Prevalence of depression and associated factors among university students in Ethiopia: Protocol for a systematic review and meta-analysis

Prevalence of depression and associated factors among university students in Ethiopia: Protocol for a systematic review and meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Prevalence of depression and associated factors among university students in Ethiopia: Protocol for a systematic review and meta-analysis Sintayehu Tsegaye Bitew, Habtamu Belay Hailu, Fekede Weldekidan, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3244502/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Depression is one of the most commonly occurring mental disorders globally and it is increasingly prevalent among university students. This systematic review and meta-analysis will provide the pooled prevalence of depression and associated factors among university students in Ethiopia. Method The studies will be identified from data base of PubMed, Google scholar, EMBASE and reference lists of previous studies. All cross-sectional studies reporting the prevalence of depression among university students in Ethiopia will be included. In order to transform the prevalence of extracted studies we will use Freeman-Tukey transformation (arcsine square root transformation and the pooled proportion will be calculated using the back-transformation of the weighted mean of the transformed proportions, using inverse arcsine variance weights for the fixed-effects model and DerSimonian-Laird weights for the random-effects model. The Cochrane Q test and I2 test statistic will be used to test heterogeneity across studies. Meta regression and Subgroup analyses will be performed to explore source of Heterogeneity between studies and evidence of publication bias will also be assessed. Discussion Estimating the prevalence of depression among university student will help policy-makers and other stakeholders in developing evidence-based mental health promotion and prevention programme in university settings. Systematic review registration: PROSPERO CRD42023418350 Prevalence depression University students Ethiopia Background Depression is one of the most commonly occurring mental disorders globally. For a certain depressed mood or loss of pressure or interest to be diagnosed as depression, the duration matters and has to be manifested for a long period of time. Mere changes of mood and feelings in everyday life cannot be considered as depression. It also affects a wide range of a person’s life which includes malfunctioned relationships with family, friends and the community at large. The resultant problems can also be extended to affecting one’s activities at school and at work place among other things.[ 1 ] Anyone can be affected by depression in one way or the other. The factors that lead to depression, including abuse, severe losses, or other stressful situations in one’s life can play an important role in developing depression.[ 1 ] With 50% more commonality, women are more prone to depression than men.[ 1 ] With the difficult transition from childhood to adulthood, university students are more vulnerable groups as they are going through this important stage of their life. This particular stage of transition found to be the most stressful time in a students’ life. Among the factors that many students going through, including anxiety as they are trying to fit in, getting good grades, uncertainty of the future, and being homesick make them more prone to the condition.[ 2 – 6 ] Several literature review and meta-analysis conducted globally revealed that depression is a common occurrence among university students. In a systematic review and meta-analysis conducted in Iran between 1995–2012, 35 published researches which included 9743 study participants have been reviewed; the findings revealed that the prevalence of depression among university students have been found to be 33%. [ 7 ] In another meta-analysis and comprehensive study involving 27 cross-sectional studies revealed that the prevalence of depression among nursing students was found to be 34%. [ 8 ] In a meta-analysis and systematic review on depression among university students in low-and-middle-income countries, involving 76,608 participants in 20 countries, the prevalence of depression was found to be about 24.4%. [ 9 ] With regard to predisposing factors, several studies have been conducted to explore the causes and resulting negative effects of depression among university students. The findings revealed that there are a wide variety of factors other than academic stressors, including the role of different bio-psychological stressors.[ 10 , 11 ] Among the different factors that make university students vulnerable to depression, living away from family, uncertainty about future employment, financial difficulties, psychological factors, such as poor resiliency, academic related pressure, competitive environment, and interpersonal relationships have been found to be predisposing factors for depression to be prevalent among university students. [ 12 , 13 ]With regard to adverse consequences resulting from depression, early on-set of depression was found to be related with a variety of outcomes, such as academic dismissal, poor academic performance, severe role impairment, and prospect of unemployment during adulthood.