A Comprehensive Systematic Review of Sepsis Burden and Healthcare Challenges in Ethiopia

Introduction Sepsis remains a significant global health challenge, particularly in low-resource settings like Ethiopia, where healthcare systems are often under-resourced and overburdened. This systematic review aimed to synthesize the available evidence on the burden, risk factors, and healthcare challenges of sepsis in Ethiopia. By consolidating existing data, the review seeks to inform policymakers, healthcare providers, and researchers about the current state of sepsis care and to guide future interventions aimed at reducing its impact. Methods A comprehensive search was conducted across multiple databases, including PubMed, MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and African Journals Online (AJOL). Grey literature sources, such as government reports and conference proceedings, were also included. The search strategy combined keywords related to sepsis, Ethiopia, burden, and healthcare challenges using Boolean operators. Studies were included if they focused on sepsis epidemiology, risk factors, or healthcare challenges in Ethiopia and were published in English. The methodological quality of included studies was assessed using standardized tools, and data were synthesized narratively due to the heterogeneity of the studies. Results A total of 50 studies were included in the qualitative synthesis. The review found that sepsis is a leading cause of morbidity and mortality in Ethiopia, with high prevalence rates in intensive care units (ICUs) and neonatal wards. Key risk factors included poverty, malnutrition, infectious diseases (e.g., pneumonia, malaria, HIV/AIDS), and delays in seeking care. Healthcare challenges included limited diagnostic capabilities, inadequate treatment resources, and a shortage of trained healthcare personnel. Despite these challenges, interventions such as healthcare worker training and improved access to essential medicines showed promise in reducing sepsis mortality. However, the review also identified significant gaps in the literature, including a lack of nationwide data and limited research on long-term outcomes. Conclusion This systematic review highlights the high burden of sepsis in Ethiopia and the significant healthcare challenges associated with its management. The findings underscore the need for high-quality, nationwide studies to address the gaps identified and to inform evidence-based interventions. Strengthening healthcare systems, improving access to diagnostics and treatments, and implementing targeted public health interventions are critical to reducing the impact of sepsis in Ethiopia. Future research should focus on long-term outcomes, cost-effective interventions, and the scalability of existing programs in resource-limited settings.