“…The prevalence in this study was relatively higher than the studies reported from Saudi Arabia, Iran, India, United Kingdom, Northeast Brazil, South Brazil, Uganda, and Nigeria which was 25.5%, 34.8%, 44.1%, 8.1%, 27.1%, 33.7%, 22.5%, and 22% respectively [22][23][24][25][26][27][28][29] and similarly higher than the studies reported from Vietnam, Jazan Province of Saudi Arabia, Southern Taiwan, Hawassa, Ethiopia, Amanuel mental health hospital, Ethiopia, Menelik II hospital, Ethiopia which was 5.4%, 20.6%,38%, 22.1%, 27.1%, and 23.2% respectively. 5,[30][31][32][33][34] This variation might have resulted from a methodological difference or study population, where data were taken from chronic medical-surgical and trauma inpatients including intensive care unit inpatients, difference in screening and diagnostic questionnaire tool used; some researchers used Kessler scale, Burden Assessment Scale, Hospital Depression, Anxiety and Stress Scale to measure mental distress and other sociodemographic and environmental factors may have increased the prevalence of mental distress in this study.…”