Human outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) are more common in Middle Eastern and Asian human populations, associated with clades A and B. In Africa, where clade C is dominant in camels, human cases are minimal. We reviewed 16 studies (n = 6198) published across seven African countries between 2012 and 2024 to assess human MERS-CoV cases. We also analyzed data from four cohort studies conducted in camel-keeping communities between 2018 and 2024 involving camel keepers, camel slaughterhouse workers, and hospital patients with acute respiratory illness (ARI). The analysis showed a pooled MERS-CoV prevalence of 2.4% (IQR: 0.6, 11.4) from 16 publications and 1.14% from 4 cohort studies (n = 2353). Symptomatic cases were rarely reported, with most individuals reporting camel contact, and only 12% had travel history to the Middle East. There was one travel-associated reported death, resulting in a mortality rate of 0.013%. The findings suggest a low camel-to-human transmission of clade C MERS-CoV in Africa. Ongoing research focuses on genomic comparisons between clade C and the more virulent clades A and B, alongside the surveillance of viral evolution. This study highlights the need for continuous monitoring but indicates that MERS-CoV clade C currently poses a minimal public health threat in Africa.

Human outbreaks of Middle east respiratory syndrome coronavirus (MERS-CoV) are more common in middle Eastern and Asian human populations, associated with clades A and B. In Africa, where clade C is dominant in camels, human cases are minimal. We reviewed 16 studies (n= 6198) published across seven African countries between 2012-2024 to assess human MERS-CoV cases. We also analyzed data from four cohort studies conducted in camel-keeping communities between 2018- 2024 involving camel keepers, camel slaughterhouse workers, and hospital patients with acute respiratory illness (ARI). The analysis showed a pooled MERS-CoV prevalence of 2.4% (IQR: 0.6,11.4) from 16 publications, and 1.14% from four cohort studies (n=2353). Symptomatic cases were rarely reported, with most individuals reporting camel contact, and only 12% had travel history to the middle East. There was one travel associated reported death, resulting in a mortality rate of 0.013%. The findings suggest low camel – to – human transmission of clade C MERS-CoV in Africa. Ongoing research focuses on genomic comparisons between clade C and the more virulent clades A and B, alongside surveillance of viral evolution. This study highlights the need for continuous monitoring but indicates that MERS-CoV clade C currently poses a minimum public health threat in Africa.

: Middle East respiratory syndrome coronavirus (MERS-CoV) remains a global health threat, with frequent hospital outbreaks in the Middle East and Asia. Transmission occurs through contact with dromedary camels, and spillover risk in Northern Kenya is significant due to high camel exposure and growing human mobility. We assessed knowledge, attitudes, practices, and risk perception (KAP-RP) regarding MERS-CoV and other coronaviruses among health care workers (HCWs) in Isiolo and Marsabit counties. A cross-sectional survey was conducted between December 2023 and January 2024. Using two-stage stratified random sampling, HCWs from public health facilities were recruited, covering clinical and nonclinical cadres. Data were collected using a structured, pretested questionnaire on KAP-RP. Scores were classified as sufficient or insufficient. Analyses included descriptive statistics, logistic regression, and Pearson correlations. Of 847 HCWs enrolled (36.4% Isiolo, 63.6% Marsabit), the majority were age 25–34 years, with a male:female ratio of 1.3:1. Clinical cadres made up 56.2%, and 77% worked in rural facilities. Only 28.1% demonstrated sufficient knowledge, 74.7% showed favorable attitudes, 25.1% adhered adequately to preventive practices, and 26.7% had high risk perception. PPE use was reported by 85.5%, but only 49.2% wore it consistently, and 33.3% changed it as required. Knowledge was higher among males, older HCWs, and Isiolo residents. Correlation analysis showed a weak positive association between knowledge and practice, a negative association with attitude, and minimal links with risk perception. Substantial knowledge gaps, inconsistent practices, and low risk perception persist, highlighting the need for context-specific, behavior-focused training to strengthen preparedness in zoonotic hot spots.