An epidemiological synthesis of emerging and re-emerging zoonotic disease threats in Cameroon, 2000-2022: a systematic review

Population factors such as urbanization, socio-economic, and environmental factors are driving forces for emerging/re-emerging zoonotic diseases in Cameroon. To inform preparedness and prioritization efforts, this study mapped out epidemiological data (including prevalence) of zoonotic diseases occurring in Cameroon between 2000 and 2022 by demographic factors. Following the PRISMA guidelines, a protocol was registered in the PROSPERO database (CRD42022333059). Independent reviewers searched the PubMed, Embase, CINAHL, Cochrane, and Scopus databases on May 30, 2022 for relevant articles; duplicates were removed, and the titles, abstracts, and full texts were screened to identify eligible articles. Out of 4142 articles identified, 64 eligible articles were retrieved in the database search and an additional 12 from the cited literature (  = 76). Thirty-five unique zoonoses (viral, bacterial, and parasitic) were indexed, including Cameroon priority zoonoses: anthrax, bovine tuberculosis, Ebola and Marburg virus disease, highly pathogenic avian influenza, and rabies. The number of studies varied by region, ranging from 12 in the Far North to 32 in the Centre Region. The most reported were as follows: brucellosis (random-effects pooled estimate proportion (effect size), ES 0.05%, 95% confidence interval (CI) 0.03-0.07;  = 6), dengue (ES 0.13%, 95% CI 0.06-0.22;  = 12), avian and swine influenza virus (ES 0.10%, 95% CI 0.04-0.20;  = 8), and toxoplasmosis (ES 0.49%, 95% CI 0.35-0.63;  = 11), although values were greater than 75%, thus there was high inter-study heterogeneity ( < 0.01). This understanding of the distribution of emerging and re-emerging zoonotic threats in Cameroon is vital to effective preventive and resource prioritization measures

An Epidemiological Synthesis of Emerging and Re-Emerging Zoonotic Disease Threats in Cameroon, 2000-2022 and Community Stakeholder Mapping

Introduction: Population factors such as urbanization, socio-economic, and environmental factors are driving forces for emerging/re-emerging diseases in Cameroon, and the effects of these are experienced differently across demographics. Indigenous rainforest communities in the Congo Basin, for example, suffer worse health outcomes compared to neighboring communities, like the Pygmies, who have a life expectancy of 22 years less than neighboring Bantus. It is important to characterize the risk of exposure of these vulnerable communities and map out, through a systematic review, descriptive epidemiological data around zoonoses, to inform preparedness and research efforts. Methods: Following the PRISMA guidelines, a protocol was registered in PROSPERO (ID: CRD42022333059). With another independent reviewer, I searched PubMed, Embase, CINAHL, Cochrane, and SCOPUS databases on May 30th, 2022, for relevant articles, removed duplicates, and screened titles, abstracts, and full texts for eligible articles from which data as abstracted. In addition, using the Mapping Action through Planning and Partnerships (MAPP) and One Health approach, we identified and convened local and national stakeholders around infectious disease prioritization. Results: Out of 4,142 articles identified from the databases, 64 were abstracted, including 12 from cited literature (total = 76). The included studies used a cross-sectional design and reported 35 unique zoonoses (viral, bacterial, and parasitic). For toxoplasmosis, dengue, brucellosis, and avian & swine influenza, heterogeneity (I2 values) were greater than 75%, indicative of the discrepancy in the sampling frame, diagnostic tools, and publication years. From community visits, we gathered that risk factors for zoonoses where inherent parts of the population, with a dependence on bush meat as a source of protein and household income, well established market distribution networks for these animals, inclination to self-treat, and heavy reliance on traditional medicine. At the health centers, there were no diagnostic tools for zoonoses and staff lacked expertise with these, unlike with neglected tropical diseases like yaws and onchocerciasis, despite there being numerous cases of acute febrile illnesses with negative malaria diagnoses. Conclusions: Developing effective preventive and countermeasures to emerging and reemerging zoonotic threats in Cameroon requires resource prioritization to expand addressing of risky health practices and pathogenic disease transmission patterns and inform community capacity building

Resilience of mental health services amidst Ebola disease outbreaks in Africa

Peer reviewed: TrueAcknowledgements: We acknowledge data obtained from the WHO MH Atlas platform that informed us of the MH situations in African countries that have experienced Ebola disease outbreaks.IntroductionHealth systems including mental health (MH) systems are resilient if they protect human life and produce better health outcomes for all during disease outbreaks or epidemics like Ebola disease and their aftermaths. We explored the resilience of MH services amidst Ebola disease outbreaks in Africa; specifically, to (i) describe the pre-, during-, and post-Ebola disease outbreak MH systems in African countries that have experienced Ebola disease outbreaks, (ii) determine the prevalence of three high burden MH disorders and how those prevalences interact with Ebola disease outbreaks, and, (iii) describe the resilience of MH systems in the context of these outbreaks.MethodsThis was a scoping review employing an adapted PRISMA statement. We conducted a five-step Boolean strategy with both free text and Medical Subject Headings (MeSH) to search 9 electronic databases and also searched WHO MINDbank and MH Atlas.ResultsThe literature search yielded 1,230 publications. Twenty-five studies were included involving 13,449 participants. By 2023, 13 African nations had encountered a total of 35 Ebola outbreak events. None of these countries had a metric recorded in MH Atlas to assess the inclusion of MH in emergency plans. The three highest-burden outbreak-associated MH disorders under the MH and Psychosocial Support (MHPSS) framework were depression, post-traumatic stress disorder (PTSD), and anxiety with prevalence ranges of 1.4–7%, 2–90%, and 1.3–88%, respectively. Furthermore, our analysis revealed a concerning lack of resilience within the MH systems, as evidenced by the absence of pre-existing metrics to gauge MH preparedness in emergency plans. Additionally, none of the studies evaluated the resilience of MH services for individuals with pre-existing needs or examined potential post-outbreak degradation in core MH services.DiscussionOur findings revealed an insufficiency of resilience, with no evaluation of services for individuals with pre-existing needs or post-outbreak degradation in core MH services. Strengthening MH resilience guided by evidence-based frameworks must be a priority to mitigate the long-term impacts of epidemics on mental well-being.</jats:sec