Decoding Infection and Transmission最新文献

{"title":"Predicting HIV testing status in pregnant women using balanced machine learning models: Insights from Sierra Leone's demographic health survey","authors":"Afeez A. Soladoye ,&nbsp;David B. Olawade ,&nbsp;Oluwakemi Jumoke Bello ,&nbsp;Claret Chinenyenwa Analikwu ,&nbsp;Raphael Igbarumah Ayo Daniel ,&nbsp;Augustus Osborne","doi":"10.1016/j.dcit.2026.100078","DOIUrl":"10.1016/j.dcit.2026.100078","url":null,"abstract":"<div><h3>Objective</h3><div>Preventing vertical HIV transmission requires comprehensive testing programmes for pregnant women, yet coverage gaps persist across Sub-Saharan Africa. In Sierra Leone, approximately one-third of pregnant women remain untested for HIV, creating substantial public health challenges. Conventional predictive models often exhibit bias towards majority classes in imbalanced datasets, hindering accurate identification of untested women who require urgent intervention. This study addresses the critical need for diagnostic prediction models that can reliably identify pregnant women at risk of not being tested for HIV. This study develops and validates diagnostic machine learning prediction models to identify HIV testing patterns among pregnant women in Sierra Leone, emphasising class balance techniques to enhance minority class detection capabilities and improve targeted intervention strategies.</div></div><div><h3>Methods</h3><div>We analysed data from 990 pregnant women (aged 15-49) using the 2019 Sierra Leone Demographic and Health Survey. Our preprocessing pipeline included categorical variable encoding, feature normalisation via Min-Max scaling, and implementation of Synthetic Minority Oversampling Technique (SMOTE) for dataset balancing. Model development employed four supervised learning algorithms: Random Forest, XGBoost, Logistic Regression, and K-Nearest Neighbors. Model performance was evaluated using macro-averaged metrics including precision, recall, F1-score, and accuracy, with 70-30 train-test split validation.</div></div><div><h3>Results</h3><div>Imbalanced dataset models demonstrated suboptimal performance with macro F1-scores between 0.46 and 0.57. Following SMOTE implementation, diagnostic performance improved substantially to 0.55-0.72. Random Forest achieved optimal macro F1-score (0.72), representing 56% improvement over standard approaches.</div></div><div><h3>Conclusions</h3><div>Class imbalance mitigation through SMOTE substantially enhances diagnostic prediction model performance for HIV testing status classification, facilitating targeted public health strategies in resource-constrained environments.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking barriers for key populations in the lenacapavir era","authors":"Victor Abiola Adepoju ,&nbsp;Abdulrakib Abdulrahim ,&nbsp;Safayet Jamil","doi":"10.1016/j.dcit.2026.100075","DOIUrl":"10.1016/j.dcit.2026.100075","url":null,"abstract":"<div><div>Despite advances in human immunodeficiency virus (HIV) prevention, key populations including men who have sex with men (MSM), sex workers, transgender individuals, people who inject drugs, and adolescent girls and young women (AGYW) continue to experience disproportionately high rates of HIV infection and limited access to prevention services. The recent approval of lenacapavir, a twice-yearly long-acting injectable pre-exposure prophylaxis (PrEP), offers a promising opportunity to overcome adherence challenges associated with daily oral PrEP. However, its successful implementation hinges on addressing the structural and social barriers that have historically excluded these populations from benefiting fully from HIV innovations. While lenacapavir's discreet, long-acting profile holds great promise, its rollout may be undermined by persistent issues such as stigma, criminalisation, lack of youth-friendly services, and health system mistrust. Many individuals from key populations still face legal and social conditions that deter them from accessing clinics, even for biannual injections. Without intentional equity-focused strategies, including peer-led service delivery, policy reform, and community-based outreach, these same barriers could restrict uptake and impact. Innovative solutions such as integrating lenacapavir into trusted drop-in centres, mobile