Anthrax vaccine suspension for injection 0.5ml ampoules

BackgroundAnthrax is one of the tropical diseases that are often overlooked... Anthrax's burden extends beyond its effects on health; it also has an economic cost. Implementing One Health policies requires knowledge, attitude, and practice (KAP) about anthrax prevention and control. However, there is no nationally aggregated evidence in Ethiopia. Therefore, this review was done to generate evidence and offer suggestions for incorporating KAP findings into One Health strategy to prevent and control anthrax in Ethiopia.MethodsThe protocol was registered in a PROSPERO with a reference CRD420251141478 and Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines were adhered. The electronic databases: Pub-Med, Scopus, Web of Science, CAB abstracts, AGRICOLA, and Google-Scholar were searched to retrieve the included studies using key search terms with database specific search strings. Studies that reported KAP outcomes in Ethiopian and were published only in English language irrespective of publication time were included in this review. The random-effects model was used to pool effect sizes using STATA 17 software. Subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity, while sensitivity analysis was performed to assess the robustness of the pooled estimates. Forest plots were used to display the results.ResultsThis study included 17 articles with 8,369 participants that met the inclusion criteria. Our synthesis found that consuming raw meat, backyard slaughtering, improperly disposing of carcasses, and sharing a home with animals are common risk factors for anthrax infection in Ethiopia. The pooled knowledge, attitude, and practice levels of anthrax prevention and control were 51.25% (95% CI: 43.93, 58.58; I2 = 98.01%), 59.26% (95% CI: 50.43%, 68.08%; I2 = 98.33%), and 50.62% (95% CI: 42.95, 58.29; I2 = 97.93%), respectively.ConclusionsHalf of the communities in Ethiopia remain with suboptimal knowledge, attitudes, and practices for anthrax prevention and control. This could lead to ineffective outbreak management, delayed reporting, and continuous transmission of anthrax to humans and animals, particularly in endemic areas. As a result, from a One Health perspective, an integrated multisectoral intervention is urgently required to promote collaboration among the human, animal, and environmental health sectors.

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Post-exposure prophylaxis may be recommended during chemical, biological, radiological or nuclear (CBRN) emergencies and must often be initiated rapidly to be effective. Understanding factors that affect uptake (initiation) and subsequent adherence (completion) will help to minimise barriers and support adherence during emergencies. This systematic review synthesises evidence on factors associated with uptake of and adherence to prophylaxis following exposure to anthrax, radiation, smallpox, or viral pandemic diseases such as influenza or COVID-19. The review was pre-registered (https://osf.io/f5nmw). We searched Medline, Embase, APA PsycINFO, Web of Science, Scopus, the Cochrane Library, and subject specific databases, with no language or date restrictions. PRISMA and synthesis without meta-analysis (SWiM) guidelines were followed alongside NICE recommendations for risk of bias assessment. Data were extracted on factors associated with, and interventions targeting, uptake and adherence to prophylaxis across the four scenarios. Of 17,217 records screened, 21 studies were included. Uptake and adherence varied widely. Evidence on associated factors was inconsistent and generally of low certainty. Few scenario-specific differences were identified; variation was more strongly associated with population and contextual factors. Common barriers included concerns about side effects, low perceived risk, and lack of trust in information sources. Evidence on the effectiveness of interventions was limited to two studies, at high risk of bias. In conclusion, preparedness should prioritise addressing shared motivational and practical barriers across settings. There is a critical need to develop and evaluate interventions to support timely uptake and adherence to prophylaxis before emergencies occur.

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BackgroundAnthrax remains a persistent public health, veterinary, and ecological challenge in Africa, sustained by fragmented surveillance systems characterized by underreporting, limited diagnostic capacity, and weak cross-sectoral coordination. The absence of integrated surveillance across human, livestock, wildlife, and environmental interfaces constrains accurate burden estimation and timely outbreak response.MethodsWe conducted a systematic review and meta-analysis following PRISMA guidelines to synthesize available evidence on anthrax epidemiology in Africa. Studies published between January 2000 and February 2025 were identified from PubMed and Web of Science. Observational studies reporting primary epidemiological data in humans, livestock, wildlife, or environmental samples were eligible. Quantitative synthesis was restricted to cross-sectional studies reporting extractable prevalence data. Pooled estimates were generated using a logit-transformed random-effects model (REML), with heterogeneity assessed using I 2 and τ2 statistics. Studies not meeting meta-analytic criteria were synthesized narratively within a One Health framework.ResultsTen cross-sectional studies comprising 19,955 samples and 2,079 confirmed anthrax cases were included in the meta-analysis. The crude aggregated prevalence was 9.88% (95% CI: 9.46%-10.30%). The pooled prevalence from the logit-transformed random-effects model was 20% (95% CI: 8%-44%). Substantial heterogeneity was observed (I 2 = 98.2%), indicating marked epidemiological variability across ecological settings, host populations, and surveillance systems. Narrative synthesis further highlighted wildlife outbreaks and environmental persistence of Bacillus anthracis, though such studies remain comparatively scarce.ConclusionThe available evidence on anthrax in Africa is limited, geographically uneven, and highly heterogeneous. The pooled estimate should therefore be interpreted as a summary measure of reported prevalence rather than a precise continental burden estimate. These findings underscore persistent transmission within fragmented surveillance systems and support strengthened One Health-based approaches integrating human, animal, wildlife, and environmental health sectors to improve surveillance, early detection, and coordinated response across Africa.

Abstract licence: CC BY