In Ethiopia individual report indicated nearly 30% of incident cases of tuberculosis remained undiagnosed. Therefore, this systematic review and meta-analysis was aimed to determine the pooled prevalence rate of undiagnosed smear positive pulmonary tuberculosis (PTB) using community based studies published in Ethiopia. MEDLINE/PubMed, ’Cochrane’ library, and Google scholar databases were searched, and reference list of studies on tuberculosis in Ethiopia were reviewed. We used table to present descriptive information of original studies and quantitative results were presented in forest plots. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The Pooled prevalence and point estimates of undiagnosed smear positive PTB were computed by a random effects model. From the nine studies included in the analysis, the pooled prevalence rate and point estimate of undiagnosed smear positive PTB was 0.11%(95% CI, 0.06–013%, p < 0.001) and 79.8/100,000(95% CI; 56.3–112.8) respectively. Pooled prevalence rate and point estimate of bacteriologically confirmed PTB were 0.17%(95%CI; 0.13–0.22%, P < 0.001) and 191/100000(95% CI; 141.3–258) respectively. The ratio of active to passive case detection was 2.3(95% CI, 0.42–4.1). Pooled prevalence rate of presumptive PTB was 2.7%(95% CI; 1.3–5.3%). The analysis revealed that the magnitude of undiagnosed smear positive PTB cases in the community is high in Ethiopia. This indicated the ongoing transmission of tuberculosis in community due to missed infectious cases. Active tuberculosis finding in the community should be strengthened in Ethiopia. 140611 .

Introduction: Orphans are at high risk for neglected tropical diseases (NTDs) and other comorbidities such as malnutrition. We investigated how many orphans suffered from scabies, other NTDs and malnutrition. Methodology: A descriptive study using medical records of orphans referred to a teaching hospital in Addis Ababa, Ethiopia from December 2014 to December 2018 was done. Files documenting NTDs were reviewed in detail for age, referral diagnosis, and nutritional status. Nutritional assessment was done using the WHO Standard growth curve, classifying children as stunted (height for age Z score < -2SD or wasted (weight for length Z score < -2SD). Results: Of the 852 orphans referred, 23.1% (196/852) was diagnosed with scabies, amongst which 28.1% (55/196) had multiple episodes. The median age (interquartile range) of the children with scabies was 3 (2-5) months. 85.2% (169/196) of the orphans with scabies were stunted and /or wasted. No other NTDs were reported. All of the scabies cases identified were not documented in the referral letter of the orphanage. Conclusions: There is ongoing transmission of scabies among children in the orphanage. Amongst orphans with scabies, an alarmingly high percentage was malnourished. Referrals from orphanages may provide an opportunity to detect NTDs and this is being missed.

Objectives We aimed to evaluate hospital mortality rates, readmission rates and length of hospital stay (LOS) among adult medical patients admitted to a teaching hospital in Ethiopia. Design We performed a retrospective study using routinely collected electronic data. Setting Data were collected from Yekatit 12 Hospital Medical College between January 2021 and July 2023. Participants The analysis included 3499 (4111 admissions) adult medical patients with complete data. Outcome measures We used mortality rates, readmission rates and LOS to measure the quality of the outcomes for the top 15 admission diagnoses. A multivariable Cox proportional hazard model was used to identify the statistically significant predictors of mortality with p values<0.05 and a 95% CI. The Kaplan-Meier curve was used to estimate the failure rate (mortality) of the admitted patients. Results The median age of patients was 50 years and men accounted for 1827 (52.3%) of all admitted cases. Non-communicable diseases accounted for 2537 (72.5%) admissions. In descending order, stroke, 644 (18.29%); heart failure, 640 (18.41%); and severe pneumonia, 422 (12.06%) were the three most common causes of admission. The readmission rate was 25.67% (1056/411), and 61.9% of them were readmitted within 30 days of index discharge. The overall median LOS was 8 days. The median LOSs in the index admission (11 vs 8 days, p value=0.001) of readmitted patients was significantly higher than not readmitted. The in-hospital mortality rate was 438 (12.5%), with the highest number of deaths occurred between days 30 and 50 of admission. The mortality rate is significantly higher among patients with communicable diseases (adjusted HR, 1.64, 95% CI: 1.34, 2.10) and elderly patients (≥65 years) (adjusted HR, 1.79, 95% CI: 1.44, 2.22). Septicemia, chronic liver diseases with complications and HIV with complications were the three common causes of death with a proportional mortality rate of 55.2%, 27.93% and 22.46%, respectively. Conclusions Mortality, median LOSs and readmission rate were comparable to other national and international studies. Multicentre compressive research using these three quality patient outcomes is required to establish national standards and evaluate institutional performance.