[ 14 , 15 ] As far as systematic reviews and meta-analyses examining the prevalence of depression among university students in Ethiopia concerned, no such studies have been conducted and published in the country. As such, in light of this important research gap, the objective of this particular review will be to identifying relevant literatures conducted on prevalence of depression among university students in Ethiopia. Objective To determine the pooled prevalence of depression among university students in Ethiopia. To identify the associated factors of depression among university students in Ethiopia. Review question What is the prevalence of depression among university students in Ethiopia? What are associated factors of depression among university students in Ethiopia? Methods This protocol is based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols(PRISMA-P).[ 16 ] The review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (refCRD42023418350). Study design Systematic review and meta-analysis will be employed to determine the pooled prevalence of Depression and associated factors among university students in Ethiopia. Data sources and search strategies A systematic meta-analysis will be done using published and unpublished articles on prevalence and associated factors of depression among university students in Ethiopia. The studies will be found through internet searches using database of PubMed, Google scholar, EMBASE and reference lists of previous prevalence studies. The search comprises both Medical Subject Headings (MeSH) and free text words (title and abstract word searches). We will use the following search terms: ((“Prevalence” OR “magnitude OR incidence”) AND (“depression” OR “depression disorder” OR “depression symptom”) AND (“university student”) AND (Ethiopia)”) AND (“risk factor” OR “associated factor”). The limit for language will be English and the limit for study category will be human. The reference lists of included studies will be manually searched for additional eligible articles. The searching of articles will be carried out from Sep, 2023 to October, 2023. Eligibility criteria Inclusion criteria. Cross-sectional study design All articles published only in English language. All articles which were done in Ethiopia and reporting the prevalence of depression and associated factors among university students will be included. Having response rate of ≥ 80% (it is the proportion of study participants who gave appropriate response to the study among the sample) Exclusion criteria. Articles without full text and data that is difficult to extract Studies published in languages other than English Studies other than cross-sectional studies like Case reports, conference reports, national survey reports and expert opinions. Selection of studies for inclusion in the review Titles and abstracts of studies retrieved from each database search will be stored and managed in an Endnote reference manager. Two review authors (STB and FW) will independently review the titles and abstracts of all studies and disagreements will be solved by discussion. Data extraction/abstraction The data extraction will be done by two researchers (STB, FW) using a standardized and pretested format. Data extraction included: title, first author, and publication year, design of the study, study population (university students), settings (university), sample size, response rate, sampling methods and female percentage and associated factors. The overall prevalence rate as well as prevalence of depression by sex subcategory will be also extracted. Disagreements on data extractions between the two investigators will be solved by discussion and consensus. Quality assessments. The quality assessment will be conducted by three authors (STB, HB and FW) using the checklist of the JBI appraisal tool for cross-sectional, cohort, and case-control studies. This tool will include different questions based on the study designs. Our studies will be cross-sectional studies so will be used a tool with nine-question items. The tools have ‘Yes’ and ‘No’ types of questions and scores will be given 1 for ‘Yes’ and 0 for ‘No’ responses.[ 17 ] Scores will be summed and converted into a percentage. Only studies that scored > 50% will be considered for both systematic review and Meta-analysis. For any scoring disagreements, which might happen between the abstractors, the sources of discrepancy will be investigated through revision. If disagreements persist, after the detailed review, the average scores of the reviewers will be calculated. Statistical analysis In order to transform the prevalence of extracted studies we will use Freeman-Tukey transformation (arcsine square root transformation) [ 18 , 19 ], which is suitable for both the fixed and random effects summary [ 20 ] this will be performed because the weight of inverse variance in meta-analyses with fixed-effects models is not optimal when dealing with binary data with low proportion. Additionally, this method is useful because it allows studies that reported a prevalence of 0 to also be included in the meta-analysis