Suicidal behaviors and associated factors among medical students in Africa: A systematic review and meta-analysis

Suicide behaviors are common among medical students, and the prevalence rates might vary across various regions. Even though various systematic reviews have been conducted to assess suicidal behaviors among medical students in general, no review has ever assessed or carried out a sub-analysis to show the burden of suicidal behaviors among African medical students which was fulfilled in the present study. A systematic review and meta-analysis of prevalence studies among African medical students from PubMed, Scopus, PsycINFO, African Journals Online, and Google Scholar databases. A total of 204 publications were identified. The studies' selection, data extraction, and methodological evaluation were performed, and meta-analysis was performed based on the random effects model. Data were obtained from 14 eligible studies, including 8585 medical students in Africa. The pooled prevalence of lifetime suicidal behaviors was 18.7% for suicidal ideation (95% CI: 14.1%-23.3; I 2 = 94.37%; p < 0.001), 3.8% for suicidal plans (95% CI: 2.7%-4.8%; I 2 = 0.03%; p < 0.001), and 5.5% for suicide attempts (95% CI: 3.8%-7.2%; I 2 = 89.47%; p < 0.001). The factors associated with suicidal ideations were female gender, use of alcohol, depression, and use of khat. Only depression was associated with suicide attempts. The review involved few studies, and not all African regions were represented. Suicidal behaviors, particularly suicide attempts, are high among medical students in Africa. However, very few studies are done in the region to clearly quantify the burden and its associated factors.