Global burden and inequities for PTSD among Healthcare Workers: A Systematic Review and Meta-Analysis

Posttraumatic stress disorder (PTSD) is a critical occupational health concern among health care workers (HCWs). Quantifying global prevalence and identifying risk factors is critical for guiding intervention and policy strategies. A systematic review and meta-analysis was performed following PRISMA guidelines (PROSPERO CRD42024587810). A literature search of PubMed, Embase, PsycINFO, Web of Science, and Cochrane Library databases was performed from database inception to March 11, 2025. Observational studies reporting PTSD prevalence and odds ratios (ORs) for PTSD risk factors among HCWs were included. The primary outcome was p ooled prevalence of PTSD and ORs for risk factors among HCWs. A total of 308 studies from 60 countries were included, comprising 371,211 HCWs. The pooled PTSD prevalence was 27.2% (95% CI, 25.3%–29.2%). Higher prevalence was observed among female (31.5%), nurses (28.6%), HCWs in low- and middle-income countries (30.0%), and those in Africa (40.8%). Prevalence increased from 20.2% (95% CI, 14.4%–26.0%) before COVID-19 to 27.8% (95% CI, 25.8%–29.8%) after its onset, with meta-regression showing a significant upward trend over time (β = 9.94*10 ^-4 , P = 0.012). The strongest risk factors for PTSD included a history of mental disorder (OR, 2.08; 95% CI, 1.54–2.80), nursing occupation (OR, 1.60; 95% CI, 1.41–1.82), and symptomatic family or friends (OR, 1.53; 95% CI, 1.22–1.90). These findings indicate a substantial psychological burden among HCWs and identify subgroups with higher vulnerability across settings.