Prevalence of bacterial eye infections and multidrug resistance patterns among eye infection suspected patients in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: Bacterial eye infections are major global health issue in developing countries like Ethiopia, poor hygiene, limited healthcare infrastructure, and inadequate treatment options contribute to the increased burden of these infections, leading to significant ocular morbidity and potential blindness. Major bacterial pathogens, including Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, and Pseudomonas aeruginosa, are responsible for these infections. The objective of this systematic review and meta-analysis is to synthesize existing literature on the prevalence of bacterial eye infections in Ethiopia, identify common bacterial pathogens, and analyze antibiotic resistance patterns.

METHODS: Comprehensive search were performed across electronic databases and grey literature using specific search terms. Eligible studies were organized in MS Excel and imported into STATA version 14 for statistical analysis. The pooled prevalence of bacterial eye infections and multidrug resistance patterns was calculated using a random-effects model, with heterogeneity assessed via the I² statistic. Publication bias was evaluated through funnel plots and Egger's test. A sensitivity analysis was conducted to assess the influence of individual studies on the overall effect size.

RESULT: The systematic review and meta-analysis of 19 studies conducted in Ethiopia revealed significant regional variations in the prevalence of bacterial eye infections and multidrug resistance (MDR). The overall pooled prevalence of bacterial eye infections was 54.07%, with substantial heterogeneity (I² = 99.2%). Prevalence rates varied across regions, with the highest in Oromia (62.98%) and the lowest in SNNPR (34.3%). Staphylococcus aureus was the most common pathogen (45.47%), followed by coagulase-negative Staphylococci (36.14%). The pooled prevalence of MDR was 66.06%, with the highest rates in Somali (87.7%) and the lowest in Tigray (37.9%). Subgroup analysis showed higher prevalence in studies before 2020 and with smaller sample sizes.

CONCLUSION: In conclusion, the study highlights a high prevalence of bacterial eye infections and multidrug resistance in Ethiopia, with significant regional variation. These findings highlight the urgent need for targeted interventions and antimicrobial stewardship programs to address the growing challenge of antibiotic resistance in Ethiopia.