Centro de Investigación en Salud Pública, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru.
Facultad de Ciencias de la Salud, Universidad Tecnológica del Peru, Lima, Peru.
PLoS One. 2024 Jul 26;19(7):e0307503. doi: 10.1371/journal.pone.0307503. eCollection 2024.
Recent outbreaks of monkeypox (Mpox) have occurred in countries outside of Africa, with large numbers of cases spreading rapidly to almost every continent. We aimed to analyze the correlation between the Global Health Security (GHS) Index (categories and indicators) and the Mpox case rate in different regions and globally.
In this cross-sectional study, we used data from Mpox cases from the WHO, and the GHS categories and indicators for detection, prevention, reporting, health system, rapid response, international norms compliance, and risk environment. Outcome measures were the relationship between GHS index (categories and indicators) and Mpox case rate using crude and adjusted non-linear regression models.
After performing adjusted analyses, only risk environment and detection and reporting index were associated with Mpox case rates in the 99 countries and the Region of the Americas, respectively. Antimicrobial resistance (AMR) indicators of the prevention category, risk communication of the rapid response category, the joint external evaluation and performance veterinary services of the norms category, and the infrastructure adequacy of the risk environment category were associated with Mpox case rates in the 99 countries (p<0.05). Laboratory systems strength and quality indicator of the detection and reporting category, and emergency response operation indicator of the response rapid category were associated with Mpox case rates in the countries of the region of the Americas (p<0.05). AMR indicator of the prevention of the emergence category, and the infrastructure adequacy of the risk environment category were associated with Mpox case rates in the countries of the European Region (p<0.05). In the countries of the other regions, only the trade and travel restrictions indicator of the rapid response category was associated with Mpox case rates (p<0.05).
Countries, particularly in the Americas region, with high levels of infrastructure adequacy and laboratory system strength and quality as measured by the GHS index are better equipped to detect more Mpox cases. Therefore, they have higher Mpox case detection rates and can successfully respond to Mpox outbreaks.
最近，猴痘（Mpox）在非洲以外的国家爆发，大量病例迅速传播到几乎每个大洲。我们旨在分析全球卫生安全（GHS）指数（类别和指标）与不同地区和全球猴痘病例率之间的相关性。
在这项横断面研究中，我们使用了来自世界卫生组织的猴痘病例数据，以及 GHS 类别和检测、预防、报告、卫生系统、快速反应、国际规范遵守和风险环境的指标。结果测量是使用粗和调整后的非线性回归模型，分析 GHS 指数（类别和指标）与猴痘病例率之间的关系。
在进行调整分析后，只有风险环境和检测与报告指数与 99 个国家和美洲地区的猴痘病例率相关。预防类别的抗微生物药物耐药性（AMR）指标、快速反应类别的风险沟通、规范类别的联合外部评估和绩效兽医服务以及风险环境类别的基础设施充足性与 99 个国家的猴痘病例率相关（p<0.05）。检测与报告类别的实验室系统强度和质量指标以及快速反应类别的应急响应操作指标与美洲地区国家的猴痘病例率相关（p<0.05）。预防类别中的 AMR 指标和风险环境类别的基础设施充足性与欧洲区域国家的猴痘病例率相关（p<0.05）。在其他区域的国家中，只有快速反应类别的贸易和旅行限制指标与猴痘病例率相关（p<0.05）。
各国，特别是美洲地区的国家，其基础设施充足性和实验室系统强度和质量水平较高，通过 GHS 指数衡量，能够更好地检测更多的猴痘病例。因此，它们的猴痘病例检出率更高，并能够成功应对猴痘疫情爆发。
