Ethiopian Medical Journal

The Sudan Virus Disease Outbreak in Uganda

Kannan Subbaram — 2026-01-26

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

Tolosa Tufa Regassa — 2026-01-26

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.

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

Tigist Workneh Leulseged — 2026-01-22

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.