clinics, or combined reproductive health services can enhance accessibility and privacy. Ensuring equitable rollout also demands investment in key population-led organisations, disaggregated data monitoring, and rights-based policy frameworks that affirm agency and safety. Lenacapavir could be a game-changer for HIV prevention, but only if systems evolve to meet the needs of those most affected. Equity must be a deliberate foundation, not a secondary consideration. If we prioritise dignity, inclusivity, and structural reform alongside scientific innovation, lenacapavir can do more than prevent infections; it can help transform global HIV prevention into a tool for justice. The era of long-acting PrEP must not replicate old exclusions but rather break new ground in empowering key populations worldwide.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and chronic kidney disease: A Case Report on Diagnosis, Management, and Recovery in an Elderly Patient","authors":"B. Naveena ,&nbsp;E. Karthikeyan","doi":"10.1016/j.dcit.2025.100073","DOIUrl":"10.1016/j.dcit.2025.100073","url":null,"abstract":"<div><div>The case report concerns the management of a 71-year-old Indian woman with chronic kidney disease (CKD), cellulitis, and COVID-19. Early diagnosis and multidisciplinary treatment are especially important since older adult patients with CKD are highly susceptible to severe COVID-19 because of their diminished self-immune defense and many comorbidities. The patient presented with fever, increased lower limb edema, and dyspnea. Laboratory, RT‒PCR, and chest computed tomography confirmed infection with SARS-CoV-2 and cellulitis. A multidisciplinary treatment plan was initiated, which included corticosteroids, antibiotics, anticoagulants, analgesics, diuretics, and supportive care. Day 1: The patient was hospitalized, and therapy was initiated. She also showed progressive improvement in fever, signs of respiratory illness, and inflammation of the legs on Days 2–5. On Day 6, a repeat CT of the chest revealed a trend toward recovery from COVID-19 pneumonia, with a severity score of 7/25. On Day 7, she was released in a stable state and on medications with a follow-up appointment. At discharge, she demonstrated great improvement in symptoms and the absence of acute complications. The patient was appreciative and relieved that the coordinated, timely services were provided to her, and the excellent communication between the healthcare team was reassuring to her during her time in the hospital. The case shows great awareness of and adherence to evidence-based management of COVID-19 in geriatric patients with CKD and other comorbidities. Early diagnosis, interdisciplinary care, and follow-up could be helpful in reducing complications and improving the clinical outcome of this high-risk population.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145814455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"World malaria report 2025: Growing biological threats, shrinking resources","authors":"Lucien Platon ,&nbsp;Feng Lu ,&nbsp;Didier Ménard","doi":"10.1016/j.dcit.2026.100076","DOIUrl":"10.1016/j.dcit.2026.100076","url":null,"abstract":"<div><div>The <em>World Malaria Report 2025</em> documents operational progress while exposing systemic vulnerabilities that could reverse two decades of gains. Several biological threats are converging in Sub-Saharan Africa: artemisinin partial resistance, parasites evading rapid diagnostic tests, insecticide-resistant mosquitoes, and the spread of <em>Anopheles stephensi</em> into urban areas. This convergence occurs as external funding drops sharply.</div><div>The resulting situation presents parallels with the period preceding chloroquine failure across Sub-Saharan Africa. A critical difference exists: molecular surveillance tools can now detect resistance before clinical failure occurs. Whether this capacity translates into effective response will depend on decisions made over the coming years.