since the transformed estimates of prevalence are weighted very slightly towards 50% [ 21 , 22 ]. The pooled proportion will be calculated using the back-transformation of the weighted mean of the transformed proportions, using inverse arcsine variance weights for the fixed-effects model and DerSimonian-Laird weights for the random-effects model. Heterogeneity across studies will be evaluated with the I2 statistic, which can show the variation between studies with a percentage. Heterogeneities of 25%, 50%, and 75% are considered as low-, moderate-, and high-level heterogeneity, respectively [ 23 ]. For studies with high heterogeneity, the DerSimonian and Laird random-effect model will be used to calculate the summary prevalence [ 23 ]. Meta regression and sub group analyses will be performed to explore the sources of heterogeneity attributed to sample size, year of publication, female percentage and assessment methods/instruments. Besides, sensitivity analysis will be performed to test the robustness of the pooled prevalence of depression by excluding each study and rerunning the meta-analysis.[ 24 ] Finally, The Egger weighted regression and Begg rank correlation test methods will be used to statistically assess publication bias (P < 0.05 will be consider as suggestive of statistically significant publication bias), if evidence of publication bias present, the trim-and fill method will be conducted.[ 10 , 25 , 26 ] The presence of associated factors will be estimated based on the effect size. The statistical significance level will be declared at a P-value of less than 0.05. All statistical analyses will be performed using STATA14 Metaprop package. Presenting and reporting the results There will be a flow diagram that shows the entire study selection process step by step, along with an explanation of why certain studies were eliminated. Tables will be used to display characteristics and quality assessment of the included studies. Forest plots will be used to display pooled estimations. Discussion Estimating the prevalence of depression and its associated factors among university student will help policy-makers and other stakeholders in developing evidence-based mental health promotion and prevention programme in university settings. Potential limitations It is anticipated that publication bias may pose as a limitation for this review. There is also a possibility of reporting and response set bias. Abbreviations 95% CI: 95% confidence interval; MeSH: Medical Subject Headings; PRISMA-P: Preferred Reporting Items for Systematic Reviews and Meta-analysis; WHO: World Health Organization Declarations Funding Not applicable Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Availability of data and materials Not applicable. Competing interests The authors declare that they have no competing interests Authors’ contributions STB conceived the study, and wrote the initial draft manuscript. HBH, AFD and FW review & editing the manuscript. STB finalized the manuscript. All authors approved the final manuscript. Acknowledgements None Author details 1 Ethiopian Defence University, College of Health Sciences, Bishoftu, Ethiopia. References Organization WH. Depression and Other Common Mental Disorders: Global Mental Disorder 2017. Abebe AM, Kebede YG, Mengistu F. Prevalence of Stress and Associated Factors among Regular Students at Debre Birhan Governmental and Nongovernmental Health Science Colleges North Showa Zone, Amhara Region, Ethiopia 2016. Psychiatry J 2018, 2018:7534937. Ashraful Islam M, Yun Low W, Ting Tong W, Wan Yuen CC, Abdullah A. Factors Associated with Depression among University Students in Malaysia: A Cross-sectional Study. KnE Life Sciences 2018, 4(4). Ghanim M, Rabayaa M, Atout S, Al-Othman N, Alqub M. Prevalence of anxiety and depression among Palestinian university students: a cross-sectional study during COVID-19 pandemic. Middle East Current Psychiatry 2022, 29(1). Musa T, Yahia A. Prevalence of depression among medical students in River Nile State Universities 2021. F1000Research 2022, 11. Olum R, Nakwagala FN, Odokonyero R. Prevalence and Factors Associated with Depression among Medical Students at Makerere University, Uganda. Adv Med Educ Pract. 2020;11:853–60. Sarokhani D, Delpisheh A, Veisani Y, Sarokhani MT, Manesh RE, Sayehmiri K. Prevalence of Depression among University Students: A Systematic Review and Meta-Analysis Study. Depress Res Treat. 2013;2013:373857. Tung YJ, Lo KKH, Ho RCM, Tam WSW. Prevalence of depression among nursing students: A systematic review and meta-analysis. Nurse Educ Today. 2018;63:119–29. Akhtar P, Ma L, Waqas A, Naveed S, Li Y, Rahman A, Wang Y. Prevalence of depression among university students in low and middle income countries (LMICs): a systematic review and meta-analysis. J Affect Disord. 2020;274:911–9. Dachew BA, Bifftu BB, Tiruneh BT, Anlay DZ, Wassie MA. Prevalence of mental distress and associated factors among university students in Ethiopia: a meta-analysis. J Ment Health. 2022;31(6):851–8. Gao L, Xie Y, Jia C, Wang W. Prevalence of depression among Chinese university students: a systematic review and meta-analysis. Sci Rep 2020, 10(1). Cui S, Ajayi B, Kim E, Egonu R. A Systematic Review and Meta-Analysis of Depression Prevalence Amongst Nigerian Students Pursuing Higher Education. 