A systematic review of chronic fatigue, its syndromes and ethnicity: prevalence, severity, co-morbidity and coping

Methods A systematic review was conducted to explore the relationship between fatigue, chronic fatigue (CFfatigue lasting for 6 months), CFS and ethnicity. Studies were population-based and health service-based. Meta-analysis was also conducted to examine the population prevalence of CF and CFS across ethnic groups. Results Meta-analysis showed that compared with the White American majority, African Americans and Native Americans have a higher risk of CFS [Odds Ratio (OR) 2.95, 95% confidence interval (CI): 0.6910.4; OR11.5, CI: 1.156.4, respectively] and CF (OR1.56, CI: 1.032.24; OR3.28, CI: 1.635.88, respectively). Minority ethnic groups with CF and CFS experience more severe symptoms and may be more likely to use religion, denial and behavioural disengagement to cope with their condition compared with the White majority. Conclusions Although available studies and data are limited, it does appear that some ethnic minority groups are more likely to suffer from CF and CFS compared with White people. Ethnic minority status alone is insufficient to explain ethnic variation of prevalence. Psychosocial risk factors found in high-risk groups and ethnicity warrant further investigation to improve our understanding of aetiology and the management of this complex condition.