A systematic review and meta-analysis of population-based anthrax prevalence in Africa with a one health narrative synthesis of outbreak surveillance

Background: Anthrax remains a persistent public health, veterinary, and ecological challenge in Africa, sustained by fragmented surveillance systems characterized by underreporting, limited diagnostic capacity, and weak cross-sectoral coordination. The absence of integrated surveillance across human, livestock, wildlife, and environmental interfaces constrains accurate burden estimation and timely outbreak response. Methods: statistics. Studies not meeting meta-analytic criteria were synthesized narratively within a One Health framework. Results: , though such studies remain comparatively scarce. Conclusion: The available evidence on anthrax in Africa is limited, geographically uneven, and highly heterogeneous. The pooled estimate should therefore be interpreted as a summary measure of reported prevalence rather than a precise continental burden estimate. These findings underscore persistent transmission within fragmented surveillance systems and support strengthened One Health-based approaches integrating human, animal, wildlife, and environmental health sectors to improve surveillance, early detection, and coordinated response across Africa.