect Dis"},{"key":"S2056472425108181_ref51","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-069257"},{"key":"S2056472425108181_ref86","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"S2056472425108181_ref108","doi-asserted-by":"publisher","DOI":"10.1002\/npr2.12153"},{"key":"S2056472425108181_ref34","first-page":"59","article-title":"Relationship between resilience, depression, stress and anxiety among nurses in a tertiary health institution in Nigeria","volume":"10","author":"Olabisi","year":"2022","journal-title":"Res J Health Sci"},{"key":"S2056472425108181_ref106","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-10070-3"},{"key":"S2056472425108181_ref71","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.574671"},{"key":"S2056472425108181_ref110","doi-asserted-by":"publisher","DOI":"10.1007\/s40200-020-00643-9"},{"key":"S2056472425108181_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X19004874"},{"key":"S2056472425108181_ref44","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.15053"},{"key":"S2056472425108181_ref116","doi-asserted-by":"publisher","DOI":"10.1080\/01612840902754537"},{"key":"S2056472425108181_ref113","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-141"},{"key":"S2056472425108181_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1601-1"},{"key":"S2056472425108181_ref83","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2021.e06351"},{"key":"S2056472425108181_ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-023-01059-9"},{"key":"S2056472425108181_ref16","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182010604"},{"key":"S2056472425108181_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.04.038"},{"key":"S2056472425108181_ref39","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S340771"},{"key":"S2056472425108181_ref91","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1965.01720310065008"},{"key":"S2056472425108181_ref48","doi-asserted-by":"publisher","DOI":"10.1177\/20503121211032810"},{"key":"S2056472425108181_ref18","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.679397"},{"key":"S2056472425108181_ref68","doi-asserted-by":"publisher","DOI":"10.18502\/sjms.v15i5.7136"},{"key":"S2056472425108181_ref95","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2020.1748481"},{"key":"S2056472425108181_ref59","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.130"},{"key":"S2056472425108181_ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.767656"},{"key":"S2056472425108181_ref41","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2022.42.210.33928"},{"key":"S2056472425108181_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-021-00701-4"},{"key":"S2056472425108181_ref42","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2022.1604835"},{"key":"S2056472425108181_ref37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254074"},{"key":"S2056472425108181_ref82","doi-asserted-by":"publisher","DOI":"10.1177\/20503121221085095"},{"key":"S2056472425108181_ref62","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S337740"},{"key":"S2056472425108181_ref60","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_2416_22"},{"key":"S2056472425108181_ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285983"},{"key":"S2056472425108181_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s41155-018-0101-4"},{"key":"S2056472425108181_ref49","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.654430"},{"key":"S2056472425108181_ref13","first-page":"100326","article-title":"The global png health workers during the COVID-19 pandemic: a systematic review and meta-analysis","volume":"8","author":"Rezaei","year":"2022","journal-title":"J Affect Disord Rep"},{"key":"S2056472425108181_ref57","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.818910"},{"key":"S2056472425108181_ref84","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpopen.2020.100017"},{"key":"S2056472425108181_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-019-0377-4"},{"key":"S2056472425108181_ref89","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"S2056472425108181_ref66","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-23-00008"},{"key":"S2056472425108181_ref112","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph120911072"},{"key":"S2056472425108181_ref107","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113441"},{"key":"S2056472425108181_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2020.05.026"},{"key":"S2056472425108181_ref46","first-page":"e1","article-title":"The psychological impact of COVID-19 on frontline doctors in Tshwane public hospitals","volume":"65","author":"Duffton","year":"2023","journal-title":"S Afr Fam Pract (2004)"},{"key":"S2056472425108181_ref97","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8341.1959.tb00467.x"},{"key":"S2056472425108181_ref47","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2021.v111i12.15841"},{"key":"S2056472425108181_ref14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0222638"},{"key":"S2056472425108181_ref70","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0259906"},{"key":"S2056472425108181_ref19","doi-asserted-by":"publisher","DOI":"10.1080\/13651501.2022.2101927"},{"key":"S2056472425108181_ref26","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20-1478"},{"key":"S2056472425108181_ref80","doi-asserted-by":"publisher","DOI":"10.1177\/20503121211000919"},{"key":"S2056472425108181_ref56","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0255340"},{"key":"S2056472425108181_ref96","doi-asserted-by":"publisher","DOI":"10.1159\/000395070"},{"key":"S2056472425108181_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15175"},{"key":"S2056472425108181_ref76","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmad094"},{"key":"S2056472425108181_ref102","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3703-5"},{"key":"S2056472425108181_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-022-04102-y"},{"key":"S2056472425108181_ref33","doi-asserted-by":"publisher","DOI":"10.4103\/1119-3077.151726"},{"key":"S2056472425108181_ref94","unstructured":"94 Spielberger, CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory (Self-Evaluation Questionnaire) . Consulting Psychologists Press, 1970."},{"key":"S2056472425108181_ref111","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2016.05.004"},{"key":"S2056472425108181_ref64","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2022.2101346"},{"key":"S2056472425108181_ref114","doi-asserted-by":"publisher","DOI":"10.1038\/srep07109"},{"key":"S2056472425108181_ref50","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001887"},{"key":"S2056472425108181_ref73","doi-asserted-by":"publisher","DOI":"10.1186\/s43045-023-00281-w"},{"key":"S2056472425108181_ref98","doi-asserted-by":"publisher","DOI":"10.2190\/OM.64.2.e"},{"key":"S2056472425108181_ref103","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007822603186"},{"key":"S2056472425108181_ref75","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.665611"},{"key":"S2056472425108181_ref74","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S306240"},{"key":"S2056472425108181_ref36","first-page":"21","article-title":"Depression amongst healthcare workers in Maiduguri, north-eastern Nigeria","volume":"3","author":"Pindar","year":"2015","journal-title":"Res J Health Sci"},{"key":"S2056472425108181_ref72","doi-asserted-by":"publisher","DOI":"10.1177\/00207640231199406"},{"key":"S2056472425108181_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"S2056472425108181_ref104","first-page":"459","article-title":"Reliability and validity of a brief instrument for assessing post-traumatic stress disorder","volume":"6","author":"Foa","year":"1993","journal-title":"J Trauma Stress"},{"key":"S2056472425108181_ref1","doi-asserted-by":"publisher","DOI":"10.1177\/00469580221147377"},{"key":"S2056472425108181_ref63","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-057708"},{"key":"S2056472425108181_ref55","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-022-01335-1"},{"key":"S2056472425108181_ref67","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0266008"},{"key":"S2056472425108181_ref88","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"S2056472425108181_ref54","first-page":"35","article-title":"Prevalence and factors associated with generalized anxiety disorder during Covid19 pandemic among healthcare workers in a tertiary facility in Edo State, Nigeria","volume":"35","author":"Osasona","year":"2023","journal-title":"J Community Med Prim Health Care"},{"key":"S2056472425108181_ref90","volume-title":"A User\u2019s Guide to the Self Reporting Questionnaire.","year":"1994"},{"key":"S2056472425108181_ref69","first-page":"28","article-title":"The prevalence and correlates of anxiety and depression amongst essential workers during the COVID-19 lockdown in Ekiti State, Nigeria","volume":"1610","author":"Falade","year":"2022","journal-title":"S Afr J Psychiatr"},{"key":"S2056472425108181_ref78","first-page":"100246","article-title":"The prevalence of common mental disorders among healthcare professionals during the COVID-19 pandemic at a tertiary Hospital in Addis Ababa, Ethiopia","volume":"6","author":"Mulatu","year":"2021","journal-title":"J Affect Disord Rep"},{"key":"S2056472425108181_ref81","doi-asserted-by":"publisher","DOI":"10.2478\/eras-2022-0002"},{"key":"S2056472425108181_ref99","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-70990-1_10"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472425108181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T02:20:47Z","timestamp":1757298047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472425108181\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":116,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["S2056472425108181"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2025.10818","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"\u00a9 Aga Khan University, 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e192"}}