2022. Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. Khan MN, Akhtar P, Ijaz S, Waqas A. Prevalence of Depressive Symptoms Among University Students in Pakistan: A Systematic Review and Meta-Analysis. Front Public Health. 2020;8:603357. Melese B, Bayu B, Wondwossen F, Tilahun K, Lema S, Ayehu M, Loha E. Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study. BMC Res Notes. 2016;9(1):485. David Moher AL, Jennifer Tetzlaff DG, Altman, The PRISMA Group. : Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine | wwwplosmedicineorg July 2009, Volume 6(Issue 7). Institute TJB. JBI Critical Appraisal Checklist for Systematic Reviews http://joannabriggsorg/research/critical-appraisal-toolshtml 2017. Julian PT, Higgins SGT, Jonathan J, Deeks, Douglas G, Altman. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60 2003, VOLUME 327. Patole S. Principles and Practice of Systematic Reviews and Meta-Analysis Springer Nature Switzerland AG https://doiorg/101007/978-3-030-71921-0 2021. Lee J, Kim KW, Choi SH, Huh J, Park SH. Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part II. Statistical Methods of Meta-Analysis. Korean J Radiol. 2015;16(6):1188–96. Systematic-Reviews-in-Health-Care-Meta-Analysis-in-Context. BMJ Publishing Group 2001 , Second edition 2001. al, Ne. Metaprop: a Stata command to perform meta-analysis of binomial data. Public Health. 2014;72:39. http://wwwarchpublichealthcom/content/72/1/39 . Laird RDN. Meta-Analysis-in-Clinical-Trials Elsevier Sci publishing April 7 1986. Coleman WLBCMWJCCJKCI. Understanding heterogeneity in meta-analysis: the role of meta-regression Int J Clin Pract 2009- oct vol 63 . MichaelBorenstein, VHedgesL, Higgins PT,. J. HannahR.Rothstein: Introduction to Meta-analysis. 2009. Khan S. Meta-Analysis Methods for Health and Experimental Studies. Springer Nat Singap Pte Ltd 2020 http://wwwspringercom/series/2848 . Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3244502","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":225106430,"identity":"22510a66-89ad-4646-a513-653a2aa70455","order_by":0,"name":"Sintayehu Tsegaye Bitew","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYBACA2YQWWEjx8/eAOJaEKMFpOdMmrFkzwEQV4IILQxALYxthxM33EgA8YnQYs7Of/AxDxuzMcPN51c3/CiQYOBv707Aq8WymZnZmIeHTY5xdk7ZzR6gwyTOnN2A32GHmdmkcyR4jJmlc9Ju8AC1GEjkEtTC/jvHQCKxTfJM2s0/RGphY85JMEjskWA/dpsoW4B+MZb+cyDBWIInh+22jIEED0G/mPMffPhx5r//cvbHjz+7+eYPME7be/FrQQI8BmCSWOUgwP6AFNWjYBSMglEwggAAriBCfQrh/CIAAAAASUVORK5CYII=","orcid":"","institution":"Ethiopian Defense University College of Health Sciences","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Sintayehu","middleName":"Tsegaye","lastName":"Bitew","suffix":""},{"id":225106432,"identity":"3121dbec-2530-4a50-b6ec-e19b096d471c","order_by":1,"name":"Habtamu Belay Hailu","email":"","orcid":"","institution":"Ethiopian Defense University College of Health Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Habtamu","middleName":"Belay","lastName":"Hailu","suffix":""},{"id":225106434,"identity":"b41b7604-e39b-4112-93d9-88262ae57178","order_by":2,"name":"Fekede Weldekidan","email":"","orcid":"","institution":"Ethiopian Defense University College of Health Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fekede","middleName":"","lastName":"Weldekidan","suffix":""},{"id":225106435,"identity":"d92430ea-fb9f-48a9-bad9-7395e07dd292","order_by":3,"name":"Asnake Fantu Dejene","email":"","orcid":"","institution":"Ethiopian Defense University College of Health Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Asnake","middleName":"Fantu","lastName":"Dejene","suffix":""}],"badges":[],"createdAt":"2023-08-08 07:44:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3244502/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3244502/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":42422965,"identity":"c4e938d5-399b-44bc-99fc-e270a2e3cea2","added_by":"auto","created_at":"2023-08-31 12:52:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":292459,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3244502/v1/bb091d46-b395-4200-b4ec-634b9bbb8652.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of depression and associated factors among university students in Ethiopia: Protocol for a systematic review and meta-analysis","fulltext":[{"header":"Background","content":"\u003cp\u003eDepression is one of the most commonly occurring mental disorders globally. For a certain depressed mood or loss of pressure or interest to be diagnosed as depression, the duration matters and has to be manifested for a long period of time. Mere changes of mood and feelings in everyday life cannot be considered as depression. It also affects a wide range of a person\u0026rsquo;s life which includes malfunctioned relationships with family, friends and the community at large. The resultant problems can also be extended to affecting one\u0026rsquo;s activities at school and at work place among other things.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] Anyone can be affected by depression in one way or the other. The factors that lead to depression, including abuse, severe losses, or other stressful situations in one\u0026rsquo;s life can play an important role in developing depression.