Viral Zoonoses of National Importance in Ghana: Advancements and Opportunities for Enhancing Capacities for Early Detection and Response

A Review of Evidence Related to the Zoonotic Characteristics of the Monkeypox Virus

The 2022 monkeypox virus (MPXV) outbreaks spurred global public health concern. In response, we undertook a living systematic review of its zoonotic characteristics, including potential reservoirs and susceptible species, transmissibility, and clinical presentation in nonhuman species. Electronic database searches yielded 148 eligible records published between 2000 and 2022. Primary reservoirs remain unidentified, with natural isolation identified in 2 species, the sooty mangabey monkey and rope squirrel. Transmission primarily occurs from animals to humans, but evidence of reverse zoonosis has emerged. Data on clinical infection and manifestations are sparse, with evidence of potentially susceptible species drawn primarily from experimental studies. Only 10% of articles were appropriate for quality assessment and most of these were rated as critically low. Overall, while evidence regarding MPXV exists, the quality of data are extremely poor, resulting in significant uncertainty regarding MPXV's zoonotic traits. High-quality empirical research to understand the impact of MPXV on animal and human populations is warranted.

Rabies in equids in Sudan

Rabies is endemic in Sudan with continuing outbreaks occurring annually, the most common animals affected are dogs, followed by goats and equids. This work focused on equid rabies, to elucidate the current situation of the disease through analysis of reports of equid rabies outbreaks in Sudan during 2010-2022 supported by laboratory confirmation of the disease. During the study period, 66 animals were affected during 35 equid rabies outbreaks. The highest incidences were found in Al Gezira (30.3%), followed by Darfur (24.2%) and Kordofan (15.2%). The highest incidence rate was observed during 2018 (33.3%), followed by 2015 (16.7%). Within seasons, the highest incidence rate was reported during October - December (33.3%), followed by July - September (30.3%). Chi-square analysis revealed a significant correlation between rabid animals and year, season, and state. Wald statistics demonstrated that year and season had a significant association with the disease. Virus antigen was identified (72.2%) in brain tissues using the fluorescent antibody test. Viral nucleic acid was amplified (n = 6) with a reverse transcriptase polymerase chain reaction assay.Contribution: As equids are kept in close contact with humans and other animals in the country, according to the present investigation, equid rabies in Sudan is a potential public health concern, emphasising the importance of implementing effective control measures.

Seroprevalence of Rift Valley fever and associated risk factors in livestock of Afar Region, northeastern Ethiopia

Rift Valley fever (RVF) is one of the emerging arthropod-borne zoonotic viral diseases with serious public and economic significance in the livestock and human populations of East Africa. Its epidemiology is inadequately recognized in Ethiopia. A cross-sectional study was conducted to investigate the seroprevalence and potential risk factors of RVF in domestic livestock of Amibara and Haruka districts of the Afar Region, northeastern Ethiopia. A total of 736 (224 cattle, 121 goats, 144 sheep, 155 camels and 92 donkeys) blood samples were collected, and serum extracted and tested using competitive ELISA. A questionnaire survey was used to assess potential risk factors of RVF infection. The overall seroprevalence was 22.0% (162/736; 95% CI: 19.41-24.79%). The seroprevalence was significantly higher in goats (42.2%, 95% CI: 39.61-44.99%) compared to that of cattle (14.3%, 95% CI: 11.74-17.09%), sheep (21.5%, 95% CI: 18.91-24.29%), or camels (30.97%, 95% CI: 28.38-33.76%) (P < 0.001). The study showed that seropositivity for IgG antibody to RVFV infection was associated with locality and species of animal. Goats were two times more likely to be seropositive for RVFV infection than cattle (OR: 2.3, 95% CI: 1.462-3.574, P = 0.001). Livestock in the Kealatburi area were five times more likely to be seropositive for RVFV infection than those in the Halidegei area (OR: 5.074, 95% CI: 3.066-8.396, P = 0.001). This study revealed that RVF is an important animal health problem in the Afar Region. Therefore, monitoring of RVF in animals, humans, and vectors along with community sensitization of high-risk populations could benefit mitigating the risk posed by the disease. Quarantine measures should be implemented to reduce the risk of RVFV introduction and dissemination among susceptible animals and ultimately transmission to humans.

