# Depression, anxiety, and medication adherence among Sudanese refugees with chronic illnesses in Aftit refugee camp, northwest Ethiopia: a cross-sectional study

## TL;DR

This study finds that nearly half of Sudanese refugees with chronic illnesses in Ethiopia experience anxiety and depression, and only 42% adhere well to their medications.

## Contribution

This is the first study to evaluate mental health and medication adherence among Sudanese refugees with chronic illnesses in Aftit refugee camp, Ethiopia.

## Key findings

- Depression and anxiety symptoms were each present in nearly 48% of participants.
- Only 42% of refugees demonstrated good medication adherence.
- Mental health issues were linked to factors like living alone, trauma, and poor living conditions.

## Abstract

Anxiety and depression are common among refugees and can affect medication adherence. However, no prior study has evaluated the mental health status and medication adherence of Sudanese refugees with chronic illness in Aftit refugee camp, Ethiopia.

To assess the prevalence of anxiety, depression, and medication adherence among Sudanese refugees in Aftit refugee camp, Ethiopia.

A cross-sectional study was conducted from October 1–30, 2024, 231 Sudanese refugees with chronic illnesses were randomly selected. Bivariate and multivariate logistic regression analyses were used. A p-value < 0.05 was considered statistically significant.

The response rate was 96.25%. The prevalence of depression and anxiety symptoms, assessed using the Hopkins Symptom Checklist, was 48.1% and 48.5%, respectively, while 42% of participants demonstrated good medication adherence based on a 6-item adherence tool. Depression was significantly associated with living alone (AOR = 6.50), longer camp stay (≥1 year) (AOR = 3.34), food/water shortages (AOR = 3.17), Khat use (AOR = 2.46), and inadequate shelter/clothing (AOR = 4.63). Anxiety was significantly associated with age > 60 (AOR = 2.98), being divorced (AOR = 5.67) or widowed (AOR = 8.36), Khat use (AOR = 2.55), loss of family/friends due to violence (AOR = 9.68), torture (AOR = 3.37), and imprisonment (AOR = 2.42). Medication adherence was significantly associated with aged > 60 (AOR = 4.78), those with higher education (AOR = 4.88), and those living alone (AOR = 3.33).

The study underscores the importance of integrating mental health screening into refugee care and addressing structural challenges like housing, and substance use to improve both mental health and medication adherence. These findings can inform health policies and refugee programs by identifying high-risk groups and guiding targeted interventions.

Main findings: Nearly half of the Sudanese refugees with chronic diseases experienced anxiety and depression, and only 42% had good medication adherence.Added knowledge: This study provides the first evidence from Ethiopia linking mental health conditions with medication adherence among Sudanese refugees with chronic illnesses.Global health impact for policy and action: The findings emphasize the urgent need to integrate mental health services into chronic disease care in refugee settings and to address basic living conditions such as shelter, food, and trauma support.

Main findings: Nearly half of the Sudanese refugees with chronic diseases experienced anxiety and depression, and only 42% had good medication adherence.

Added knowledge: This study provides the first evidence from Ethiopia linking mental health conditions with medication adherence among Sudanese refugees with chronic illnesses.

Global health impact for policy and action: The findings emphasize the urgent need to integrate mental health services into chronic disease care in refugee settings and to address basic living conditions such as shelter, food, and trauma support.