A time of decline: an eco-anthropological and ethnohistorical investigation of mpox in the Central African Republic

Résumé

The Central African Republic (CAR) has experienced repeated mpox outbreaks since 2001. Although several mpox epidemiological risk factors for zoonotic and interhuman transmission have been documented, the reasons for more frequent epidemic outbreaks are less well understood, relying on vague explanatory categories, including deforestation, hunting, and civil unrest. To gain insight into increasingly frequent outbreaks, we undertook a mixed methods ethnohistorical, eco-anthropological analysis in two CAR regions: the Lobaye, experiencing one or more annual outbreaks in the past decade, and the Sangha-Mbaere, with a longer-term history but less frequent outbreaks. We comparatively examined changing political economies, forest use practices, and understandings of mpox. In 2022, we conducted 40 qualitative ethnohistorical, anthropological interviews in Sango and French and conducted participant-observation of forest activities. For comparative purposes, we also drew on intensive field research conducted in one of these sites, consisting of participant-observation and a database of historical data on hunting, trapping, and meat consumption collected over 6 months in 1993. We find increased rodent capture and consumption in both sites in the past 30 years, and expanded practices of other potentially risky activities. We also find important differences in risky practices between the Lobaye and Sangha-Mbaere participants. Significantly, Lobaye and Sangha participants underscored historical processes of decline producing mpox among other emergences but they framed these declension processes diversely as economic, political, nutritional, and moral. Our findings are important because they mobilize new types of evidence to shed light on the processual dynamics of mpox outbreaks in the CAR. This study also reveals variability across two sites within the same country, highlighting the importance of comparative, fine-grained anthropological and historical research to identify underlying dynamics of mpox outbreaks. Finally, our study points to the need for mpox interventions and risk communication accounting for these regional differences, even within a single country.

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