Background: Preoperative anxiety, otherwise managed preoperatively, can cause high rate of cardiac mortality, adverse effects during anesthetic induction and patient recovery which correlate with high postoperative pain, increased analgesic and anesthetic consumption, prolonged hospital stay, poor quality of life decrease satisfaction with perioperative care. Objective: The systematic review and meta-analysis aimed to provide evidence on global prevalence and determinates of preoperative anxiety among surgical patients. Methods: A three stage search strategy was conducted on PubMed/Medline, Cochran, Science Direct and LILACS databases. Publication bias was checked with a funnel plot and objective diagnostic test was conducted with Egger's correlation and Begg's regression tests. Results: The global pooled prevalence of preoperative anxiety among surgical patients was 48% (95% confidence interval (CI): 39 to 47%, 28 studies, 14652 participants. The systematic review and Meta-Analysis revealed that preoperative anxiety was approximately 4 times more likely in patients who had fear of complications, RR = 3.53(95 % confidence interval (CI: 3.06 to 4.07, six studies). Conclusion: The review revealed that approximately fifty percent of patients experienced preoperative anxiety which entails the policy makers and health care stakeholders should implement mitigating strategies to prevent and manage preoperative anxiety. Registration: This systematic Review and Meta-Analysis is registered in research Registry (UIN: researchregistry5619). Highlights:

Background Suicide is the act of intentionally causing one's own death. HIV/AIDS continues to be associated with an under-recognized risk for suicidal behavior. Suicidal behavior among people living with HIV/AIDS is not only a predictor of future attempted suicide and completed suicide, but it is also associated with poor quality of life and poor adherence with antiretroviral therapy. Objective The aim of this study was to assess the prevalence of suicidal ideation and attempt and associated factors among people living with HIV/AIDS in selected public hospitals of Amhara region, central Ethiopia. Methods Institutional based cross-sectional study design was employed. The study was conducted in four public hospitals in North Shewa Zone from May to December 2017. Study population comprised all HIV-infected individuals from Antiretroviral Therapy (ART) clinic. A total of 348 study subjects were recruited using systematic random sampling and 326 completed the interview. Suicidality module from Composite International Diagnostic Interview (CIDI) was modified to assess suicidal behavior. Crude and adjusted OR was analyzed using logistic regression and the level of significance of association was determined at P value < 0.05. Result A total of 326 (93.7%) study subjects were interviewed. The magnitude of suicidal ideation and attempt was found to be 16% and 7.1%, respectively. Low monthly income, living alone, suicidal thought before knowing seropositive status, family history of suicide, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes in the last 12 months of the study period due to HIV status and ever use of khat (a psychoactive substance) was statistically significant associated factor with suicidal ideation. And low monthly income, experiencing mild and moderate-to-severe depression and anxiety symptoms, being gossiped sometimes and often in the previous 12 months of the study period due to HIV status and using alcohol currently were significantly associated factors with suicidal attempt. Conclusion Suicidal ideation and attempt among people living with HIV/AIDS (PLWHA) in this study were higher than prevalence in the general population. This shows suicidal ideation and attempt is a mental health concern of PLWHA and it needs great attention in Ethiopia.

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