ABSTRACT

Objective

Sudden cardiac arrest (SCA) remains the leading cause of sport-related death worldwide, yet survival outcomes in Africa are critically poor. We conducted a formative assessment of the knowledge, attitudes and practices of professional football stakeholders in Cameroon as a model for identifying system-level gaps in SCA preparedness in low-resource sport settings.

Methods

We conducted a cross-sectional survey during the 2024/2025 season across five pre-competition medical centres in Cameroon. Eligible participants were players, referees, coaches and physiotherapists from Elite 1, Elite 2 and the Female Super League who had two or more seasons of professional experience. A validated questionnaire, adapted from international guidelines, was used to assess sociodemographic data, knowledge, attitudes and practices. Data were analysed descriptively with subgroup comparisons using SPSS V.20.

Results

A total of 745 participants were enrolled: 536 players, 90 referees, 84 coaches and 35 physiotherapists. Most (66.4%) demonstrated poor knowledge of SCA, only 12% reported confidence in cardiopulmonary resuscitation (CPR) or automated external defibrillator (AED) use and referees showed the lowest preparedness scores despite their critical first-responder role. While one-third expressed positive attitudes, self-reported barriers to providing CPR included fear of harm (66.3%) and legal concerns (78.3%). Only 33.4% reported good practices, with significant gaps in AED access, CPR training and emergency action plan awareness.

Conclusion

This assessment identified critical gaps in SCA preparedness in Cameroonian football, exposing gaps that likely extend across Africa and similar environments. Compulsory CPR/AED training, AED availability and enforceable emergency action plans are urgently needed to align African football with international best practice and strengthen the survival chain.