Mental health problems in pregnant and postpartum women living with HIV in sub-Saharan Africa: Systematic review and meta-analysis protocol

• Published in: PloS one 2024-10, Vol.19 (10), p.e0308810
• Main Authors: Danso-Appiah, Anthony, Akuffo, Kwadwo Owusu, Owiredu, David
• Format: Article
• Language: English
• Subjects: Africa South of the Sahara - epidemiology; Analysis; At risk populations; Bias; Biology and Life Sciences; Care and treatment; Comparative studies; Confidence intervals; Diagnosis; Estimates; Evaluation; Female; Flow charts; Gender equity; Health aspects; Health problems; Heterogeneity; HIV; HIV (Viruses); HIV Infections - epidemiology; HIV Infections - psychology; HIV patients; Human immunodeficiency virus; Humans; Impact analysis; Medicine and Health Sciences; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental Health; Meta-analysis; Meta-Analysis as Topic; Physical Sciences; Postpartum; Postpartum Period - psychology; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - virology; Pregnant women; Psychological aspects; Puerperium; Quality assessment; Research and Analysis Methods; Reviews; Risk assessment; Searching; Sensitivity analysis; Statistical analysis; Study Protocol; Subgroups; Synthesis; Systematic Reviews as Topic; Underserved populations; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0308810

Existing evidence on the burden of mental health problems among pregnant and postpartum women living with HIV, a vulnerable population in sub-Saharan Africa (SSA), is limited and fragmented, affecting the development of context-sensitive and integrated interventions. This systematic review aims to provide an up-to-date and comprehensive synthesis of available evidence to estimate the burden and identify the determinants of mental health problems among pregnant and postpartum women living with HIV across countries in sub-Saharan Africa. We will retrieve all relevant studies (published and unpublished) through searches in PubMed, Embase, PsycINFO, CINAHL, LILACS, Google Scholar, Scopus and Web of Science from inception to 30th June 2024, without language restriction. We will use the following search terms 'mental health disorder', 'mental health problem', 'pregnant women', 'postpartum women' and 'HIV' nested with all applicable alternate terms and the names of countries in SSA for running the searches. We will also search HINARI, African Index Medicus, African Journals Online, Academic Search Premier, medRxiv, ProQuest, EBSCO Open Dissertations, and reference lists of relevant studies. We will contact experts in the field for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. Two reviewers will independently select studies using a pretested study selection flow chart developed from the pre-specified eligibility criteria. Two reviewers will extract data using a pretested data extraction form and assess the risk of bias in the included studies using the risk of bias tool for prevalence studies by Hoy et al. (2012). Any disagreements will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence of mental health problems among pregnant and postpartum women living with HIV) will be evaluated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), and mean difference for continuous outcomes, all will be reported with their 95% confidence intervals (CIs). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I2 statistic. If substantial heterogeneity is found, random-effects model meta-analysis will be performed; otherwise, fixed-effect meta-analysis will be employed. We will conduct subg