Prevalence and factors associated with postoperative nausea and vomiting in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Postoperative nausea and vomiting (PONV) is a common complication that adversely affects patient recovery and satisfaction after surgery. Globally, PONV affects 20–30% of surgical patients and up to 70–80% in high-risk groups. In Ethiopia, reported incidences vary, but a comprehensive assessment is lacking. Objective: This systematic review and meta-analysis aimed to determine the pooled prevalence of PONV and identify associated risk factors among surgical patients in Ethiopia. Methods: A systematic search identified nine cross-sectional studies published between 2020 and 2024, including 2935 participants from various Ethiopian regions. Data on PONV prevalence and associated risk factors were extracted. A random-effects meta-analysis was performed to calculate pooled prevalence and odds ratios (ORs). Heterogeneity was assessed using the I 2 statistic, and publication bias was evaluated with Egger’s test. Results: The pooled prevalence of PONV in Ethiopia was 28.1% (95% CI: 22.5–35.1%), with significant heterogeneity observed ( I 2 = 93.4%). Subgroup analyses revealed variations by region, type of surgical procedure, and anesthetic technique. The meta-analysis identified several significant risk factors for PONV: female sex (OR = 4.66, 95% CI: 2.81–7.73), history of previous PONV (OR = 6.59, 95% CI: 3.27–13.30), intraoperative or postoperative opioid use (OR = 3.39, 95% CI: 2.35–4.90), history of motion sickness (OR = 4.13, 95% CI: 2.72–5.43), and longer duration of surgery (OR = 6.72, 95% CI: 5.52–8.19). Conclusion: PONV remains a significant postoperative complication in Ethiopia, with several key risk factors identified. These findings support targeted risk assessment and prevention strategies to improve patient outcomes. Further research is needed to explore additional risk factors and optimize management in resource-limited settings.