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Received Mar 7, 2017; Revised May 15, 2017; Accepted May 31, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
There is an escalating burden of stroke in sub-Saharan Africa (SSA), which is now among the leading causes of disease and disability in the region [1]. A key complication of stroke is depression, which while being associated with tremendous poststroke morbidity is frequently under-recognized and undertreated, especially in SSA, where resources are relatively limited and the issues of mental health are underappreciated.
A recently published scientific statement on poststroke depression (PSD) by the American Heart Association/American Stroke Association (AHA/ASA) [2] highlighted the current state of evidence regarding scientific knowledge and clinical practice of PSD. However, there was only one study from SSA [3] out of a combined total of 236 citations in the five systematic reviews [4–8] in the AHA/ASA statement.
The limited data on PSD in SSA in the AHA/ASA scientific statement was likely due to the publication of African studies in typically less visible and less accessible media, such as databases of African literature. Yet, extrapolating results derived from a global pool of studies to SSA may mask the true state of burden of depression in stroke survivors living in the subregion.
The objective of this study was to conduct a systematic review and meta-analysis of PSD studies among patients in SSA to arrive at a pooled estimate of prevalence and to identify the qualitative and quantitative relationships of key clinical characteristics with occurrence of PSD.
2. Methods
This review followed conventional recommendations for the methodology and reporting of systematic reviews [9, 10].
2.1. Search Strategy
The search strategy aimed to find both published and unpublished studies. An initial search of the African Journal OnLine (12 February 2017; repeated 14 May 2017), Medline (Ovid SP 1946—15 February 2017;...