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

The Central African Republic (CAR) has experienced repeated mpox  outbreaks since 2001. Although several mpox epidemiological risk factors  for zoonotic and interhuman transmis- sion 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 an ethno- historical, eco-anthropological  analysis in two CAR regions: the Lobaye prefecture, experiencing one or  more annual outbreaks in the past decade, and the Sangha-Mbaere  prefecture, with a longer history of mpox 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 and participant-observation of forest activities in two  languages (Sango and French). 

We compared contemporary practices with  hunting, trapping, and meet consumption practices, documented through  quantitative and qualitative observation in one research site, 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. Simultaneously, we also identify important differences  in risky practices between our Lobaye and Sangha-Mbaere participants.  

In addition, 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.