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] With 50% more commonality, women are more prone to depression than men.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eWith the difficult transition from childhood to adulthood, university students are more vulnerable groups as they are going through this important stage of their life. This particular stage of transition found to be the most stressful time in a students\u0026rsquo; life. Among the factors that many students going through, including anxiety as they are trying to fit in, getting good grades, uncertainty of the future, and being homesick make them more prone to the condition.[\u003cspan additionalcitationids=\"CR3 CR4 CR5\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eSeveral literature review and meta-analysis conducted globally revealed that depression is a common occurrence among university students. In a systematic review and meta-analysis conducted in Iran between 1995\u0026ndash;2012, 35 published researches which included 9743 study participants have been reviewed; the findings revealed that the prevalence of depression among university students have been found to be 33%. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] In another meta-analysis and comprehensive study involving 27 cross-sectional studies revealed that the prevalence of depression among nursing students was found to be 34%. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn a meta-analysis and systematic review on depression among university students in low-and-middle-income countries, involving 76,608 participants in 20 countries, the prevalence of depression was found to be about 24.4%. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eWith regard to predisposing factors, several studies have been conducted to explore the causes and resulting negative effects of depression among university students. The findings revealed that there are a wide variety of factors other than academic stressors, including the role of different bio-psychological stressors.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAmong the different factors that make university students vulnerable to depression, living away from family, uncertainty about future employment, financial difficulties, psychological factors, such as poor resiliency, academic related pressure, competitive environment, and interpersonal relationships have been found to be predisposing factors for depression to be prevalent among university students. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]With regard to adverse consequences resulting from depression, early on-set of depression was found to be related with a variety of outcomes, such as academic dismissal, poor academic performance, severe role impairment, and prospect of unemployment during adulthood.[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAs far as systematic reviews and meta-analyses examining the prevalence of depression among university students in Ethiopia concerned, no such studies have been conducted and published in the country. As such, in light of this important research gap, the objective of this particular review will be to identifying relevant literatures conducted on prevalence of depression among university students in Ethiopia.\u003c/p\u003e \u003cp\u003e \u003cb\u003eObjective\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo determine the pooled prevalence of depression among university students in Ethiopia.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo identify the associated factors of depression among university students in Ethiopia.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eReview question\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat is the prevalence of depression among university students in Ethiopia?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat are associated factors of depression among university students in Ethiopia?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis protocol is based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols(PRISMA-P).[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] The review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (refCRD42023418350).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eSystematic review and meta-analysis will be employed to determine the pooled prevalence of Depression and associated factors among university students in Ethiopia.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData sources and search strategies\u003c/h2\u003e \u003cp\u003eA systematic meta-analysis will be done using published and unpublished articles on prevalence and associated factors of depression among university students in Ethiopia. The studies will be found through internet searches using database of PubMed, Google scholar, EMBASE and reference lists of previous prevalence studies. The search comprises both Medical Subject Headings (MeSH) and free text words (title and abstract word searches). We will use the following search terms:\u003c/p\u003e \u003cp\u003e((\u0026ldquo;Prevalence\u0026rdquo; OR \u0026ldquo;magnitude OR incidence\u0026rdquo;) AND (\u0026ldquo;depression\u0026rdquo; OR \u0026ldquo;depression disorder\u0026rdquo; OR \u0026ldquo;depression symptom\u0026rdquo;) AND (\u0026ldquo;university student\u0026rdquo;) AND (Ethiopia)\u0026rdquo;) AND (\u0026ldquo;risk factor\u0026rdquo; OR \u0026ldquo;associated factor\u0026rdquo;). The limit for language will be English and the limit for study category will be human. The reference lists of included studies will be manually searched for additional eligible articles. The searching of articles will be carried out from Sep, 2023 to October, 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003e \u003cb\u003eInclusion criteria.