Monkeypox Outbreak in the Democratic Republic of Congo: A Comprehensive Review of Clinical Outcomes, Public Health Implications, and Security Measures.
The Monkeypox virus (MPXV), a member of the Orthopoxvirus genus, is responsible for the zoonotic disease known as MPX. Primarily found in western and central Africa, emerging studies indicate a shift in transmission dynamics. Ongoing MPX outbreaks in the Democratic Republic of Congo (DRC) have escalated into significant public health concerns.
This review endeavors to provide a comprehensive analysis of the public health implications, clinical consequences, and preventive measures related to the current MPX outbreak in the DRC. It focuses on the epidemiology, clinical manifestations, and public health responses to this global health challenge.
The research synthesizes data regarding MPX outbreaks in the DRC, drawing from academic journals, public health reports, and case studies through a narrative review approach.
The recent outbreak in the DRC has identified approximately 12,569 suspected MPX cases, resulting in 581 fatalities, which corresponds to a case fatality rate (CFR) of 4.6%. These cases have been documented across 156 health sectors in 22 out of 26 provinces, representing the highest case count recorded to date. The epidemic has also encroached upon previously unaffected regions. Hospitalization rates have varied between 4% and 10%, with a significant percentage of cases attributed to sexual transmission. Analysis of demographic and geographic data revealed distinct patterns in viral spread. Clinical outcomes have varied, with an average CFR close to 10%, influenced by factors such as timely diagnosis and access to healthcare services. Rural areas have accounted for over 70% of the cases, highlighting the necessity for targeted public health interventions. Control measures have focused on community awareness campaigns and immunization programs, reaching approximately 50% of the at-risk population; however, challenges related to resource limitations and political instability have impeded effective response strategies.
The ongoing MPX outbreak in the DRC poses a substantial public health challenge. While progress has been made in managing the epidemic, it remains imperative to address resource deficiencies and enhance public health systems. Strengthening international collaboration, expanding healthcare access, and improving surveillance capabilities are critical to mitigating the risk of future outbreaks.
Salomon I
，Hamitoglu AE
，Hertier U
，Belise MA
，Sandrine U
，Darius B
，Abdoulkarim MY
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《Immunity Inflammation and Disease》
Environmental, socioeconomic, and sociocultural drivers of monkeypox transmission in the Democratic Republic of the Congo: a One Health perspective.
Monkeypox (mpox) is an emerging zoonotic disease that has persistently impacted public health in endemic regions of West and Central Africa for over half a century. The Democratic Republic of the Congo (DRC) remains one of the countries most affected. Understanding the risk factors for disease transmission from a One Health perspective is of great importance in the risk assessment, prevention, and control of zoonotic diseases. Therefore, this study aimed to investigate the risk factors for human mpox transmission at the human-animal-environment interface in the DRC.
Epidemiological, environmental, socioeconomic, and sociocultural data from the DRC from 2000 to 2015 were obtained from publicly available dataset. Using these data, we applied negative binomial regression model, least absolute shrinkage and selection operator regression model, and principal component analysis (PCA) to identify key environmental, socioeconomic, and sociocultural factors contributing to mpox transmission. Moreover, a grey prediction model GM (1, n) was constructed to predict the epidemic trend of mpox post-2015 and validated using suspected mpox case data in the DRC from 2016 to 2021, sourced from the United States Centers for Disease Control and Prevention.
Between 2000 and 2021, a total of 43,628 suspected mpox cases were reported in the DRC, with a peak of 6216 cases in 2020. From 2016 to 2021, suspected cases accounted for over half (24,379/43,628, 55.9%) of the total reported during the 2000-2021 period. The proportion of primary forest [incidence rate ratio (IRR): 1.023, 95% confidence interval (CI): 1.018-1.027], index of economic well-being (IRR: 1.046, 95% CI: 1.039-1.052), and mean annual precipitation (IRR 1.040, 95% CI: 1.031-1.049) were positively associated with mpox incidence. PCA identified five principal components, explaining 69% of the variance in the environmental, socioeconomic, and sociocultural variables. The first component was characterized by socioeconomic factors. The GM (1, n) model, based on the proportion of primary forest, index of economic well-being, and mean annual precipitation, predicted the epidemic trend (revealed relative error: 2.69).
Both socioeconomic and environmental factors play important roles in mpox transmission. Our study further highlighted the importance of considering the interconnectedness among humans, animals, and the environment, and treating these factors as a whole to explain the transmission and emergence of mpox outbreaks in the DRC according to the One Health concept.
Lu G
，Chong Z
，Xu E
，Na C
，Liu K
，Chai L
，Xia P
，Yang K
，Zhu G
，Zhao J
，Müller O
... -
《-》
Evolving Epidemiology of Mpox in Africa in 2024.
For decades after the identification of mpox in humans in the Democratic Republic of Congo (DRC) in 1970, the disease was largely confined to the rural areas of Central and West Africa and thus did not garner broad attention. On August 13, 2024, mpox was declared a Public Health Emergency of Continental Security (PHECS) by the Africa Centers for Disease Control and Prevention (Africa CDC), a notice that was followed the next day by a declaration of a Public Health Emergency of International Concern (PHEIC) by the World Health Organization.
In this study we analyzed all mpox cases and deaths, based on clinical or laboratory diagnosis, that were reported to the Africa CDC from January 1, 2022, to October 30, 2024, to identify temporal variations, geographic distributions, and epidemiologic trends.
From January 1, 2022, to August 18, 2024, a total of 45,652 mpox cases were clinically diagnosed and laboratory-confirmed in 12 African countries. These cases resulted in 1492 deaths (case fatality rate, 3.3%). From 2022 to 2024, weekly laboratory-confirmed mpox cases increased by a factor of 2.8 (from 176 to 489 cases), whereas all weekly reported cases (including those with a clinical diagnosis) increased by a factor of 4.3 (from 669 to 2900 cases). The DRC, which had reported approximately 88% of mpox cases in Africa in 2024, had 19,513 cases before the emergency declaration, with a case fatality rate of 3.1% - a weekly average of 591 cases as compared with 281 in 2023. In 2024, six African countries reported their first imported mpox infections, with Burundi also reporting local transmission.
The high mpox disease burden in Africa, especially in the DRC - with a rising number of cases, high case fatality rate, and high degree of spread to other previously mpox-free African countries - is cause for increased international concern. Case detection, contact tracing, public health measures, and affordable vaccines are needed to implement interventions in the DRC to reduce the risk of global spread of the virus.
Ndembi N
，Folayan MO
，Komakech A
，Mercy K
，Tessema S
，Mbala-Kingebeni P
，Ngandu C
，Ngongo N
，Kaseya J
，Abdool Karim SS
... -
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