Rabies control in Ghana: Stakeholders interventions, challenges and opportunities

Background

Rabies remains a significant public health issue in Ghana, predominantly affecting rural communities with limited access to health care and veterinary services. The disease is primarily transmitted through bites from infected domestic dogs and leads to many deaths worldwide each year. Despite various interventions, Ghana continues to struggle with rabies control and prevention. This narrative paper focuses on rabies control in Ghana, examining stakeholders' interventions, challenges faced, and opportunities available.

Methods

The paper reviews existing rabies control measures in Ghana, including dog vaccination efforts and One Health strategies. It also discusses the limitations of these interventions, such as minimal vaccination coverage, weak surveillance, and inadequate intersectoral coordination.

Results

Ghana has implemented dog vaccination campaigns, but coverage remains minimal. Additionally, weak disease surveillance, cultural perceptions, and inadequate coordination across sectors have hampered the country's ability to control rabies effectively.

Conclusion

Adopting One Health principles, which integrate human, animal, and environmental health efforts, is emphasized as a critical strategy to eliminate rabies in Ghana by 2030. By addressing these challenges and leveraging available opportunities, Ghana can strengthen its rabies control programs and work toward a rabies-free future.

Assessing the Knowledge and Awareness Among Selected Tertiary Students in the Accra Metropolis on Zoonotic Infections

Background

Zoonotic infections are a serious threat to human health and a direct risk that could potentially be fatal. Animals both domestic and wild serve as reservoirs for zoonotic infections. Thus, frequent contact with animals might occasionally result in the transfer of infections from animals to people. Ghana is especially susceptible to the effects of zoonotic infections due to the increase in the household human-animal ratio. This study assessed the awareness and knowledge level of tertiary students in a selected tertiary institution on zoonotic infections.

Methods

A quantitative research method was employed making use of a descriptive cross-sectional study design. The target population chosen for the research was mainly students from the University of Ghana. A stratified sampling technique was used in selecting participants for the study. 440 participants were selected for the study. The university's four primary colleges served as the strata for the basis of data collection.

Results

The study revealed a moderate knowledge level among students. The term "zoonoses" was understood by the majority (70%) of the respondents. Respondents knew at least one route of transmission of zoonotic infection. For the spread of zoonotic infections, close contact with infected animals and consumption of contaminated food were seen as ways of spread by a majority.

Conclusion

Although the basic strategies required for the control and elimination of the zoonotic diseases in such tertiary institutions are well known and practiced as per the study findings, zoonoses still persists and this can be attributed to low education on the subject. Knowledge and awareness level on zoonoses especially in tertiary institutions such as the University of Ghana could be improved if relevant authorities create adequate enlightenment programs on improving the knowledge of zoonotic diseases through a variety of media including seminars, workshop, television, radio, newspaper and social media.

The neglected continuously emerging Marburg virus disease in Africa: A global public health threat

Background and Aim

Severe viral hemorrhagic fever (VHF) is caused by Marburg virus which is a member of the Filoviridae (filovirus) family. Many Marburg virus disease (MVD) outbreaks are reported in five decades. A major notable outbreak with substantial reported cases of infections and deaths was in 2022 in Uganda. The World Health Organisation (WHO) reported MVD outbreak in Ghana in July 2022 following the detection of two probable VHF patients there. Further, the virus was reported from two other African countries, the Equatorial Guinea (February 2023) and Tanzania (March 2023). There have been 35 deaths out of 40 reported cases in Equatorial Guinea, and six of the nine confirmed cases in Tanzania so far.

Methods

Data particularly on the several MVD outbreaks as reported from the African countries were searched on various databases including the Pubmed, Scopus, and Web-of-science. Also, the primary data and reports from health agencies like the WHO and the Centers for Disease Control and Prevention CDC) were evaluated and the efficacy reviewed.

Results

Chiroptera in general and bat species like Rousettus aegyptiacus and Hipposideros caffer in particular are natural reservoirs of the Marburg virus. MVD-infected nonhuman primate African fruit-bat and the MVD-infected humans pose significant risk in human infections. Cross-border viral transmission and its potential further international ramification concerns raise the risk of its rapid spread and a potential outbreak. Occurrence of MVD is becoming more frequent in Africa with higher case fatality rates. Effective prophylactic and therapeutic interventions to counter this deadly virus are suggested.

Conclusion

In the face of the lack of effective therapeutics and preventives against MVD, supportive care is the only available option which contributes to the growing concern and disease severity. In view of the preventive approaches involving effective surveillance and monitoring system following the "One Health" model is extremely beneficial to ensure a healthy world for all, this article aims at emphasizing several MVD outbreaks, epidemiology, zoonosis of the virus, current treatment strategies, risk assessments, and the mitigation strategies against MVD.

