BACKGROUND: Although anthrax occurs globally, the burden of the disease remains particularly
high in Africa. Furthermore, the disease anthrax has significant public health and economic
implications. However, sufficient attention has not been given to the geographic distribution of
anthrax outbreaks and cases in Lesotho. Therefore, this study investigates the spatial patterns of
anthrax outbreaks and cases among livestock in Lesotho from 2005 to 2016. METHODS: A cross-sectional
study design was adopted to realise the objectives of this study using retrospective data of anthrax
outbreaks and cases recorded by the Department of Livestock Services (DLS) between 2005 and 2016.
Anthrax outbreaks were geo-coded at village level and aggregated at district level. Proportions
and 95% CI of anthrax outbreaks and cases by village and district were calculated. Cartographic
maps displaying the distribution of anthrax outbreaks and cases at village and district level were
constructed. RESULTS: A total of 38 outbreaks were reported over the study period, and they were
clustered in the Lowlands districts of Lesotho. Most outbreaks (52.6%, 20/38) in livestock were reported
in the Maseru district. The Leribe district reported the lowest proportions of outbreaks (5.3%, 2/38)
and cases (0.6%, 3/526). At the village level, 18% (7/38) of outbreaks were in Maseru Urban, followed by
Ratau (16%, 6/38) and Mofoka (13%, 5/38). The Maseru district reported the highest (1.3%, 369/29,070)
proportion of cases followed by Mafeteng (0.9%, 73/8530). The village with the most cases was Kolo
(10.5%, 21/200), followed by Thaba-Chitja (7.7%, 33/430). CONCLUSION: Anthrax outbreaks and cases
exclusively occur in the Lowlands districts of Lesotho, with villages such as Mahobong, Pitseng,
Kolo, and Thaba-Chitja having a higher risk of anthrax disease. Findings of the present study have
serious public health implications in light of the fact that between 2003 and 2008 Lesotho’s main abattoir
was closed; hence, most of the meat in Lesotho was imported and/or sourced from the informal
slaughter facilities. Much larger studies are needed to further investigate factors contributing to spatial
disparities in anthrax outbreaks and cases observed in this study. Findings of the present study can be
used to guide the formulation of a policy on prevention and control of anthrax in Lesotho.http://www.mdpi.com/journal/ijerphpm2021Paraclinical Science