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Epidemiological mapping and risk profiling build on the idea that diseases are tied to social-ecological systems that govern the distribution and abundance of transmissible pathogens, vectors and hosts. This is the heart of the emerging field of ecohealth, which examines how biological, cultural, demographic, economic, physical, political and social environments change and how these changes affect the health and wellbeing of humans, animals and ecosystems and the services they provide. This paper is an overview of a special issue of Acta Tropica , whose 15 publications reflect a geographically and epidemiologically diverse landscape of ecohealth. Nowhere is an ecohealth approach better suited than in Africa and its myriad of landscapes that include contexts varying from profuse expanses of tropical rain forests to the world’s greatest desert. The publication of African ecohealth-related projects displays a biological, cultural and social diversity in health system contexts and a wide variety of contributions pertaining to different, often neglected, tropical diseases, including brucellosis, Buruli ulcer, fascioliasis, malaria, Q fever, rabies, Rift Valley fever and schistosomiasis. Pursuing an ecohealth approach provides a platform that brings together community members, decision makers, scientists and other stakeholders with a view to understand how ecosystem changes affect health conditions. Taken together, the presentation of this variety of papers dealing with environmental variables associated with health inaugurates the vital concept of ecohealth. By emphasizing that all organisms are part of social-ecological systems, the long-term wellbeing of both people and animals depending on healthy and productive ecosystems is highlighted. [ABSTRACT FROM AUTHOR]

Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed. [ABSTRACT FROM AUTHOR]

Brucellosis is a major neglected zoonotic disease, whose burden both in animals and humans is severely under-reported. Diagnosis in humans identifies cases in order to treat the disease at the individual level. In animals diagnosis is implemented at the population level in the context of appropriate control or eradication strategies. Molecular and bacteriological diagnosis are rarely undertaken in sub-Saharan Africa, at least outside research projects, due to cost, skills and laboratory infrastructure issues. The brucellosis toolbox contains a wide range of serological tests, but the perfect test for use in animals and humans respectively does not exist. Drug and diagnostic discovery for the neglected zoonoses are notoriously poor, and there is limited investment interest in developing new tools for brucellosis diagnosis. But are current tools being used to their full capacity? The rose Bengal test (RBT) stands out as an efficient, practical and very cheap test adapted for use in the resource-poor context. In this paper, we argue that a social science or system’s approach to explore the practicality of improving diagnostic capacity at the point-of care in high-risk brucellosis areas of rural Africa may be a step towards solving the issue of under-diagnosis, but this must go hand-in-hand with implementation of control measures at source in the animal reservoir and capacity to treat human cases. [ABSTRACT FROM AUTHOR]

• Human lice include Pediculus humanus (body lice), Pediculus humanus capitis (head lice) that frequently affect children, and Pthirus pubis , commonly known as crab lice. • Body lice, mainly found among disadvantaged persons, are known to be vectors of serious human bacterial infectious diseases including epidemic typhus, recurrent fever, trench fever, and plague. • In Africa, human infections transmitted by lice remained poorly known and underestimated. Lice are host-specific insects. Human lice include Pediculus humanus (body lice) which are known to be vectors of serious human bacterial infectious diseases including epidemic typhus, relapsing fever, trench fever and plague; Pediculus humanus capitis (head lice) that frequently affect children; and Pthirus pubis , commonly known as crab lice. In Africa, human infections transmitted by lice remained poorly known and therefore, underestimated, perhaps due to the lack of diagnostic tools and professional knowledge. In this paper we review current knowledge of the microorganisms identified in human lice in the continent of Africa, in order to alert health professionals to the importance of recognizing the risk of lice-related diseases. [ABSTRACT FROM AUTHOR]

Rabies is a fatal but preventable disease that remains notoriously underreported. Weak data availability hampers advocacy, constitutes a barrier to resource allocation and inhibits effective prevention and control. To gain better insight into the global rabies burden and human vaccine demand several studies were funded through the Vaccine Alliance (GAVI) learning agenda. With the help of this funding, Swiss TPH and local in country partner organizations implemented a One Health research project in Chad, Côte d'Ivoire and Mali to collect data at household, public health facility and veterinary level. This paper describes the implementation of this research project and evaluates its success on amount of information gained, achieved capacity building, impact on knowledge creation and influence on national and international policies. The project was based on the One Health concept and guided by the principles of transboundary research partnerships formulated by the Swiss Academy of Sciences. Data was collected on bite incidents and health seeking from over 24'000 households, on access to treatment of over 8'800 bite cases registered in public health facilities and on the status of over 1'800 rabies suspect animals. Selected country specific datasets have contributed to more than 10 scientific articles so far. On the international level, the multi-level data collection provided a unique set of indicators to inform, along with results from other studies, new WHO rabies immunization recommendations and a vaccine investment case scenario to prevent human rabies. New rabies burden estimates based on the data gathered are published for Mali and will be modelled for the whole West and Central African region. On the national level, the project facilitated communication between animal health and human health workers catalyzing creation of local and national committees and formulation of national action plans for Mali and Côte D'Ivoire. Major challenges arose from lack of data collection and documentation experience of human health and veterinary workers and weak infrastructural capacities of the veterinary and human health systems of the project countries. Through adherence to the principles of transboundary research partnerships, project team members acquired valuable research and networking skills despite language barriers, enabling them to play key roles in the future agenda towards national, regional and global canine rabies elimination. Project external collaborations with local public institutions was facilitated through long-term local partnerships. Both factors enabled success in project implementation and outcomes by identifying and mitigating risks in advance, resolving challenges amiably and enabling mutual knowledge creation as a fructuous ground for sustained commitment. Lack of immediate follow-up funding did not allow to maintain activities beyond the project timeframe. However, the national and international policy changes triggered, as well as the strengthened local disease control and research capacities provides sustainable basis for the elimination of dog transmitted human rabies. [ABSTRACT FROM AUTHOR]

