Prevalence and antimicrobial susceptibility level of typhoid fever in Ethiopia: A systematic review and meta-analysis

•The diagnosis of typhoid fever was under or overestimated depending on the diagnostic modality.•Widal test is none reliable diagnosis method of typhoid fever causing high diagnosis uncertainty.•Salmonella S. Typhi was resistant for most nationally recommended antibiotics in Ethiopia.•Continued monitoring and surveillance is needed to inform the rising resistance of S. Typhi.•Evidence-based decision-making on the diagnosis and resistance of typhoid fever is crucial. Typhoid fever continues to be a health challenge in low-and middle-income countries where access to clean water and sanitation infrastructure is scarce. The non-confirmatory diagnostic method continues to hinder effective diagnosis and treatment, ensuring in a high antimicrobial resistance. This systematic review and meta-analysis aimed to estimate the pooled prevalence and antimicrobial susceptibility level of typhoid fever in Ethiopia. The review was designed based on the condition-context-population review approach. Fifteen eligible articles were identified from PubMed, Google Scholar, and Science Direct databases. Risk of bias and quality of studies were assessed using the Joanna Briggs Institute’s appraisal criteria. Heterogeneity was assessed using Cochran’s Q test and I2 statistics. The review protocol was registered in PROSPERO (registration number CRD42021224478). The estimated pooled prevalence of typhoid fever from blood and stool culture diagnosis was 3% (95% CI: 2%–4%, p