Preparing for future outbreaks in Ghana: An overview of current COVID-19, monkeypox, and Marburg disease outbreaks

Amidst the ongoing COVID-19 pandemic, Ghana is currently grappling with simultaneous outbreaks of Marburg virus disease and human monkeypox virus. The coexistence of these outbreaks emphasizes the imperative for a collaborative and global approach to enhance surveillance and expedite case detection. While Ghana has made efforts to respond to these outbreaks, this paper outlines the lessons learned and proposes recommendations in this regard. It is crucial to intensify response efforts at the local, regional, and national levels to effectively contain the spread of these infectious diseases. Therefore, this paper suggests prioritizing the following recommendations as crucial for assisting Ghana in adequately preparing for future outbreaks and safeguarding global public health: strengthening surveillance system through digitization, rapid and effective response; risk communication and community engagement; healthcare system readiness; and research and collaboration. Also, prioritizing building healthy public policies and developing personal skills of health personnel across the country is key for future outbreak response.

Reviewing the Past, Present, and Future Risks of Pathogens in Ghana and What This Means for Rethinking Infectious Disease Surveillance for Sub-Saharan Africa

The current epidemiological transition makes us wonder how the parallel of infectious diseases (IDs) might be at the end of each passing year. Yet, the surveillance of these IDs continues to focus on high-profile diseases of public health importance without keeping track of the broad spectrum of the IDs we face. Here, we presented the prevalence of the broad spectrum of IDs in Ghana. Data from the annual reports on Gold Coast now Ghana, Global Infectious Diseases and Epidemiology Network (GIDEON), and the District Health Information Management System II (DHIMS2) databases were examined for records of ID prevalence in Ghana. Using the IDs from these databases, the paper assessed the epidemiological transition, pathogen-host interactions, spatiotemporal distribution, transmission routes, and their potential areas of impact in Ghana. The topmost ID recorded in health facilities in Ghana transitioned from yaws in the 1890s to malaria in the 1950s through 2020. We then presented the hosts of a pathogen and the pathogens of a host, the administrative districts where a pathogen was found, and the pathogens found in each district of Ghana. The highest modes of transmission routes were through direct contact for bacteria and airborne or droplet-borne for viral pathogens. From GIDEON, 226 IDs were identified as endemic or potentially endemic in Ghana, with 42% cited in peer-reviewed articles from 2000 to 2020. From the extent of risk of endemic or potentially endemic IDs, Ghana faces a high risk of ID burden that we should be mindful of their changing patterns and should keep track of the state of each of them.

COVID-19: an opportunity to re-evaluate the implementation of a One Health approach to tackling emerging infections in Nigeria and other sub-Saharan African countries

Background

One Health (OH) has resurfaced in the light of the ravaging COVID-19 pandemic. It has been accepted by many local and global health authorities as a suitable approach for preventing and responding to infectious disease outbreaks including pandemics.

Main body

One Health (OH) is a multisectoral and interdisciplinary framework for managing the animal, human, and ecosystem determinants of health. Globally, the majority of emerging infections in humans including SARS-Cov2—the causative agent of COVID-19—are transmitted from animals through environmental contacts in the last few decades. Yet, even when the biological and social interactions at the human, animal, and environmental interface that drive spillover of zoonotic diseases have been proven, OH strategies to address associated complex health challenges today are still rudimentary in many national health systems. Despite the disproportionate burden of infectious diseases in sub-Saharan Africa, OH is minimally incorporated into routine disease control and national health security programs. Challenges include poor policy support for OH in sub-Saharan Africa, and where some form of policy framework does exist, there are significant implementation bottlenecks. In this paper, we identified ideological, technical, operational, and economic barriers to OH implementation in Nigeria and sub-Saharan Africa, and highlighted possible recommendations across these domains. In order to yield sustainable benefits, a relevant OH policy approach in the sub-Saharan African health systems must derive from a buy-in of the critical mass of stakeholders in the society.

Conclusion

The implementation of sustainable OH approaches as a countermeasure to recurring emerging infections is a developmental priority for sub-Saharan African countries. A deep understanding of the local context must be leveraged to develop integrative OH solutions that are bold, rooted in science, and proven to be compatible with the level of development in sub-Saharan Africa.