• Cordylobia anthropophaga is the major causative agent of myiasis in africa. • Myiasis affects travellers returning from endemic regions in africa. • Human myiasis is either underreported or mostly undiagnosed in africa. • Research on botanicals in the control of parasites is in its early stages. • Impact of human myiasis on the african economy is not properly documented. The article reviews literature on myiasis in Africa and cases that originated in Africa over the last two decades (1998–2018). The relevant literature was obtained by using several databases (Science-Direct, JSTOR, Google Scholar, Ebscohost and PubMed). We searched for the following words or their combination myiasis, maggots, fly species responsible for myiasis found in Africa, and the different types of myiasis. References in several articles provided links to other relevant works. Only papers written in English were reviewed. In total, we reviewed 51 articles which covered a total of 849 myiasis cases. The review encompasses geographical distribution of the disease, dipteran species responsible, predisposing factors, sex of the patient, type of myiasis and treatment. Myiasis is found in most parts of the African continent, however only 18 articles reported myiasis cases in Africa during the period under review. The rest of the articles report cases from the rest of the world but acquired by travellers when visiting Africa. Cordylobia anthropophaga (Blanchard) was responsible for 93.28% of all the reported cases in this review. The low number of articles on human myiasis reported in Africa may be due to underreporting by physicians or most cases are not diagnosed. Therefore, the actual prevalence of myiasis in Africa is currently unknown. Human myiasis: Factors that affect the disease and its distribution. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Abstract: Health research ethics has its roots in protecting individuals participating in clinical trials. There is, however, nascent interest in ethics in public health, although it does not yet cover ethics in the development of public health products. The paper reviews the history of the development of malaria vector interventions, which initially aimed at promoting colonial interests. Attempts at eradicating malaria in Africa ended in 1969, and DDT, the leading malaria vector control tool was banned soon after. Insecticide Treated Nets, which later gave rise to Long Lasting Insecticidal Nets have resurrected malaria mosquito vector control, and their development has set new benchmarks, which it is suggested should be followed by all vector control tools under development. Furthermore, DDT has been exonerated and is back in the vector control arsenal. New tools under development include the sterile male technique, genetically modified mosquitoes, entomopathogenic fungi, and odorants.The paper proposes that these new tools be tested in community settings, abiding by all the leading bioethical principles, and calls for the development and implementation of international ethical guidelines for trials in public health. [Copyright &y& Elsevier]

Abstract: Although Africa''s health research capacity is still weak, African R&D institutions are contributing immensely to the development of health policies, guidelines and products essential for diagnosis, treatment, prevention and control of Africa''s leading health problems. In order to increase Africa''s contributions, all health research stakeholders should participate in setting health research priorities and agenda, followed by establishing health research networks and consortia, holistic capacity strengthening, and gathering of baseline data. The evaluation of candidate tools, and the research preceding it, must abide by international scientific and ethical standards, and must involve institutional and national regulatory authorities. The funding of product development and product availability in Africa benefits from national governments, bilateral, multilateral, and philanthropic agencies. When a trial is over poses many social and ethical issues, and not infrequently existing guidelines may not be adequate. Mechanisms for making products available in resource constrained countries are presented, as are problems relating to manufacturing, markets and procurement. So are obligations to trial and research communities. The paper concludes by outlining the obligations of each stakeholder, in order to make research products readily available in resource constrained settings. [Copyright &y& Elsevier]

Abstract: With research projects that use animals on the increase worldwide and in Africa in particular, animal research ethics should continue to be reviewed to improve the welfare of animals used in research. The welfare of animals used in research has gained attention globally that has led to the development of guidelines and in some instances national laws governing animal experimentation. Although there may not be empirical data on the existence or adequacy of national and/or institutional policies and guidelines on the use of animals in research in Africa, most African countries are not yet at the same level as developed countries. Consequently, some researchers based at institutions in developed countries may be tempted to ‘export’ their research activities to collaborating African institutions where ethical and legal frameworks on use of animals may be less stringent than in the developed countries. An appreciation of the intrinsic value of animals should be enough driving force for human beings to strive to promote humane treatment of animals. This paper gives an overview of uses and potential abuses of animals in research for the benefit of stakeholders such as researchers, research institutions, Ethics Review Committees (ERCs) and policy makers and ends with suggestions on possible ways of ensuring humane treatment of animals used in research in Africa in particular and globally in general. [Copyright &y& Elsevier]