Anthrax outbreaks and epidemics in Zambia, 1990-2011: A review

Abstract

Anthrax is endemic in Zambia. A review was conducted for literature published on the epidemiology of anthrax in Zambia using google, google scholar and PubMed. A total of 7 publications were obtained using search words: anthrax, Zambia, epidemiology, outbreak and surveillance; and of these, 2 were full PubMed Central articles, 4 were abstracts without full articles and one was a citation. In Zambia in 1990, out of 220 human cases of anthrax, 19.1% died; between 1991 and 1998, 7.7% of 248 human cases died; between 1999 and 2007, out of 1790 human cases, 4.6% died; and in 2011, the case mortality rate was 1.2% out of 521 human cases. In Western province of Zambia, the overall cattle:human anthrax ratio was 1:1.47 and a reduction (Slope=0.738, 95% CI [-1.394, -0.083]) in the human case fatality rate was observed between 1999 and 2007. There is scanty information on anthrax in Zambia. The cattle:human anthrax infection ratio was lower than the expected ratio of 1:10 suggesting under-reporting of human cases or good outbreak/epidemic control. A reduction in the case fatality rate indicates good case management. An active surveillance of human cases of anthrax is recommended immediately there is an outbreak of bovine anthrax in order for people to start treatment early and avoid severe forms of anthrax.