{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:09:06Z","timestamp":1790845746130,"version":"4.1.0"},"reference-count":26,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Resources to respond to emerging and re-emerging infectious disease emergencies are limited.\nAim:\u00a0To support preparedness planning and resource allocation, a prioritisation methodology was applied to rank epidemic-prone diseases in Eastern Africa.\nSetting:\u00a0The study took place in the eastern region of Africa representing 14 member states.\nMethods:\u00a0A multi-criteria decision analysis (MCDA) combined with a modified Delphi approach, adapted from the Africa Centres for Disease Control and Prevention (CDC\u2019s) continental prioritisation framework was employed. A planning team of epidemiologists and infectious disease experts designed the exercise, implemented through a three-day workshop in Comoros from 9 May 2023 to 11 May 2023. The workshop convened 43 experts from Eastern Africa member states and partner organisations to rank diseases. Participants assessed each disease against 19 predefined criteria, grouped into four overarching domains: risk trajectory, epidemic potential, disease severity, and preparedness and medical countermeasures. Overall risk was calculated as the product of risk trajectory, epidemic potential, and disease severity.\nResults:\u00a0Twenty-eight experts (88%, 28 of the eligible participants,\u00a0n\u00a0= 32) prioritised 22 potential epidemic-prone diseases. The top 10 were Ebola virus disease (risk = 12.7), Marburg virus disease (11.8), cholera (11.1), coronavirus disease 2019 (COVID-19) (9.9), influenza (8.9), measles (8.6), yellow fever (8.5), Crimean-Congo haemorrhagic fever (8.2), malaria (8.0) and Rift Valley fever (7.9). The unknown disease, defined as one caused by a hypothetical novel pathogen (often referred to as \u2018Disease X\u2019), Crimean-Congo haemorrhagic fever, Rift Valley fever and mpox received the lowest preparedness rating.\nConclusion:\u00a0Ebola virus disease (EVD), Marburg virus disease (MVD) and cholera ranked highest in risk, while unknown disease and zoonoses showed the lowest preparedness.\nContribution:\u00a0Amid current funding constraints, these findings provide evidence to guide Africa CDC and partners in strengthening emergency preparedness and response in Eastern Africa, highlighting priority diseases while underscoring the need for further analysis of capacity gaps.<\/jats:p>","DOI":"10.4102\/jphia.v17i1.1496","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T12:52:34Z","timestamp":1771937554000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prioritisation and risk ranking of epidemic-prone diseases for emergency preparedness and response in Eastern Africa using a multi-criteria decision analysis framework, 2023"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9363-1247","authenticated-orcid":false,"given":"Neema","family":"Kamara","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5079-2873","authenticated-orcid":false,"given":"Motuma","family":"Guyassa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3966-2736","authenticated-orcid":false,"given":"Georgios","family":"Theocharopoulos","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00s9v1h75","id-type":"ROR","asserted-by":"publisher"}],"name":"European Centre for Disease Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6816-9147","authenticated-orcid":false,"given":"Anouar S.","family":"Mohamed","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9756-7036","authenticated-orcid":false,"given":"Halifa M.","family":"Said","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047h8wb98","id-type":"ROR","asserted-by":"publisher"}],"name":"Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8594-6054","authenticated-orcid":false,"given":"Despina","family":"Pampaka","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00s9v1h75","id-type":"ROR","asserted-by":"publisher"}],"name":"European Centre for Disease Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4689-4583","authenticated-orcid":false,"given":"Jonathan","family":"Suk","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00s9v1h75","id-type":"ROR","asserted-by":"publisher"}],"name":"European Centre for Disease Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9381-527X","authenticated-orcid":false,"given":"Lul P.","family":"Riek","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/047h8wb98","id-type":"ROR","asserted-by":"publisher"}],"name":"Centers for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-8795","authenticated-orcid":false,"given":"Merawi","family":"Aragaw","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Impouma B, Roelens M, Williams GS, et al. 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