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and host factors associated with drug-induced liver injury in 264 pulmonary tuberculosis patients from Hainan province, China","authors":"Bingrui Gao ,&nbsp;Xinyu Wang ,&nbsp;Lei Sang ,&nbsp;Wenping Gong","doi":"10.1016/j.dcit.2026.100080","DOIUrl":"10.1016/j.dcit.2026.100080","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) remains a major global public-health threat. Yet clinical portraits of patients in China's tropical south—especially Hainan—are still thinly documented. We set out to characterize the presentation of pulmonary TB on the island, quantify the impact of molecular diagnostics, and ask how sex, age, and diabetes shape both disease expression and treatment safety.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the charts of 264 culture- or GeneXpert-confirmed pulmonary-TB cases admitted to the Hainan branch of the PLA General Hospital between June 2013 and August 2025. Patients were stratified by sex, age (cut-off 60 years), diabetes status, and date of admission (before vs. after June 2019, when GeneXpert was introduced). Continuous and categorical variables were analyzed in GraphPad Prism 10; <em>p</em> &lt; 0.05 defined significance.</div></div><div><h3>Results</h3><div>Of 264 patients (175 men, 89 women; median age 58 years), key findings were: (1) Diagnostic speed: median time to initial diagnosis fell from 5 days (IQR 1–7) pre-2019 to 1 day (IQR 1–7) after molecular testing was adopted (<em>p</em> = 0.0018). (2) Sex: men had more pleural effusion (<em>p</em> = 0.0067) and a higher incidence of drug-induced liver injury after treatment (35/115 vs 9/65; <em>p</em> = 0.0182). They also exhibited higher leukocyte, neutrophil, haemoglobin, CRP, procalcitonin, and IL-6 levels (all <em>p</em> &lt; 0.05). (3) Age: patients ≥60 years showed more multi-lobar involvement, more dyspnoea, higher neutrophil counts, CRP, procalcitonin, and IL-6, but lower haemoglobin than younger adults (all <em>p</em> &lt; 0.05). (4) Diabetes: the 60 diabetic patients had a higher body mass index (BMI) (22.60 ± 3.38 vs 20.79 ± 3.35 kg m⁻²; <em>p</em> = 0.0004), yet no significant divergence in symptoms or inflammatory markers. (5) Imaging: patchy infiltrates predominated (49.62 %), followed by nodules (26.37 %) and cavitation (18.94 %).</div></div><div><h3>Conclusions</h3><div>Rolling out molecular diagnostics in Hainan compressed the diagnostic window dramatically. Host factors—male sex and older age—were linked to heavier inflammation and a greater risk of hepatotoxicity. These data argue for universal rapid molecular testing and sex-/age-tailored monitoring of adverse drug reactions in routine TB care.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147656560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic characterization of Enterobacter hormaechei subsp. xiangfangensis isolated from a urinary tract infection: insights into antibiotic resistance determinant and mobile genetic elements","authors":"Dého Aristide Gbégbé,&nbsp;Okran Beyosse Christophe Kacou,&nbsp;N'goran Parfait N'zi,&nbsp;Kouamé Abraham N'guessan,&nbsp;Djédoux Maxime Angaman","doi":"10.1016/j.dcit.2026.100074","DOIUrl":"10.1016/j.dcit.2026.100074","url":null,"abstract":"<div><h3>Objective</h3><div>Urinary tract infections (UTIs) remain a major public health concern in resource-limited settings, where reliance on conventional urine culture and sensitivity testing may result in misdiagnosis and inappropriate antibiotic prescriptions. This study aimed to provide the first genomic characterization of <em>Enterobacter hormaechei</em> subsp. <em>xiangfangensis</em> isolated from a UTI case in Côte d’Ivoire, focusing on antimicrobial resistance, mobile genetic elements, and epidemiological relevance.</div></div><div><h3>Methods</h3><div>A bacterial isolate (20LM111) was recovered from a UTI patient at Daloa Regional Hospital. Antimicrobial susceptibility testing was performed, followed by genomic DNA extraction, Illumina NextSeq sequencing, and de novo genome assembly. <em>In silico</em> analyses were conducted to identify antimicrobial resistance genes, plasmid replicons, prophage regions, virulence factors, and multilocus sequence type.</div></div><div><h3>Results</h3><div>The isolate exhibited resistance to doxycycline, tetracycline, ampicillin, amoxicillin–clavulanate, nalidixic acid, cefuroxime, ceftriaxone, and cefoxitin. Genomic analysis identified the resistance genes dfrA14, blaACT-16_1, and fosA_7, while no virulence-associated genes were detected. The draft genome size was 4,697,941 bp with a GC content of 55.42 % and was assigned to sequence type ST114. Two plasmids (IncFIB[pQil] and IncR) and four prophage regions were identified.