| The increasing conflict in many regions of the world often require deployment of peace-keeping forces to regions with potential for both Chemical, Biological, Radiological, Nuclear and High Explosive (CBRNE) terrorism risks. While much is known about regions with potential risks for Chemical, Nuclear and High Explosive terrorism, there is paucity of data documenting exposure of peace-keeping personnel to accidental, deliberate and/or covert use of endemic Sub-Saharan Africa biological warfare agents as weapons of mass destruction in their area of operations. Knowing potential biological warfare agents in areas with conflict such as Sub-Saharan Africa is critical for preparing peace-keeping forces for rapid deployment.;This study analyzed and evaluated endemic Sub-Saharan Africa biological agents with potential for overt and/or covert use for bioterrorism. The study also described the impact of these biological agents on peace-keeping forces that are deployed to Sub-Saharan Africa. In addition, this study evaluated and determined the deficiencies in the peace-keepers' pre- and post-deployment preparedness.;Approximately 11,000 published peer-reviewed studies from 1900 through 2007 identified using PubMed, Medline, EMBASE, CAB Health and CINAH, including text books and non-indexed manuscripts were systematically reviewed and utilized to ascertain biological agents with potential for weaponization and bioterrorism in Sub-Saharan Africa region. Several prominent Sub-Saharan Africa endemic biological agents were found to have bioterrorism potentials. The endemic biological warfare agents that are most likely to be used by terrorists included Bacillus anthracis, Francisella tularensis, Yersinia pestis, Vibrio cholerae, Salmonella typhi, Dengue fever virus, Nairovirus (Crimean-Congo hemorrhagic fever virus), Ricins, Burkholderia mallei, Staphylococcal enterotoxin B, Arenavirus (Lassa fever virus), and Clostridium botulinum toxin. Other endemic biological agents and least likely to be used by terrorists are Brucella abortus, Brucella melitensis, Yellow fever virus, Variola major virus, Monkeypox virus, Phlebovirus (Rift valley fever virus), Alphavirus (Chikungunya virus), Filovirus (Ebola and/or Marburg viral hemorrhagic fever virus), Coxiella burnetii, and Rickettsia prowazekii.;Conclusively, many of the Sub-Saharan endemic biological warfare agents are not currently in the terrorist's arsenal because of the complexity of production and dissemination. However, given the current wave of global technology transfer their production and utilization by terrorists or terrorist groups is eminent. Hence it is critical to incorporate knowledge of endemic biological warfare agents in the training of peace-keeping troops prior deployment and reemphasized when deployed to Sub-Saharan Africa. There is also the need to sufficiently train and prepare peace-keeping forces personnel that are deployed to other regions of the world with similar political, economic, and religious issues as seen in Sub-Saharan Africa. |
