Pooled prevalence of post-traumatic stress disorder among flood survivors of India: a systematic review and meta-analysis

Abstract Background Floods are among the most frequent and destructive natural disasters worldwide, and India remains one of the most affected countries. Post-traumatic stress disorder (PTSD) is a common and enduring psychological consequence of flood exposure. Objectives This systematic review and meta-analysis aimed to estimate the pooled prevalence of PTSD among flood survivors in India and to identify factors influencing prevalence variation across regions and populations. Methods Following PRISMA 2020 and MOOSE guidelines, a systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted to identify studies published between 2005 and 2024 on the prevalence of PTSD among flood survivors in India. Study quality was appraised using the JBI checklist. A random-effects meta-analysis (STATA v18) was performed with subgroup, meta-regression, sensitivity, and publication bias analyses. Results A total of 12 studies, encompassing 3,819 participants and 1,948 PTSD cases, were included. The pooled prevalence of PTSD among flood survivors in India was 50.4% (95% CI: 42.8%–57.9%); however, this estimate should be interpreted cautiously given the substantial heterogeneity (I² = 98.8%). Subgroup analyses indicated statistically significant variation (p < 0.05) by age group, region, study setting, assessment tool, and study design, which likely contributed to the observed heterogeneity. No statistically significant association was found between survey timing post-flood and PTSD prevalence (p = 0.47). No risk of bias was noted, which confirms the stability and reliability of the meta-analytic findings. As PTSD prevalence among Indian flood survivors is substantially higher, integrating mental health assessment and intervention for disaster preparedness is essential.