Prevalence and Predictors of Trauma-Related Mental Health Outcomes Among Refugees and Internally Displaced Persons in Africa During Conflict and Crisis: A Systematic Review and Meta-Analysis

Abstract

Background: Refugees and internally displaced persons (IDPs) in Africa are frequently exposed to armed conflict, violence, and displacement-related trauma, placing them at heightened risk of mental health disorders. This systematic review and meta-analysis aimed to estimate the prevalence of trauma-related mental health outcomes among refugees and IDPs in African conflict and crisis settings.

Methods: We conducted a systematic search of PubMed, PsycINFO, Scopus, African Journals Online (AJOL), and the UNHCR digital library, including grey literature, for studies published between January 2000 and July 2025. Eligible studies reported prevalence rates of PTSD, depression, anxiety, or psychological distress using validated instruments among African refugee or IDP populations. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist. A random-effects meta-analysis was performed to calculate pooled prevalence estimates. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through funnel plot analysis.

Results: Out of 3,365 identified records, 40 studies met inclusion criteria for qualitative synthesis, and 35 were included in the meta-analysis. The pooled prevalence estimates were 37.8% (95% CI: 32.5–43.2%) for PTSD, 32.1% (95% CI: 27.0–37.8%) for depression, and 30.4% (95% CI: 25.3–36.1%) for anxiety. Subgroup analysis indicated higher prevalence among IDPs compared to refugees and among studies conducted in East and Central Africa. Significant heterogeneity was observed across studies (I² > 90%).

Conclusions: The findings reveal alarmingly high levels of trauma-related mental health conditions among refugees and IDPs in Africa, with considerable regional and population-based variations. These results underscore the urgent need for culturally adapted, trauma-informed mental health interventions in conflict-affected African settings.

Keywords: Refugees, Internally Displaced Persons, PTSD, Depression, Anxiety, Mental Health, Africa, Conflict, Crisis, Meta-analysis, Systematic Review