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eCross-sectional study design\u003c/p\u003e \u003cp\u003eAll articles published only in English language.\u003c/p\u003e \u003cp\u003eAll articles which were done in Ethiopia and reporting the prevalence of depression and associated factors among university students will be included.\u003c/p\u003e \u003cp\u003eHaving response rate of \u0026ge;\u0026thinsp;80% (it is the proportion of study participants who gave appropriate response to the study among the sample)\u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion criteria.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eArticles without full text and data that is difficult to extract\u003c/p\u003e \u003cp\u003eStudies published in languages other than English\u003c/p\u003e \u003cp\u003eStudies other than cross-sectional studies like Case reports, conference reports, national survey\u003c/p\u003e \u003cp\u003ereports and expert opinions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSelection of studies for inclusion in the review\u003c/h2\u003e \u003cp\u003eTitles and abstracts of studies retrieved from each database search will be stored and managed in an Endnote reference manager. Two review authors (STB and FW) will independently review the titles and abstracts of all studies and disagreements will be solved by discussion.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eData extraction/abstraction\u003c/h2\u003e \u003cp\u003eThe data extraction will be done by two researchers (STB, FW) using a standardized and pretested format. Data extraction included: title, first author, and publication year, design of the study, study population (university students), settings (university), sample size, response rate, sampling methods and female percentage and associated factors. The overall prevalence rate as well as prevalence of depression by sex subcategory will be also extracted. Disagreements on data extractions between the two investigators will be solved by discussion and consensus.\u003c/p\u003e \u003cp\u003e \u003cb\u003eQuality assessments.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe quality assessment will be conducted by three authors (STB, HB and FW) using the checklist of the JBI appraisal tool for cross-sectional, cohort, and case-control studies. This tool will include different questions based on the study designs. Our studies will be cross-sectional studies so will be used a tool with nine-question items. The tools have \u0026lsquo;Yes\u0026rsquo; and \u0026lsquo;No\u0026rsquo; types of questions and scores will be given 1 for \u0026lsquo;Yes\u0026rsquo; and 0 for \u0026lsquo;No\u0026rsquo; responses.[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eScores will be summed and converted into a percentage. Only studies that scored\u0026thinsp;\u0026gt;\u0026thinsp;50% will be considered for both systematic review and Meta-analysis. For any scoring disagreements, which might happen between the abstractors, the sources of discrepancy will be investigated through revision. If disagreements persist, after the detailed review, the average scores of the reviewers will be calculated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eIn order to transform the prevalence of extracted studies we will use Freeman-Tukey transformation (arcsine square root transformation) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], which is suitable for both the fixed and random effects summary [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] this will be performed because the weight of inverse variance in meta-analyses with fixed-effects models is not optimal when dealing with binary data with low proportion. Additionally, this method is useful because it allows studies that reported a prevalence of 0 to also be included in the meta-analysis since the transformed estimates of prevalence are weighted very slightly towards 50% [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe pooled proportion will be calculated using the back-transformation of the weighted mean of the transformed proportions, using inverse arcsine variance weights for the fixed-effects model and DerSimonian-Laird weights for the random-effects model. Heterogeneity across studies will be evaluated with the I2 statistic, which can show the variation between studies with a percentage. Heterogeneities of 25%, 50%, and 75% are considered as low-, moderate-, and high-level heterogeneity, respectively [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. For studies with high heterogeneity, the DerSimonian and Laird random-effect model will be used to calculate the summary prevalence [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Meta regression and sub group analyses will be performed to explore the sources of heterogeneity attributed to sample size, year of publication, female percentage and assessment methods/instruments. Besides, sensitivity analysis will be performed to test the robustness of the pooled prevalence of depression by excluding each study and rerunning the meta-analysis.