DOI: 10.12688/f1000research.185526.1 ISSN: 2046-1402

Cross-Border Ebola Virus Disease Preparedness in Uganda and the Democratic Republic of the Congo: A Systematic Review of Health Security Capacities, Gaps, and Priorities

Chinyere Nkemjika Anyanwu, Rachelle Soki Marasi, Regina Idu Ejemot-Nwadiaro, Bunu Umi Omar, Theoneste Hakizimana, Nwanganga Ihuoma Ubosi, Zeinab Adam Abakar Mohamed, Chima Paul Okechukwu Ugwu, Emeka Anyanwu
Show PDF Cite
Background Recurrent Ebola virus disease (EVD) outbreaks in the Democratic Republic of the Congo (DRC) continue to pose substantial cross-border health security risks to neighbouring countries, particularly Uganda. Although numerous preparedness initiatives have been implemented to prevent, detect, and respond to cross-border Ebola transmission, evidence on their effectiveness, strengths, and persistent gaps remains fragmented across peer-reviewed and grey-literature sources. This review synthesized available evidence on cross-border Ebola preparedness in Uganda and the DRC and identified key capacities, challenges, and priorities for strengthening regional health security. Methods A systematic review was conducted in accordance with PRISMA 2020 and reported using the Synthesis Without Meta-analysis (SWiM) framework. PubMed, Scopus, Web of Science, African Journals Online (AJOL), and major grey-literature sources were searched from January 2000 to 18 May 2026. Findings were synthesized across nine predefined preparedness domains. Results Seventy-one evidence sources were included, comprising 32 primary studies and 39 grey-literature documents. Evidence was most concentrated in border surveillance and point-of-entry preparedness (24 sources), contact tracing and rapid response (22 sources), cross-border mobility and importation risk (18 sources), infection prevention and control (17 sources), and regional governance and coordination (17 sources). Preparedness activities included mobility mapping, traveller screening, healthcare-worker training, laboratory strengthening, risk communication, and cross-border coordination mechanisms. The synthesis identified substantial preparedness capacity across surveillance systems, laboratory readiness, healthcare-facility preparedness, and regional collaboration. However, important gaps persisted in some major preparedness domains. Conclusions Cross-border Ebola preparedness in Uganda and the DRC has expanded considerably over the past two decades through investments in surveillance systems, laboratory networks, healthcare-worker preparedness, and regional coordination. Nonetheless, persistent vulnerabilities remain in humanitarian settings, preparedness sustainability, and emerging preparedness domains. Strengthening integrated, sustainable, and cross-border health-security systems will be critical for mitigating future Ebola threats and enhancing epidemic preparedness across East Africa.

More from our Archive