Document analysis in Marburg virus outbreak response reports in Africa (2021–2025) to guide future manual updates

Abstract

Marburg virus disease (MVD) represents a re-emerging public health threat in Africa, with five documented outbreaks across four countries between 2021 and 2025 resulting in 89 cases and 34 deaths. This comparative review examined outbreaks in Guinea (2021, 1 case, CFR 100%), Ghana (2022, 3 cases, CFR 67%), Tanzania (2023 and 2025; 9 and 10 cases, CFR 67% and 100% respectively), and Rwanda (2024, 66 cases, CFR 23%), using WHO Situational Reports, After Action Reviews, and peer-reviewed literature. Analysis across six thematic domains; coordination, surveillance, case management and infection prevention and control (IPC), laboratory diagnostics, risk communication, and logistics/financing revealed progressive strengthening of national response capacities. Coordination evolved from externally led approaches in early outbreaks to structured, government-led multisectoral systems in Rwanda and Tanzania. Surveillance advanced from external laboratory dependence to digital tools and integrated systems, though early case detection and quarantine adherence remain critical gaps. Case management and IPC improved through integration with water, sanitation, and hygiene measures; however, community mistrust and stigma continued to undermine response effectiveness. Risk communication advanced with rumor tracking and targeted campaigns, though inconsistent community involvement limited impact. Financing shifted from donor dependency toward emerging domestic mechanisms and operational tracking. A critical cross-cutting lesson emerged regarding knowledge-sharing platforms. One Health Communities of Practice (OHCoPs) were identified as mechanisms to institutionalize learning, strengthen multisectoral collaboration, and translate recommendations into practice. While African MVD responses increasingly align with WHO guidance, significant gaps persist in early detection, sustained community engagement, and sustainable financing. Institutionalizing OHCoPs and updating global guidance with recent outbreak lessons will strengthen resilience against future MVD and zoonotic threats. © 2025 Korean Society of Global Health.