Suicidal behavior and Ethiopian students: a systematic review and meta-analysis study

Suicidal behavior encompasses a spectrum that progresses from suicidal ideation to suicidal attempts. In Ethiopia, although existing research shows considerable variation in the reported prevalence of suicidal ideation and attempts, along with methodological weaknesses and inconsistent findings, there has been no comprehensive systematic review or meta-analysis study to date examining the prevalence and associated factors among Ethiopian students.

A search of published articles was made by the following databases: PubMed/MEDLINE, HINARI, Web of Science, PsycINFO, EMBASE, Psychiatry Online, World Health Organization (WHO) reports, and other gray literature was conducted by searching Google, Google Scholar, and other internet search engines. Using the preset search methods, 12 publications for suicidal Ideation and 10 for suicidal attempt were included based on the eligibility criteria. The data were retrieved in Microsoft Excel spreadsheet format and exported to Stata version 14 for analysis. The statistical heterogeneity was assessed by the I² test. Due to the presence of high heterogeneity among included studies, a random-effect meta-analysis model was used. Egger's weighted regression test and funnel plots are used to check the presence of publication bias.

The pooled prevalence of suicidal ideation and attempt among students in Ethiopia was found to be 19.3% (95% CI: 16.02, 22.5) and 8.99% (95% CI: 6.57, 11.43), respectively. Poor social support (ideation: AOR = 2.43, 95% CI: 1.86, 3.16; attempt: AOR = 2.24, 95% CI: 1.50, 3.36), depression (ideation: AOR = 2.85, 95% CI: 2.00, 4.05; attempt: AOR = 4.04, 95% CI: 2.10, 7.80), family history of suicide (ideation: AOR = 3.49, 95% CI: 2.66, 4.58; attempt: AOR = 4.13, 95% CI: 2.17, 7.83), and disappointment with academic performances (ideation: AOR = 2.65, 95% CI: 1.79, 3.92; attempt: AOR = 2.65, 95% CI: 1.79, 3.92) were factors significantly associated. However, being female (AOR = 2.32, 95% CI: 1.29, 4.14) and anxiety disorders (AOR = 3.38, 95% CI: 1.38, 8.28) were significantly associated with suicidal ideation only.

This study revealed that, the pooled prevalence of suicidal ideation and attempt among students in Ethiopia is relatively high. The study also identified that poor social support, depression, family history of suicide and disappointment with their school performance were the factors significantly associated with both suicidal ideation and attempt. However, being female and anxiety disorders were significantly associated with suicidal ideation alone. Also, special attention should be given to students with a family history of suicide, depression, anxiety, poor social support, disappointment with their school performance, and for female students, to prevent suicidal behaviors.

Not applicable.