Rangaraya Medical College, Kakinada, Andhra Pradesh, India.
Squad Medicine and Research (SMR), Visakhapatnam, Andhra Pradesh, India.
Rev Med Virol. 2023 Sep;33(5):e2472. doi: 10.1002/rmv.2472. Epub 2023 Aug 2.
Monkeypox (mpox) is a significant health concern affecting children and adolescents globally. This systematic review and meta-analysis aims to synthesise the available evidence on the proportion of children and adolescents affected by the mpox virus. A comprehensive search was conducted in seven electronic databases (PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane) to identify the original reports on mpox cases in children and adolescents till 15 January 2023. Descriptive reports on probable or laboratory-confirmed mpox in children and adolescents (0-17 years old) were considered eligible. Studies not providing separate data for the above age group and case-control studies were excluded. The primary outcome was pooled proportion of mpox cases among children and adolescents. Proportion meta-analysis and heterogeneity between studies were determined using a restricted maximum likelihood estimator, and a random-effects model was fitted to the data. Sensitivity analysis and subgroup analysis were also conducted. A drapery plot was also provided as a complementary figure to the forest plot. The protocol was prospectively registered with PROSPERO (CRD42023392475). A total of 440 studies were identified, of which 37 were included in the review and 25 in the meta-analysis (62,701 participants with 3306 children and adolescents). The pooled proportion of children and adolescents was 0.46 (95% CI: 0.30-0.63, I :100%). The proportion of children and adolescents was significantly lower (p < 0.001) in the ongoing pandemic 0.04 (95% CI: 0.00-0.32) than before 2022 0.62 (95% CI: 0.49-0.74). The meta-regression showed that the higher the study's sample size, the lower the proportion of children among the mpox cases. Both overall and subgroup heterogeneity were high. Adolescents and children below 5 years are commonly affected by the ongoing pandemic. In conclusion, the high proportion of children affected by the mpox virus highlights the need for increased research and targeted interventions to prevent and control the spread of the virus in this population.
猴痘（mpox）是一个全球性的重大健康问题，影响着儿童和青少年。本系统评价和荟萃分析旨在综合现有证据，以确定受 mpox 病毒影响的儿童和青少年的比例。我们在七个电子数据库（PubMed、Scopus、Web of Science、EMBASE、ProQuest、EBSCOHost 和 Cochrane）中进行了全面检索，以确定截至 2023 年 1 月 15 日关于儿童和青少年猴痘病例的原始报告。符合条件的报告是针对儿童和青少年（0-17 岁）的可能或实验室确诊的猴痘病例的描述性报告。未提供上述年龄组单独数据和病例对照研究的报告被排除在外。主要结果是儿童和青少年中猴痘病例的汇总比例。使用受限最大似然估计来确定比例荟萃分析和研究之间的异质性，并使用随机效应模型拟合数据。还进行了敏感性分析和亚组分析。还提供了一个窗帘图作为森林图的补充。该方案已在 PROSPERO（CRD42023392475）中进行了前瞻性注册。共确定了 440 项研究，其中 37 项纳入了综述，25 项纳入了荟萃分析（62701 名参与者中有 3306 名儿童和青少年）。儿童和青少年的汇总比例为 0.46（95%CI：0.30-0.63，I ：100%）。在正在进行的大流行中，儿童和青少年的比例明显较低（p<0.001），为 0.04（95%CI：0.00-0.32），而 2022 年之前为 0.62（95%CI：0.49-0.74）。元回归表明，研究样本量越大，猴痘病例中儿童的比例越低。总体和亚组异质性均较高。青少年和 5 岁以下儿童通常受到正在进行的大流行的影响。总之，受 mpox 病毒影响的儿童比例较高，这突出表明需要加强研究和针对性干预，以防止和控制该人群中病毒的传播。
