Objective: This systematic review was aimed to address the prevalence and causes of intestinal obstruction in Ethiopia. Methods: Systematic searches were conducted on PubMed, EMBASE, CINAHL, Scopus, African Journals Online, HINARI, and other supplementary sources, including Google Scholar. We conducted methodological quality assessments for the articles by employing a critical appraisal checklist of Joanna Briggs Institute. Results: The reported prevalence of intestinal obstruction in Ethiopia ranges from 18.6% to 50.7% among patients with acute abdomen. However, the prevalence varies from 4.3% to 34.6% among total surgical admissions. The leading causes of small intestinal obstruction were small bowel volvulus, intussusception, and adhesion. Sigmoid volvulus was the most commonly reported cause of large intestine obstruction, followed by colonic cancer. Conclusion: The highest reported prevalence of intestinal obstruction in Ethiopia was 50.7% among patients with acute abdomen and 34.6% among surgical admissions. Small intestine volvulus and sigmoid volvulus were the common causes of small and large bowel obstructions, respectively. Therefore, clinicians have to consider the common causes during the diagnosis and management of intestinal obstruction.

Objectives: This study was aimed to assess the length of stay and its associated factors among adult patients who visited Emergency Department of Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Method: A hospital-based cross-sectional study was conducted among 400 adult patients who visit the Emergency Department. Systematic random sampling technique and an interviewer-administered data collection method was used. Data analyses were done using STATA version 16. Bivariable and multivariable logistic regression analysis was used to control the potential confounders. The analysis outputs were presented using an odds ratio with a corresponding 95% confidence interval (CI). Independent variables were defined as statistically significant at p-values <0.05 in the final model. Result: A total of 169 [42.25% (95% CI: 37.5%−47.0%)] patients stayed longer than 24 h in the Emergency Department. We identified factors significantly associated with length of stay in ED include: patients treated at orange triage type (adjusted odds ratio (AOR) = 0.267; 95% CI: 0.13–0.53), laboratory request (AOR: 3.05; 95% CI: 1.49–6.23), radiological requests (AOR: 1.80; 95% CI: 1.05–3.07), and diagnosed with medical condition (AOR: 2.27; 95% CI: 1.21–4.26). Conclusion: A significant number of patients stay longer in the Emergency Department. Evaluation of the clinical diagnosis, diagnostic investigations, and organizational factors is essential to reduce the length of stay in the Emergency Department.

Background: Surgical intervention is one of the core components of the health care system, yet not free of risks. Once postoperative complications occur, patients are subjected to extra costs for treatment, longer hospital stay, and associated disabilities. The chance of death also increases once patients develop postoperative complications. However, the extent of in-hospital postoperative complications was not well studied in Ethiopia, particularly in the Eastern part of the country. As a result, this study was aimed to determine the magnitude of postoperative complications and to identify associated factors among surgical patients treated at a tertiary hospital, eastern Ethiopia. Methods: A prospective cohort study was conducted from July 1, 2019 to January 30, 2020. Patients from general surgery, neurosurgery, orthopedic, and pediatric surgery were incorporated into the study. The calculated sample size was 384 using single population formulas. Data were analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with postoperative complications. The significance level of associations was considered with a P-value < 0.05 and an adjusted odds ratio (AOR) at a 95% confidence interval(CI). Results: 8The magnitude of postoperative complications was 12.5% (95% CI=9.4– 16.2%). From those who had developed postoperative complications, 20.5% were deceased. Factors associated with postoperative complications were cigarette smoking (AOR=4.02, 95% CI=1.86– 8.66), patients with a morbidity status according to the American Society of Anesthesiologists (ASA) category 2 (AOR=7.83; 95% CI=2.95– 20.75), ASA 3 (AOR=9.62; 95% CI=1.70– 54.46), and ASA 4 (AOR=3.25; 95% CI=1.22– 8.60), operative hours of 1– 2 hours duration (AOR=3.38; 95% CI=1.45– 7.94), operative hours of more than 2 hours (AOR=4.36; 95% CI=1.91– 9.95), and intraoperative complications (AOR=5.96; 95% CI=1.707– 20.87). Conclusion: This study showed a higher proportion of postoperative complications associated mortality rates compared to similar studies across the world. The majority of patients who developed complications and died were those who were operated on on an emergency basis. This mandates to follow the damage control surgery protocol, though further study might be needed to sort out the likely causes for this increased risk.

Background: Trauma is an ever evolving world problem that needs close attention and devising means to prevent and treat. The aim of the study is to identify the main reason for trauma admissions and assess the patient outcome after intervention. Therefore, knowing its actual nature might aid in postulating possible intervention as well as prevention measures. Method: A cross-sectional study was conducted from August to December 2015 in Jimma University Specialized Hospital, which is located in south-western Ethiopia. Two hundred and eleven consecutive trauma admissions to surgery department were included in the study. Data were collected and analyzed using computer software SPSS V.23. Result: A total of 211 admitted trauma patients were studied with male to female ratio of 3.14. The leading cause of trauma admission was road traffic collision at 84 (39.8%) and the least being bullet injury which was 6 (2.8%). Hospital mortality was 31 (14.7%). Factors associated with outcome of patients before discharge from hospital were male sex, adjusted OR (AOR)=2.3, 95% CI 1.08 to 4.75; Glasgow Coma Scale score 15/15, AOR=0.04, 95% CI 0.00 to 0.46; and hemoglobin >10 g/L, AOR=0.225, 95% CI 0.074 to 0.464, p<0.05. Conclusion: Road traffic collision takes the top position from all causes of trauma and unlike other developed countries and low and middle-income countries, pedestrians and motorcyclists were the major victims of the collision in this study. Level of evidence VI (This level of effectiveness rating scheme is based on the following: Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. (p. 7). St. Louis, MO: Mosby Elsevier.

Complicated appendicitis makes up a significant proportion of acute appendicitis. There are well established associated factors for the development of complications, but the magnitude varies between developed and developing countries. This study was aimed to look for possible incriminated factors for higher rate of complicated appendicitis among patients treated in public hospitals found in the Harari region, Eastern Ethiopia. Multi-center case-control study with 1:2 was conducted on adult complicated appendicitis patients. The sample size of 414 was determined using an Open Epi and a simple random sampling technique was used to select the samples. Kobo collect was used for data collection by trained medical doctors. Data analysis was made using a statistical package for social studies version 23. The findings were presented in tables and elaborated in texts. Binary logistic regression analysis was conducted to determine association between predictors and outcome variable with adjusted odds ratio at 95% confidence interval, p value less than 0.05. A total of 402 patients included in the study with 268(66.7%) simple appendicitis and 134(33.3%) complicated appendicitis. More patients with complicated appendicitis had a history of another health facility visit compared to the simple appendicitis groups. Duration of chief complaint, history of constipation, having history of visit to health facilities without surgical intervention for their current problem and fever has shown moderate to strong associations on binary logistic regression analysis. Delayed presentation, patients who had a history of a visit to primary health care facilities and private clinics where surgical intervention not available were also found to have an increased risk of developing complicated appendicitis.