Prevalence of Post‑Traumatic Stress Disorder and Anxiety in Conflict‑Affected Populations of Palestine, Sudan, and Yemen: A Systematic Review and Meta‑Analysis
Description
Abstract Background: Armed conflict in Palestine, Sudan, and Yemen has displaced millions and exposed civilians to chronic trauma. Post‑traumatic stress disorder (PTSD) and anxiety are among the most common mental health consequences, yet no systematic synthesis has pooled prevalence estimates across these three contexts. Methods: We conducted a systematic review and meta‑analysis in accordance with PRISMA 2020 guidelines. PubMed, Scopus, PsycINFO, and Web of Science were searched up to September 2025. Eligible studies were observational, English‑language, and reported PTSD or anxiety prevalence among civilians, refugees, or internally displaced persons (IDPs) in Palestine, Sudan, or Yemen. Data were extracted on sample size, instruments, cut‑offs, and outcomes. Risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist. Random‑effects models with logit transformation were used to pool prevalence, with subgroup analyses by country, displacement type, population, and instrument. Results: Twelve studies (n ≈ 5,700 participants) were included. Pooled PTSD prevalence was 38% (95% CI: 32–44%), with high heterogeneity (I² = 86%). Anxiety prevalence was 34% (95% CI: 27–41%). Subgroup analyses showed higher PTSD prevalence in Yemen (45%) compared to Palestine (37%) and Sudan (33%). IDPs and refugees had higher prevalence than nondisplaced civilians. Children and adolescents exhibited greater PTSD prevalence (42%) than adults (35%). Studies using the Child PTSD Symptom Scale (CPSS) reported higher prevalence than those using the PCL or HTQ. Sensitivity analyses excluding high‑risk studies yielded similar results. Conclusion: PTSD and anxiety are highly prevalent in conflict‑affected populations of Palestine, Sudan, and Yemen, particularly among displaced groups and children. These findings underscore the urgent need for scalable, culturally adapted mental health interventions and sustained humanitarian support. Keywords: Post‑traumatic stress disorder; Anxiety; Refugees; Internally displaced persons; Palestine; Sudan; Yemen; Meta‑analysis; Conflict; Mental health