Breaking the under-reporting cycle for zoonotic diseases in low-income and middle-income countries through national-level integration of community-based surveillance and response: insights from Cameroon, Chad, Côte d’Ivoire, and Mali - 18/09/25

Doi : 10.1016/S1473-3099(25)00421-9

Katherine E L Worsley-Tonks, PhD ^a,⁎ , Mahamat Fayiz Abakar, PhD ^b,^c, Zanan Coulibaly, DVM ^a,^d, Marie Paulette Deya-Yang, DVM ^e, Linda Esso, MD ^f,^g, Jean Marc Kameni Feussom, DVM ^e,^h, Vessaly Kallo, DVM ^d, Zakaria Keita, MD ⁱ, Monique Lechenne, PhD ^j,^k, Magloire Tchamba Kombou, DVM ^e, Inès Emah Manda, BS ^f, Christiane Mangou, MD ^l, Stephanie Mauti, PhD ^j,^k, Aime Gilert Mbonda Noula, PhD ^g,^m, Rodrigue Poueme Namegni, DVM ⁿ, Perrine Parize, MD ^a,^p, Mathurin Cyrille Tejiokem, PhD ⁿ, Isaac Tiembre, PhD ^l, Abdallah Traoré, ProfPhD ^o, Jakob Zinsstag, ProfPhD ^j,^k, Hervé Bourhy, ProfPhD ^a,^p
^a Institut Pasteur, Université Paris Cité, Lyssavirus Epidemiology and Neuropathology Unit, Paris, France
^b Institut de Recherche en Elevage pour le Développement, N’Djaména, Chad
^c Institut national de santé publique du Tchad, N’Djaména, Chad
^d Direction des Services Vétérinaires et du Bien-Être Animal, Abidjan, Côte d’Ivoire
^e Cameroon Epidemiological Network for Animal Diseases, Ministry of Livestock, Fisheries and Animal Industries, Yaoundé, Cameroon
^f Minstère de la Santé Publique, Yaoundé, Cameroun
^g University of Yaounde I, Yaoundé, Cameroon
^h Epidemiology-Public Health-Veterinary Association, Yaoundé, Cameroon
ⁱ Université des Sciences des Techniques et des Technologies de Bamako, Centre Universitaire de Recherche Clinique, Bamako, Mali
^j Swiss Tropical and Public Health Institute, Allschwil, Switzerland
^k University of Basel, Basel, Switzerland
^l Institut National d’Hygiène Publique, Abidjan, Côte d’Ivoire
^m International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
ⁿ Epidemiology and Public Health Service, Centre Pasteur du Cameroun, Yaoundé, Cameroon
^o Laboratoire Central Vétérinaire, Bamako, Mali
^p National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, Paris, France

^*Correspondence to: Dr Katherine E L Worsley-Tonks, Institut Pasteur, Université Paris Cité, Lyssavirus Epidemiology and Neuropathology Unit, 75015 Paris, FranceInstitut PasteurUniversité Paris CitéLyssavirus Epidemiology and Neuropathology UnitParis75015France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 18 September 2025

Summary

Zoonotic diseases remain a major threat to both human and animal populations, especially in low-income and middle-income countries. A key challenge in managing these diseases is insufficient coordination between human and animal health sectors and the communities they serve, which often results in delayed outbreak detection and minimal disease control. Community health workers and community animal health workers can help fill this gap by identifying suspected cases early and facilitating communication between communities and health services. However, challenges, such as a scarcity of resources, political and social barriers, and quantitative evaluation of performance and impact, have hindered the broader deployment of community health workers and community animal health workers. In this Personal View, we highlight the need to better integrate community health workers and community animal health workers into health systems for zoonotic disease surveillance and response and illustrate how this can be achieved with examples from Cameroon, Chad, Côte d’Ivoire, and Mali. The framework we put forward provides a step-by-step approach on how to effectively integrate community-based zoonotic disease surveillance, response, and awareness, both at scale and in a sustainable manner. Ultimately, this practical framework offers a path to more resilient and responsive public and animal health infrastructures in the regions most affected by zoonotic diseases.

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