</div></div><div><h3>Conclusion</h3><div>This study highlights the value of whole-genome sequencing for improving UTI diagnostics, monitoring antimicrobial resistance, and enhancing surveillance of high-risk <em>Enterobacter</em> clones in resource-limited settings.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mosquito immunity and its defense against malaria parasite","authors":"Meilin Li ,&nbsp;Biao He ,&nbsp;Yuanli Gao ,&nbsp;Wenyue Xu","doi":"10.1016/j.dcit.2026.100081","DOIUrl":"10.1016/j.dcit.2026.100081","url":null,"abstract":"<div><div>Mosquito immunity serves as a critical factor limiting the development of <em>Plasmodium</em> parasites within mosquitoes. Unlike vertebrate, mosquitoes rely solely on innate immune responses, which nonetheless effectively suppress <em>Plasmodium</em> development. This review outlines the components and characteristics of the mosquito immune system and summarizes recent advances in understanding immune responses targeting ookinetes, oocysts on the midgut basal lamina, and sporozoites in the hemolymph and salivary glands. It highlights mosquito immune strategies during the two developmental bottlenecks of <em>Plasmodium</em>—pre- and post-oocyst formation, as well as key unresolved scientific questions in the field. This review aims not only provide a crucial theoretical underpinning for elucidating the molecular mechanisms of <em>Plasmodium</em> transmission and developing novel malaria transmission-blocking strategies, but also guide future research directions.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147713451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend, pattern, and outcome of meningitis cases in Northwest, Nigeria: A 10 Year review of case-based surveillance data","authors":"Usman Muhammad Ibrahim ,&nbsp;Boateng Kofi ,&nbsp;Salisu Muazu Babura ,&nbsp;Sunday Audu ,&nbsp;Abba Ahmed Danzomo ,&nbsp;Salihu Abdullahi Ahmed ,&nbsp;Faruk Abdullahi Namadi ,&nbsp;Musa Mahdi Wade ,&nbsp;Saidu Yusuf ,&nbsp;Nuruddeen Muhammad ,&nbsp;Usman L. Shehu ,&nbsp;Rayyan Muhammad Garba ,&nbsp;Kabiru Abdulsalam ,&nbsp;Abubakar Mayana Sanusi ,&nbsp;Abubakar Mohammed Jibo","doi":"10.1016/j.dcit.2026.100077","DOIUrl":"10.1016/j.dcit.2026.100077","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to describe the epidemiological pattern of Cerebrospinal meningititis (CSM) cases, and related mortality in Jigawa State, Northwest Nigeria, over a 10-year period.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive cross-sectional study of 1943 line-listed CSM cases spanning 2015–2024, in line with the Integrated Disease Surveillance and Response (IDSR) guidelines. Data were analyzed using SPSS version 22 at a 5 % level of significance.</div></div><div><h3>Results</h3><div>Patient ages ranged from 1 to 70 years, with a median of 12 years (IQR 6–17). Adolescents aged 10–19 years constituted the largest proportion of cases (39.7 %). The highest burden of CSM occurred in 2023 (71.6 % of cases). Overall, case fatality was 8 %. Unlike previous years, when outbreaks peaked in the early weeks, the 2023 outbreak extended from epidemiological week 50 through week 1 of 2024. The overall attack rate at the state level was 25.8 per 100,000 population. Mortality was significantly higher among cases not admitted for care; admitted patients were 50 % less likely to die (aOR = 0.5; 95 % CI: 0.4–0.8). Laboratory results from the National Reference Laboratory (NRL) showed 59.4 % positivity, with serogroup C (<em>Neisseria meningitidis</em> type C) accounting for 57.1 % of confirmed cases. All positive cultures correlated with PCR positivity (100 %, p &lt; 0.001), and nearly all (99.7 %, p &lt; 0.001) confirmed <em>N. meningitidis</em> type C. Other detected pathogens included <em>N. meningitidis</em> X, <em>Streptococcus pneumoniae</em>, and non-groupable <em>Neisseria</em>.</div></div><div><h3>Conclusions</h3><div>Recurrent CSM outbreaks in Jigawa State are linked with considerable illness and death, primarily affecting individuals aged 1–29 years, most of whom lacked prior vaccination against any meningococcal serotype. The predominant strains are not covered by the current national immunization program. There is an urgent need for government and partners to introduce the Multivalent Meningococcal Conjugate Vaccine (MMCV), in line with WHO recommendations.