Evidence map›Paper›PMID 42351068›Full record

Observational studyBMC public health2026

Prevalence and associated factors of anxiety and depression among hemodialysis patients in Sudan during armed conflict: a multicenter cross-sectional study.

Yasir Abdelrafi Dafalla Fadlelmoula, Mohamed Adil Ahmed Mohamed Ahmed Madani, Israa Alamin Mohammed Hussein, Moram Elfadel Abdelrhaman Gasmalha, Nadine Mohieldin Ibrahim Gasmelseed, Alzaki Joda Alzaki Hmidah, Marwan Abdulazeez Abdullah Mohammed, Tasneem Mohamed Abuobeida Mohamed, Hind Musa Mana Mohammed, Sohaib Mohammed Mokhtar Ahmed

Abstract readMulticenter StudyObservational Study
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Observational study in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

10 authors.

Yasir Abdelrafi Dafalla FadlelmoulaFaculty of Medicine, Gezira University, Wad Madani, Sudan. yassirabdalrafie@gmail.com.
Mohamed Adil Ahmed Mohamed Ahmed MadaniFaculty of Medicine, Gezira University, Wad Madani, Sudan.
Israa Alamin Mohammed HusseinFaculty of Pharmacy, University of Gadarif, Gadarif, Sudan.
Moram Elfadel Abdelrhaman GasmalhaFaculty of medicine and health science, University of Omdurman Islamic, Omdurman, Sudan.
Nadine Mohieldin Ibrahim GasmelseedFaculty of Medicine, Sudan International University, Khartoum, Sudan.
Alzaki Joda Alzaki HmidahFaculty of Medicine, Gezira University, Wad Madani, Sudan.
Marwan Abdulazeez Abdullah MohammedFaculty of Medicine, Gezira University, Wad Madani, Sudan.
Tasneem Mohamed Abuobeida MohamedFaculty of Medicine, Gezira University, Wad Madani, Sudan.
Hind Musa Mana MohammedFaculty of Medicine, University of Elimam Elmahdi, White Nile, Sudan.
Sohaib Mohammed Mokhtar AhmedFaculty of Medicine and Health Sciences, University of Gadarif, Gadarif, Sudan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic kidney disease (CKD) receiving hemodialysis are at high risk of depression and anxiety, especially in conflict settings where healthcare access is disrupted. No large-scale study in Sudan has simultaneously assessed depression and anxiety during armed conflict. This study aims to estimate the prevalence of anxiety and depressive symptoms and assess their associations with sociodemographic characteristics, dialysis duration, and comorbidities among hemodialysis patients in Sudan during the ongoing armed conflict.

methodsA multicenter, cross-sectional study was conducted across 13 dialysis units in nine Sudanese states between April and December 2025. A total of 811 adult patients (≥ 18 years) on maintenance hemodialysis were recruited via convenience sampling. Depression and anxiety were assessed using the validated Arabic versions of the PHQ-9 and GAD-7, respectively. Binary logistic regression identified factors associated with depression and anxiety.

resultsThe prevalence of depressive symptoms was 40.3% (n = 327) and anxiety symptoms 28.6% (n = 232). Comorbid diabetes mellitus (Depression: OR = 2.66, 95% CI: 1.71-4.13; Anxiety: OR = 2.01, 95% CI: 1.28-3.14) and use of neurotoxic medications were associated with higher odds of both conditions. Longer dialysis duration (> 12 months) was associated with lower odds. Female sex and lower dialysis frequency (one session/week) were uniquely linked to higher odds of depression, while older age (≥ 74 years) was protective against anxiety. Geographic variation was observed, with higher odds in Gadarif state.

conclusionDepression and anxiety are highly prevalent among hemodialysis patients in Sudan, exacerbated by ongoing conflict. Diabetes, neurotoxic medications, and regional disparities are key associated factors. Targeted mental health screening and support should be integrated into nephrology care, focusing on high-risk subgroups and conflict-affected regions.

Indexed as

AnxietyArmed ConflictsDepressionRenal DialysisRenal Insufficiency, ChronicAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceRisk FactorsSudanAnxietyArmed conflictChronic kidney diseaseDepressionHemodialysisMental healthSudan

Identifiers

PMID42351068
PMCPMC13556103

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