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eFinally, The Egger weighted regression and Begg rank correlation test methods will be used to statistically assess publication bias (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 will be consider as suggestive of statistically significant publication bias), if evidence of publication bias present, the trim-and fill method will be conducted.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe presence of associated factors will be estimated based on the effect size. The statistical significance level will be declared at a P-value of less than 0.05. All statistical analyses will be performed using STATA14 Metaprop package.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003ePresenting and reporting the results\u003c/h2\u003e \u003cp\u003eThere will be a flow diagram that shows the entire study selection process step by step, along with an explanation of why certain studies were eliminated. Tables will be used to display characteristics and quality assessment of the included studies. Forest plots will be used to display pooled estimations.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eEstimating the prevalence of depression and its associated factors among university student will help policy-makers and other stakeholders in developing evidence-based mental health promotion and prevention programme in university settings.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePotential limitations\u003c/h2\u003e \u003cp\u003eIt is anticipated that publication bias may pose as a limitation for this review. There is also a possibility of reporting and response set bias.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e95% CI: 95% confidence interval; MeSH: Medical Subject Headings; PRISMA-P: Preferred Reporting Items for Systematic Reviews and Meta-analysis; WHO: World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSTB conceived the study, and wrote the initial draft manuscript. HBH, AFD and FW review\u0026nbsp;\u0026amp; editing\u0026nbsp;the manuscript. \u0026nbsp;STB finalized the manuscript. All authors approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eEthiopian Defence University, College of Health Sciences, Bishoftu, Ethiopia.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrganization WH. Depression and Other Common Mental Disorders: Global Mental Disorder 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbebe AM, Kebede YG, Mengistu F. Prevalence of Stress and Associated Factors among Regular Students at Debre Birhan Governmental and Nongovernmental Health Science Colleges North Showa Zone, Amhara Region, Ethiopia 2016. \u003cem\u003ePsychiatry J\u003c/em\u003e 2018, 2018:7534937.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAshraful Islam M, Yun Low W, Ting Tong W, Wan Yuen CC, Abdullah A. Factors Associated with Depression among University Students in Malaysia: A Cross-sectional Study. KnE Life Sciences 2018, 4(4).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGhanim M, Rabayaa M, Atout S, Al-Othman N, Alqub M. Prevalence of anxiety and depression among Palestinian university students: a cross-sectional study during COVID-19 pandemic. Middle East Current Psychiatry 2022, 29(1).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMusa T, Yahia A. Prevalence of depression among medical students in River Nile State Universities 2021. \u003cem\u003eF1000Research\u003c/em\u003e 2022, 11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlum R, Nakwagala FN, Odokonyero R. Prevalence and Factors Associated with Depression among Medical Students at Makerere University, Uganda. Adv Med Educ Pract. 2020;11:853\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSarokhani D, Delpisheh A, Veisani Y, Sarokhani MT, Manesh RE, Sayehmiri K. Prevalence of Depression among University Students: A Systematic Review and Meta-Analysis Study. Depress Res Treat. 2013;2013:373857.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTung YJ, Lo KKH, Ho RCM, Tam WSW. Prevalence of depression among nursing students: A systematic review and meta-analysis. 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A Systematic Review and Meta-Analysis of Depression Prevalence Amongst Nigerian Students Pursuing Higher Education. 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391\u0026ndash;400.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan MN, Akhtar P, Ijaz S, Waqas A. Prevalence of Depressive Symptoms Among University Students in Pakistan: A Systematic Review and Meta-Analysis. Front Public Health. 2020;8:603357.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMelese B, Bayu B, Wondwossen F, Tilahun K, Lema S, Ayehu M, Loha E. Prevalence of mental distress and associated factors among Hawassa University medical students, Southern Ethiopia: a cross-sectional study. BMC Res Notes. 