Listeria monocytogenes at the food-human interface: A review of risk factors influencing transmission and consumer exposure in Africa

In African public health systems, Listeria monocytogenes is a pathogen of relatively low priority. Yet, the biggest listeriosis outbreak recorded to date occurred in Africa in 2018. This review highlights the factors that potentially impact L. monocytogenes transmission risks through African food value chains (FVCs). With the high rate of urbanisation, African FVCs have become spatially longer yet still informal. At the same time, dietary diversifications have resulted in increased consumption of processed ready-to-eat (RTE) meat, poultry, fishery and dairy products typically associated with a higher risk of L. monocytogenes consumer exposure. With frequent cold chain challenges, the potential of L. monocytogenes growth in contaminated RTE foods can further amplify consumer exposure risks. Moreover, the high prevalence of untreated HIV infections, endemic anaemia, high fertility rate and a gradually increasing proportion of elderly persons expands the fraction of listeriosis-susceptible groups among African populations. With already warmer tropical conditions, the projected climate change-induced increases in ambient temperatures are likely to exacerbate listeriosis risks in Africa. As precautionary approaches, African countries should implement systems for the detection and reporting of listeriosis cases and food safety regulations that provide L. monocytogenes standards and limits in high-risk RTE foods.