Ethiopian Medical Journal

Technology-Enabled Logistics Management in Healthcare Systems: A Systematic Review

2025-11-12T19:19:10+00:00

Abstract

Background :Healthcare logistics has undergone rapid technological transformation as digital, automated, and data-intensive tools widely used in tracking, and coordination of medical commodities, information, and services. Despite rapid acceleration of technology-enabled logistic concepts and shift in patient care modalities, existing reviews often focus on isolated technologies; such as AI, blockchain or automation without synthesizing how these tools shape logistics performance across diverse health-system contexts. This review therefore aimed to synthesize current evidence on technology-enabled logistics and articulates how these tools influence operational efficiency, supply chain transparency, responsiveness and continuity of care.

Methods: A systematic search of PubMed, Scopus, Embase, Web of Science, and grey literature sources (Jan 2010–Dec 2022) identified 3,367 database records and 17 grey literature entries. The screening was conducted by two reviewers, and yielded 140 articles. An inductive thematic synthesis approach was used.

Results: Five themes were found from the synthesis of this review: digital supply chain systems, advanced technological applications, artificial intelligence, remote monitoring and care logistics, and secure digital data-sharing among supply chain actors. Across these domains, technology-enabled logistics tools found to be consistently improved inventory management, improved traceability, enhanced documentation quality and increased coordination across facilities.

Conclusions: Technology-enabled logistics systems are gaining attention to improve healthcare operations. This system bringing measurable gains in efficiency and thus, service quality. However, interoperability challenges, workforce readiness, and regulatory issues continue to impede adoption. Examining contextual feasibility and the socio-technical factors that determine whether these innovations translate into sustainable and equitable improvements can be future research agenda.

The Sudan Virus Disease Outbreak in Uganda

2025-12-01T08:11:40+00:00

Sudan virus disease (SVD) is a severe viral haemorrhagic fever caused by the Sudan virus (SUDV), a member of the Ortho ebolavirus genus, which also includes Ebola virus. Like Ebola virus disease, SVD has a high fatality rate and begins with non-specific symptoms like fever, abdominal pain, anorexia, and fatigue, progressing to severe manifestations like haemorrhagic bleeding, shock, multiorgan failure. Fruit bats are considered the primary reservoir for the virus while animals like primates and forest antelopes also contribute to its transmission to humans. Secondary transmission occurs through direct contact with infected individuals or during funeral rituals involving direct interaction with the deceased. On January 30, 2025, Uganda’s Ministry of Health officially declared an outbreak of Sudan virus disease (SVD) after confirming Sudan virus (SUDV) in a 32-year-old Male nurse from Kampala. He had presented with fever, chest pain, difficulty breathing and unexplained bleeding. Despite seeking medical care from multiple health facilities and a traditional healer, the patient died on January 29, 2025, at the National Referral Hospital. Postmortem laboratory tests confirmed the presence of SUDV, marking the first case of this disease in the current outbreak. In Uganda, 14 cases of SVD have been reported as of 5th March 2025.

Electrical Cable as a Missed Intraocular Foreign Body with Orbital Extension: A Case Report

2025-11-21T19:37:26+00:00

Background: Intraocular Foreign Bodies (IOFBs) are one of the common causes of visual loss. Missed IOFBs can lead to devastating complications.

Case Report: A 14-year-old boy presented with one-month history of vision loss in the right eye from an electric cable used to whip a cart-horse. He was treated with unspecified eye drops and intravenous antibiotics at peripheral facilities. At a Tertiary hospital, CT scan revealed panophthalmitis and IOFB with orbital extension. He was managed with evisceration and foreign body removal.

Conclusion: A high index of suspicion and appropriate investigations help minimize complications in patients with IOFBs.

Idiopathic Hypereosinophilic Syndrome with Pulmonary Nodules Mimicking Lung Secondaries: A Case Report

2025-11-05T11:17:24+00:00

Idiopathic Hypereosinophilic Syndrome (IHES) is a condition that presents with eosinophilia of more than 1.5 × 10⁹/L associated with organ damage. IHES is a rare disease, with an incidence of 0.36-6.3 per 100,000 people. It can affect multiple organ systems, including the lungs, and mimic various pulmonary pathologies. Its imaging characteristics, especially those of multiple lung nodules, often resemble those of secondary malignancies, leading to misdiagnosis. We present a case of hypereosinophilic syndrome that looked like lung secondaries, which initially resolved with steroid therapy but later relapsed with the development of steroid dependence.

Accuracy and Reliability of MedBrain in Assisting Triage and Diagnosis of Common Acute Pediatric Conditions in Ethiopia

2025-11-21T19:47:47+00:00

Background: Childhood illnesses are a leading cause of morbidity and mortality in Sub-Saharan Africa, where healthcare infrastructure and trained personnel are limited. MedBrain, a digital decision support system (DDSS), aims to enhance pediatric emergency care by supporting mid-level healthcare workers in low-resource settings.

Objective: To evaluate MedBrain’s diagnostic and triage performance among children presenting with common acute conditions to the emergency departments of two large hospitals in Ethiopia.

Methods: A prospective observational diagnostic accuracy study was conducted between July 2024 and April 2025 at St. Paul’s Hospital Millennium Medical College and Alert Comprehensive Specialized Hospital. MedBrain’s triage and diagnostic performance were compared against healthcare professionals’ triage and pediatricians’ top presumptive diagnoses as gold standards. Performance metrics included accuracy, sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), likelihood ratios (LR+ and LR–), and Cohen’s Kappa for reliability. Diagnostic performance was assessed for MedBrain’s top three ranked diagnoses (Top 1: highest probability diagnosis; Top 2: top two diagnoses; Top 3: top three diagnoses).

Results: Of 1,204 patients screened, 274 were excluded for conditions not yet represented in MedBrain’s database (including malaria), leaving 930 participants. Most were infants (33.8%) and children under 5 (31.9%), with pneumonia (20.4%) the most common diagnosis. MedBrain achieved 72.2% triage agreement, with 3.7% over-triage and 24.2% under-triage. Total diagnostic accuracy was 84.1% (Top 1), 91.5% (Top 2), and 93.3% (Top 3), with Sn of 93.3% and PPV of 100%. For prevalent conditions (pneumonia, acute bronchitis, late-onset neonatal sepsis, acute gastroenteritis, bronchiolitis, and meningitis), accuracy exceeded 97.4%, and Sp and PPV at 100%. Sn increased from 73.0–98.6% (Top 1) to ≥90–100% (Top 2–3). NPV increased from 97.1–99.9% (Top 1) to 98.9–100% (Top 2) and 99.2–100% (Top 3). LR– improved from 0.014–0.270 (Top 1) to 0–0.100 (Top 2) and 0–0.079 (Top 3). Similarly, Cohen’s Kappa rose from 0.830–0.993 (Top 1) to 0.943–1.000 (Top 2) and 0.955–1.000 (Top 3). Diagnostic failures were rare, highest for late-onset neonatal sepsis (0.8%), bronchiolitis (0.5%) and pneumonia (0.4%) and none for gastroenteritis.

Conclusion: MedBrain demonstrated high diagnostic accuracy and reliability in Ethiopian pediatric emergency settings. Under-triage and limited disease coverage remain challenges, warranting further validation with expanded disease libraries and in diverse settings.