BACKGROUND: The burden of critical illness in low-income countries is high and expected to rise. This has implications for wider public health measures including maternal mortality, deaths from communicable diseases, and the global burden of disease related to injury. There is a paucity of data pertaining to the provision of critical care in low-income countries. This study provides a review of critical care services in Ethiopia. METHODS: Multicenter structured onsite surveys incorporating face-to-face interviews, narrative discussions, and on-site assessment were conducted at intensive care units (ICUs) in September 2020 to ascertain structure, organization, workforce, resources, and service capacity. The 12 recommended variables and classification criteria of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) taskforce criteria were utilized to provide an overview of service and service classification. RESULTS: A total of 51 of 53 (96%) ICUs were included, representing 324 beds, for a population of 114 million; this corresponds to approximately 0.3 public ICU beds per 100,000 population. Services were concentrated in the capital Addis Ababa with 25% of bed capacity and 51% of critical care physicians. No ICU had piped oxygen. Only 33% (106) beds had all of the 3 basic recommended noninvasive monitoring devices (sphygmomanometer, pulse oximetry, and electrocardiography). There was limited capacity for ventilation (n = 189; 58%), invasive monitoring (n = 9; 3%), and renal dialysis (n = 4; 8%). Infection prevention and control strategies were lacking. CONCLUSIONS: This study highlights major deficiencies in quantity, distribution, organization, and provision of intensive care in Ethiopia. Improvement efforts led by the Ministry of Health with input from the acute care workforce are an urgent priority.

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Introduction A novel coronavirus disease (COVID-19) broke out in Wuhan, Hubei Province, China, in December 2019 that continues to pose major challenges to trauma care around the world. The objective of this study was to assess the effects of COVID-19 on the pattern of traumatic injuries and outcomes. Methodology This retrospective, descriptive study was conducted over a three-month period at Addis Ababa Burn Emergency and Trauma (AaBET) Hospital, Addis Ababa, Ethiopia. It compared pre- and post-COVID-19 data from the hospital registry and reports. Specifically, data from March through May, 2019 (pre-COVID-19) were compared to data from March through May, 2020 (during COVID-19). The data were analyzed using SPSS 20.0. Descriptive analyses of the variables are reported as numbers and percentages. Results There were a total of 5179 emergency visits during the study period, of which 2763 were trauma cases (53.4%). Among trauma cases, 1441 (52.1%) were attributable to road traffic injuries. During the COVID-19 period, 1901 patients were admitted, of which 1412 (74.3%) were trauma cases. Of the trauma cases during the COVID-19 period, 476 (33.7%) were attributable to road traffic injuries. There was a 42% decrease in emergency visits during the COVID-19 period. Although there was a 4.5% rise in trauma cases during the COVID-19, traffic injury-related trauma cases decreased by 50.7% during the same period. A significant increase in non-road traffic injury was noted during the lockdown period. These include interpersonal and domestic violence, and significant decreases were noted in multiple site injuries. Further, admissions were significantly decreased. Conclusion During the period of lockdown, there was a significant decrease in road traffic injuries in AaBET hospital and an increase in non-road traffic injuries. Implementation of preventive measures will decrease road-traffic injury burden.