OBJECTIVES : Ethiopia has recorded one of the highest number of visceral leishmaniasis (VL) cases in sub-Saharan Africa. We aimed to perform a systematic review and meta-analysis on visceral leishmaniasis treatment outcomes from the existing literatures in Ethiopia.

METHODS : The Cochrane guidelines to conduct the meta-analysis following the PRISMA statement was used to conduct a computerized systematic search of the Pubmed, Google Scholar, and ScienceDirect databases. The Cochrane Q and the I were used to evaluate heterogeneity of studies. Treatment outcomes were assessed at end of treatment and at 6 months follow-up. Subgroup analyses were performed on treatment outcomes based on the different antileishmanial treatment options and patients’ HIV status.

RESULTS : Fifteen studies were included in the final analyses. At end of treatment, an overall treatment success rate of 82.6% was noticed. At 6 months follow-up, the overall treatment success rate was 72.0%. Treatment success rates at end of treatment were lower for patients treated with SSG when compared to treatment success rates in patients who took other antileishmanial medications (81.5% vs 87.1%). However, at 6 months follow-up, the success rates were better for patients treated with sodium stibogluconate (80.2% vs 76.0%) than patients who received alternative treatment options. HIV-negative individuals were found to have better treatment success rates (93.2% vs 66.7%) when compared to the HIV-infected patients at the end of treatment.

CONCLUSIONS : Antimonials have shown better treatment efficacy in the management of VL in Ethiopia especially at 6 months follow-up. A combination of these drugs, sodium stibogluconate in particular, with paromomycin gave good treatment success rates with shorter duration of treatment making it rational to use it as a first-line medication in the country. On the other hand, liposomal amphotericin b should be reserved for patients with severe disease, HIV co-infection, and intolerance to the adverse effects of antimonials.