Influenza and SARS-CoV-2 Prevalence, Co-circulation, and Determinants among Acute Febrile Patients in Ethiopia: A Systematic Review and Meta-analysis, Protocol.

1. Background The emergence of SARS-CoV-2 coincided with the ongoing spread of pandemic and seasonal influenza viruses presented an unprecedented public health impact in Ethiopia. Due to their comparable clinical manifestations and modes of transmission, these viruses provide challenges for diagnosis and treatment. It is essential to comprehend the combined and comparative epidemiology of these viruses in order to inform clinical guidelines, immunization plans, respiratory disease surveillance, and public health measures. Although there are primary studies on both viruses in Ethiopia, the results are inconsistent. This systematic review and meta-analysis are to synthesize the available studies on the prevalence/proportion, determinants and genetic diversity of influenza and SARS-CoV-2 among acute febrile patients in Ethiopia, providing a providing a comprehensive picture of their epidemiological features. 2. Objectives The primary objective is to systematically review and meta-analyze the available literature on the epidemiology of influenza and SARS-CoV-2 in Ethiopia. The specific objectives include: • Estimate the pooled prevalence/proportion of influenza (by type/subtype: A/H1N1, A/H3N2, B) and SARS-CoV-2 among acute febrile patients in Ethiopia. • Identify and synthesize factors associated with (risk factors for) influenza and SARS-CoV-2 infection. • Identify and summarize the circulating genetic lineages/clades of influenza and SARS-CoV-2 viruses.