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Mpox in the Democratic Republic of Congo: Analysis of National Epidemiological and Laboratory Surveillance Data, 2010 - 2023
Government of the United States of America - Division of High Consequence Pathogens and Pathology; Government of the United States of America - Centers for Disease Control and Prevention (CDC)
Background: The Democratic Republic of the Congo (DRC) has the highest global burden of mpox. The incidence has risen, but recent analyses of epidemiological trends are lacking.
Methods: We analysed national epidemiological and laboratory surveillance data from 2010 to 2023. We calculated incidence based on suspected cases, case fatality ratios (CFR), and percentage of laboratory-confirmed cases. We assessed geospatial, demographic, and seasonal trends.
Findings: Between 2010 and 2023, the DRC reported 60,967 suspected mpox cases and 1,798 suspected deaths (CFR 2·9%). The number of reporting provinces increased from 18/26 in 2010 to 24/26 in 2023. The annual incidence increased from 2·96 per 100,000 in 2010 to 11·5 per 100,000 in 2023. The highest incidence (46·5 per 100,000) and CFR (5·9%) were observed in children under 5. Incidence was higher in rural compared to urban areas. No clear seasonal pattern was observed. PCR testing was performed for 7,438 suspected cases (12·2%), yielding 4,248/7,438 (57·1%) confirmed cases. Median age of confirmed cases (13 years) remained stable, though the 95th percentile increased over time.
Interpretation: The incidence and geographical distribution of suspected mpox cases increased substantially since 2010. Improvements in surveillance and decentralised testing are essential to monitor mpox trends and direct interventions effectively, to address the public health emergency declarations issued in August 2024.
Funding: Belgian Directorate-General Development Cooperation and Humanitarian Aid; Research Foundation – Flanders; European Civil Protection and Humanitarian Aid Operations; Department of Economy, Science, and Innovation of the Flemish government; Canadian Institutes of Health Research; and International Development Research Centre.
Declaration of Interest: LL has consulted for BioNtech and received research funding from Sanofi, both not relevant for this work. All other authors declare no conflict of interest.
Ethical Approval: This study was approved by the National Ethical Committee of the DRC (472/CNES/MMS/2023) and the Institute of Tropical Medicine Antwerp Institutional Review Board (1699/23).
Bangwen, Eugene and Diavita, Ruth and De Vos, Elise and Hasivirwe Vakaniaki, Emmanuel and Nundu, Sabin S. and Mutombo, Annie and Mulangu, Felix and Abedi, Aaron Aruna and Malembi, Emile and Kalonji, Thierry and Kacita, Cris and Kinganda-Lusamaki, Eddy and Wawina-Bokalanga, Tony and Brosius, Isabel and Van Dijck, Christophe and Bottieau, Emmanuel and Vercauteren, Koen and Amuri-Aziza, Adrienne and Makangara-Cigolo, Jean-Claude and Muyamuna, Elisabeth and Pukuta, Elisabeth and Nguete, Beatrice and Kaba, Didine and Kabamba, Joelle and Hughes, Christine and Tshiani Mbaya, Olivier and Rimoin, Anne W. and Hoff, Nicole A. and Kindrachuk, Jason and Peeters, Martine and Low, Nicola and McCollum, Andrea and Shongo, Robert and Mukadi, Daniel Bamuleka and Muyembe-Tamfum, Jean-Jacques and Ahuka-Mundeke, Steve and Liesenborghs, Laurens and Mbala, Placide, Mpox in the Democratic Republic of Congo: Analysis of National Epidemiological and Laboratory Surveillance Data, 2010 - 2023. Available at SSRN: https://ssrn.com/abstract=4954317 or http://dx.doi.org/10.2139/ssrn.4954317
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