Résumé
Infectious diseases are an increasing threat to food security, small‐scale livelihoods and the sustainability of aquaculture in low‐ and middle‐income countries (LMICs). In sub‐Saharan Africa, aquaculture is expanding rapidly but production systems often remain fragile. In West Africa, particularly in Benin, Côte d'Ivoire and Senegal, production remains modest despite rising demand. Interactions between farming practices, environmental exposures (e.g., contaminants and agricultural effluents) and pathogen emergence are poorly documented. Here we review evidence on production systems, reported pathogens, diagnostic and surveillance capacity in these three countries. We find that (i) production relies mainly on small‐scale ponds, cages often within integrated agro‐aquaculture systems with recurring constraints in biosecurity, water management and governance; (ii) available evidence is fragmented and uneven across pathogen groups, with most reports focusing on bacterial and parasitic conditions and major gaps for viruses, fungi, co‐infections, antimicrobial resistance and combined environmental pressures; and (iii) health management and laboratory capacities remain constrained, but existing networks and experience from terrestrial animal health provide entry points for integrated and participatory surveillance. We discuss these patterns through an exposome‐informed One Health lens, highlighting how multiple exposure pathways link farms, watersheds and nearby communities. Based on this synthesis, we outline research and policy priorities to strengthen health resilience and to support more sustainable small‐scale freshwater aquaculture in West Africa and, with relevance to other tropical LMIC settings.