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and big data for decoding infectious disease transmission dynamics and outbreak prediction","authors":"Bellarmin Michael,&nbsp;Harish Veerasami,&nbsp;Nandhini Jayaprakash","doi":"10.1016/j.dcit.2026.100079","DOIUrl":"10.1016/j.dcit.2026.100079","url":null,"abstract":"<div><div>Understanding and predicting infectious disease transmission remains a central challenge in global health due to the complex interplay of pathogen evolution, host biology, environmental conditions, and human behavior. Traditional epidemiological models, while foundational, are often limited in their ability to integrate heterogeneous, high-dimensional data or capture nonlinear, cross-scale dynamics that govern real-world outbreaks. Recent advances in artificial intelligence and big data analytics are fundamentally reshaping this landscape. This review provides a comprehensive overview of recent progress in Artificial Intelligence (AI)-enabled infectious disease research, highlighting how Machine learning (ML), deep learning and network-based approaches integrate diverse data streams including epidemiological surveillance, pathogen genomics, multi-omics profiles, environmental variables, and human mobility to decode transmission dynamics across molecular, ecological, and population scales. Case studies spanning viral, vector-borne, bacterial and zoonotic pathogens illustrate how AI models enhance outbreak forecasting, identify high-risk populations, and link molecular variation with transmissibility and disease severity. Beyond predictive performance, review discuss about AI in driving a conceptual shift from parameter driven epidemiology toward mechanism-aware, multi-scale modeling of infection and spread.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated review of ecology, epidemiology, and public health burden of anthrax in Africa","authors":"Adelekan Oluseyi Okunlade ,&nbsp;Ridwan Olamilekan Adesola ,&nbsp;Ibrahim Idris ,&nbsp;Favour Akinfemi Ajibade","doi":"10.1016/j.dcit.2026.100082","DOIUrl":"10.1016/j.dcit.2026.100082","url":null,"abstract":"<div><div>The emergence and re-emergence of anthrax across Africa remain a persistent public health and veterinary concern. In recent years, several African countries have experienced recurrent outbreaks, underscoring the need for sustained and coordinated interventions by national and international stakeholders. This review synthesizes past and current knowledge on the ecology, epidemiology, and public health challenges associated with anthrax in Africa. Anthrax is a zoonotic disease caused by <em>Bacillus anthracis</em>, affecting both humans and animals, with transmission primarily occurring through direct contact with infected animals or animal products, as well as inhalation of bacterial spores. Recent outbreaks reported in 2025 in Democratic Republic of Congo, Nigeria, Uganda, and Ethiopia highlight the continued circulation of the pathogen across diverse ecological settings. Notably, wildlife losses exceeding 50 hippopotamuses and buffalo were reported in the Democratic Republic of Congo, while Uganda documented 1165 human anthrax cases between 2017 and 2024. Key challenges identified include weak disease surveillance systems, reduced external funding—particularly the withdrawal of support from the United States Agency for International Development—limited vaccine coverage, underreporting, and inadequate laboratory diagnostic capacity. Addressing these constraints is critical to reducing the burden of anthrax and safeguarding livelihoods across the continent. Anthrax remains a disease of significant public health and economic importance in Africa, and its continued re-emergence emphasizes the urgent need for integrated prevention and control strategies. The adoption of a One Health approach, encompassing human, animal, and environmental health sectors, is essential for effective and sustainable anthrax control in Africa.</div></div>","PeriodicalId":100358,"journal":{"name":"Decoding Infection and Transmission","volume":"4 ","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147750698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}