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Mpox in the Democratic Republic of Congo: Analysis of National Epidemiological and Laboratory Surveillance Data, 2010 - 2023

30 Pages Posted: 19 Sep 2024

See all articles by Eugene Bangwen

Eugene Bangwen

Institut National de Recherche Biomédicale

Ruth Diavita

Institut National de Recherche Biomédicale

Elise De Vos

Institut National de Recherche Biomédicale

Emmanuel Hasivirwe Vakaniaki

Institut National de Recherche Biomédicale

Sabin S. Nundu

Institut National de Recherche Biomédicale

Annie Mutombo

Democratic Republic of Congo - Ministry of Health

Felix Mulangu

Democratic Republic of Congo - Ministry of Health

Aaron Aruna Abedi

Democratic Republic of Congo - Ministry of Health

Emile Malembi

Democratic Republic of Congo - Ministry of Health

Thierry Kalonji

Democratic Republic of Congo - Ministry of Health

Cris Kacita

Democratic Republic of Congo - Ministry of Health

Eddy Kinganda-Lusamaki

Institut National de Recherche Biomédicale

Tony Wawina-Bokalanga

Institut National de Recherche Biomédicale

Isabel Brosius

University of Antwerp - Department of Clinical Sciences

Christophe Van Dijck

University of Antwerp - Department of Clinical Sciences

Emmanuel Bottieau

University of Antwerp - Department of Clinical Sciences

Koen Vercauteren

University of Antwerp - Department of Clinical Sciences

Adrienne Amuri-Aziza

Institut National de Recherche Biomédicale

Jean-Claude Makangara-Cigolo

Institut National de Recherche Biomédicale

Elisabeth Muyamuna

Institut National de Recherche Biomédicale

Elisabeth Pukuta

Institut National de Recherche Biomédicale

Beatrice Nguete

Kinshasa School of Public Health

Didine Kaba

Kinshasa School of Public Health

Joelle Kabamba

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Christine Hughes

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Olivier Tshiani Mbaya

Government of the United States of America - Centers for Disease Control and Prevention (CDC)

Anne W. Rimoin

University of California, Los Angeles (UCLA) - Department of Epidemiology

Nicole A. Hoff

University of California, Los Angeles (UCLA) - Department of Epidemiology

Jason Kindrachuk

University of Manitoba - Department of Infectious Diseases and Medical Microbiology

Martine Peeters

University of Montpellier

Nicola Low

University of Bern - Institute of Social and Preventive Medicine

Andrea McCollum

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)

Robert Shongo

Democratic Republic of Congo - Ministry of Health

Daniel Bamuleka Mukadi

Institut National de Recherche Biomédicale

Jean-Jacques Muyembe-Tamfum

Institut National de Recherche Biomédicale

Steve Ahuka-Mundeke

National Multisectoral Committee for Ebola Response; Institut National de Recherche Biomédicale

Laurens Liesenborghs

KU Leuven - Rega Institute for Medical Research

Placide Mbala

Institut National de Recherche Biomédicale

More...

Abstract

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).

Keywords: Mpox, Monkeypox virus, Incidence, Surveillance, Mpox Confirmatory Testing, DR Congo

Suggested Citation

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

Eugene Bangwen

Institut National de Recherche Biomédicale ( email )

Ruth Diavita

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Elise De Vos

Institut National de Recherche Biomédicale ( email )

Emmanuel Hasivirwe Vakaniaki

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Sabin S. Nundu

Institut National de Recherche Biomédicale ( email )

Annie Mutombo

Democratic Republic of Congo - Ministry of Health ( email )

Felix Mulangu

Democratic Republic of Congo - Ministry of Health ( email )

Aaron Aruna Abedi

Democratic Republic of Congo - Ministry of Health ( email )

Emile Malembi

Democratic Republic of Congo - Ministry of Health ( email )

Thierry Kalonji

Democratic Republic of Congo - Ministry of Health ( email )

Cris Kacita

Democratic Republic of Congo - Ministry of Health ( email )

Eddy Kinganda-Lusamaki

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Tony Wawina-Bokalanga

Institut National de Recherche Biomédicale ( email )

Isabel Brosius

University of Antwerp - Department of Clinical Sciences ( email )

Christophe Van Dijck

University of Antwerp - Department of Clinical Sciences ( email )

Belgium

Emmanuel Bottieau

University of Antwerp - Department of Clinical Sciences ( email )

Koen Vercauteren

University of Antwerp - Department of Clinical Sciences ( email )

Adrienne Amuri-Aziza

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Jean-Claude Makangara-Cigolo

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Elisabeth Muyamuna

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Elisabeth Pukuta

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Beatrice Nguete

Kinshasa School of Public Health ( email )

Didine Kaba

Kinshasa School of Public Health ( email )

Kinshasa
Democratic Republic of the Congo

Joelle Kabamba

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

Christine Hughes

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

1600 Clifton Rd., NE
Atlanta, GA 30333
United States

Olivier Tshiani Mbaya

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

Anne W. Rimoin

University of California, Los Angeles (UCLA) - Department of Epidemiology ( email )

Nicole A. Hoff

University of California, Los Angeles (UCLA) - Department of Epidemiology ( email )

Jason Kindrachuk

University of Manitoba - Department of Infectious Diseases and Medical Microbiology

Winnipeg
Canada

Martine Peeters

University of Montpellier ( email )

Nicola Low

University of Bern - Institute of Social and Preventive Medicine ( email )

Bern
Switzerland

Andrea McCollum

Government of the United States of America - Division of High Consequence Pathogens and Pathology ( email )

Atlanta, GA
United States

Government of the United States of America - Centers for Disease Control and Prevention (CDC) ( email )

1600 Clifton Rd., NE
Atlanta, GA 30333
United States

Robert Shongo

Democratic Republic of Congo - Ministry of Health ( email )

Daniel Bamuleka Mukadi

Institut National de Recherche Biomédicale ( email )

Jean-Jacques Muyembe-Tamfum

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Steve Ahuka-Mundeke

National Multisectoral Committee for Ebola Response

United States

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

Laurens Liesenborghs (Contact Author)

KU Leuven - Rega Institute for Medical Research ( email )

Leuven
Belgium

Placide Mbala

Institut National de Recherche Biomédicale ( email )

Kinshasa
Democratic Republic of the Congo

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