2016;9(1):485.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavid Moher AL, Jennifer Tetzlaff DG, Altman, The PRISMA Group. : Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. \u003cem\u003ePLoS Medicine | wwwplosmedicineorg\u003c/em\u003e July 2009, Volume 6(Issue 7).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstitute TJB. JBI Critical Appraisal Checklist for Systematic Reviews \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://joannabriggsorg/research/critical-appraisal-toolshtml\u003c/span\u003e\u003cspan address=\"http://joannabriggsorg/research/critical-appraisal-toolshtml\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJulian PT, Higgins SGT, Jonathan J, Deeks, Douglas G, Altman. Measuring inconsistency in meta-analyses. \u003cem\u003eBMJ 2003;327:557\u0026ndash;60\u003c/em\u003e 2003, VOLUME 327.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatole S. Principles and Practice of Systematic Reviews and Meta-Analysis \u003cem\u003eSpringer Nature Switzerland AG\u003c/em\u003e https://doiorg/101007/978-3-030-71921-0 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee J, Kim KW, Choi SH, Huh J, Park SH. Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part II. Statistical Methods of Meta-Analysis. Korean J Radiol. 2015;16(6):1188\u0026ndash;96.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSystematic-Reviews-in-Health-Care-Meta-Analysis-in-Context. \u003cem\u003eBMJ Publishing Group 2001\u003c/em\u003e, Second edition 2001.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eal, Ne. Metaprop: a Stata command to perform meta-analysis of binomial data. Public Health. 2014;72:39. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://wwwarchpublichealthcom/content/72/1/39\u003c/span\u003e\u003cspan address=\"http://wwwarchpublichealthcom/content/72/1/39\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaird RDN. Meta-Analysis-in-Clinical-Trials Elsevier Sci publishing April 7 1986.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eColeman WLBCMWJCCJKCI. Understanding heterogeneity in meta-analysis: the role of meta-regression Int J Clin Pract 2009-\u003cem\u003eoct vol 63\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMichaelBorenstein, VHedgesL, Higgins PT,. J. HannahR.Rothstein: Introduction to Meta-analysis. 2009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan S. Meta-Analysis Methods for Health and Experimental Studies. Springer Nat Singap Pte Ltd 2020 \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://wwwspringercom/series/2848\u003c/span\u003e\u003cspan address=\"http://wwwspringercom/series/2848\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Prevalence, depression, University students, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-3244502/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3244502/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepression is one of the most commonly occurring mental disorders globally and it is increasingly prevalent among university students. This systematic review and meta-analysis will provide the pooled prevalence of depression and associated factors among university students in Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies will be identified from data base of PubMed, Google scholar, EMBASE and reference lists of previous studies. All cross-sectional studies reporting the prevalence of depression among university students in Ethiopia will be included. In order to transform the prevalence of extracted studies we will use Freeman-Tukey transformation (arcsine square root transformation and the pooled proportion will be calculated using the back-transformation of the weighted mean of the transformed proportions, using inverse arcsine variance weights for the fixed-effects model and DerSimonian-Laird weights for the random-effects model. The Cochrane Q test and I2 test statistic will be used to test heterogeneity across studies. Meta regression and Subgroup analyses will be performed to explore source of Heterogeneity between studies and evidence of publication bias will also be assessed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEstimating the prevalence of depression among university student will help policy-makers and other stakeholders in developing evidence-based mental health promotion and prevention programme in university settings.\u003c/p\u003e\n\u003cp\u003eSystematic review registration: PROSPERO CRD42023418350\u003c/p\u003e","manuscriptTitle":"Prevalence of depression and associated factors among university students in Ethiopia: Protocol for a systematic review and meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-08-14 05:50:47","doi":"10.21203/rs.3.rs-3244502/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e185ee36-3fce-4371-9995-4de5b1b512a8","owner":[],"postedDate":"August 14th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-09-01T17:14:17+00:00","versionOfRecord":[],"versionCreatedAt":"2023-08-14 05:50:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3244502","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3244502","identity":"rs-3244502","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}