Kinganda-Lusamaki Eddy, Baketana Lionel Kinzonzi, Ndomba-Mukanya Etienne, Bouillin Julie, Thaurignac Guillaume, Aziza Adrienne Amuri, Luakanda-Ndelemo Gradi, Nuñez Nicolas Fernandez, Kalonji-Mukendi Thierry, Pukuta Elisabeth Simbu, Nkuba-Ndaye Antoine, Lofiko Emmanuel Lokilo, Kibungu Emile Malembi, Lushima Robert Shongo, Ayouba Ahidjo, Mbala-Kingebeni Placide, Muyembe-Tamfum Jean-Jacques, Delaporte Eric, Peeters Martine, Ahuka-Mundeke Steve
TransVIHMI, University of Montpellier (UM), French Institute of Health and Medical Research (INSERM), French National Research Institute for Sustainable Development (IRD), 34394 Montpellier, France.
Institut National de Recherche Biomédicale (INRB), Kinshasa P.O. Box 1197, Democratic Republic of the Congo.
Pathogens. 2023 Jul 7;12(7):916. doi: 10.3390/pathogens12070916.
Human Mpox cases are increasingly reported in Africa, with the highest burden in the Democratic Republic of Congo (DRC). While case reporting on a clinical basis can overestimate infection rates, laboratory confirmation by PCR can underestimate them, especially on suboptimal samples like blood, commonly used in DRC. Here we used a Luminex-based assay to evaluate whether antibody testing can be complementary to confirm cases and to identify human transmission chains during outbreak investigations. We used left-over blood samples from 463 patients, collected during 174 outbreaks between 2013 and 2022, with corresponding Mpox and VZV PCR results. In total, 157 (33.9%) samples were orthopox-PCR positive and classified as Mpox+; 124 (26.8%) had antibodies to at least one of the three Mpox peptides. The proportion of antibody positive samples was significantly higher in Mpox positive samples (36.9%) versus negative (21.6%) ( < 0.001). By combining PCR and serology, 66 additional patients were identified, leading to an Mpox infection rate of 48.2% (223/463) versus 33.9% when only PCR positivity is considered. Mpox infections were as such identified in 14 additional health zones and 23 additional outbreaks (111/174 (63.8% versus 88/174 (50.6%)). Our findings highlight the urgent need of rapid on-site diagnostics to circumvent Mpox spread.
非洲报告的人类猴痘病例日益增多，刚果民主共和国（DRC）的负担最重。虽然基于临床的病例报告可能高估感染率，但通过聚合酶链反应（PCR）进行实验室确诊可能低估感染率，尤其是在刚果民主共和国常用的血液等非最佳样本上。在此，我们使用基于Luminex的检测方法来评估抗体检测是否可以作为补充手段，以确诊病例并在疫情调查期间识别人际传播链。我们使用了2013年至2022年期间174次疫情中收集的463名患者的剩余血液样本，并获得了相应的猴痘和水痘带状疱疹病毒（VZV）PCR检测结果。总共有157份（33.9%）样本的正痘病毒PCR检测呈阳性，并被归类为猴痘阳性；124份（26.8%）样本对三种猴痘肽中的至少一种有抗体。抗体阳性样本在猴痘阳性样本中的比例（36.9%）显著高于阴性样本（21.6%）（<0.001）。通过将PCR和血清学检测相结合，又识别出66名患者，从而使猴痘感染率达到48.2%（223/463），而仅考虑PCR阳性时为33.9%。在另外14个卫生区和23次疫情中也发现了猴痘感染（111/174（63.8%）对88/174（50.6%））。我们的研究结果凸显了迫切需要快速现场诊断以遏制猴痘传播。
