Determinants of viral haemorrhagic fever risk in Africa's tropical moist forests: A scoping review of spatial, socio-economic, and environmental factors.

BACKGROUND

Viral haemorrhagic fevers (VHFs) are identified by international health authorities as priorities for research and development, as they pose a threat to global health and economy. VHFs are zoonotic diseases whose acute forms in humans present a haemorrhagic syndrome and shock, with mortality rates of up to 90%. This work aims at synthetizing existing knowledge on spatial and spatially aggregable determinants that support the emergence and maintenance of VHFs in African countries covered by tropical moist forest, to better identify and map areas at risk.

METHODOLOGY/PRINCIPAL FINDINGS: Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-ScR) guidelines, extension for scoping reviews, we searched the PubMed, Embase, CAB Abstracts, and Scopus databases. English and French peer-reviewed documents were retrieved using Boolean logic and keyword search terms. The analysis of 79 articles published between 1993 and 2023 offers a comprehensive overview of the complex interactions among abiotic, biotic, demographic, socio-economic, cultural, and political risk factors in driving the emergence and maintenance of VHFs in African countries covered by tropical moist forests. Human-to-human transmission is mainly driven by socio-economic, political, and demographic factors, whereas zoonotic spillover is determined by almost all groups of factors, especially those of an anthropogenic nature.

CONCLUSIONS/SIGNIFICANCE: Many questions remain unanswered regarding the epidemiology of VHFs in tropical forests. By elucidating spatially relevant determinants which have already been studied, this review seeks to advance VHFs hotspot predictions, risk mapping for disease surveillance and control systems improvement.