Document Type

Capstone Experience

Graduation Date

12-2022

Degree Name

Master of Public Health

Department

Epidemiology

First Committee Member

David Brett-Major, MD, MPH

Second Committee Member

Jana Broadhurst, MD, PhD, DTM&H

Third Committee Member

James Lawler, MD, MPH, FIDSA

Fourth Committee Member

Frankline Sevidzem Wirsiy, PhD, MSc

Abstract

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.

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