Bangwen Eugene, Diavita Ruth, De Vos Elise, Vakaniaki Emmanuel Hasivirwe, Nundu Sabin Sabiti, Mutombo Annie, Mulangu Felix, Abedi Aaron Aruna, Malembi Emile, Kalonji Thierry, Kacita Cris, Kinganda-Lusamaki Eddy, Wawina-Bokalanga Tony, Kremer Cécile, Brosius Isabel, Van Dijck Christophe, Bottieau Emmanuel, Vercauteren Koen, Amuri-Aziza Adrienne, Makangara-Cigolo Jean-Claude, Muyamuna Elisabeth, Pukuta Elisabeth, Nguete Beatrice, Kaba Didine, Kabamba Joelle, Hughes Christine M, Tshiani-Mbaya Olivier, Rimoin Anne W, Hoff Nicole A, Kindrachuk Jason, Hens Niel, Peeters Martine, Low Nicola, McCollum Andrea M, Shongo Robert, Mukadi-Bamuleka Daniel, Muyembe-Tamfum Jean-Jacques, Ahuka-Mundeke Steve, Liesenborghs Laurens, Mbala-Kingebeni Placide
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
Lancet. 2025 Feb 1;405(10476):408-419. doi: 10.1016/S0140-6736(24)02669-2.
DR Congo has the highest global burden of mpox, a disease caused by infection with the monkeypox virus. The incidence has risen since 1980, but recent analyses of epidemiological trends are lacking. We aimed to describe trends in suspected and confirmed mpox cases in DR Congo using epidemiological and laboratory mpox surveillance data collected from 2010 to 2023, and provide insights that can better inform the targeting and monitoring of control strategies.
We analysed aggregated national epidemiological surveillance data and individual-level laboratory data from 2010 to 2023. We calculated incidence based on suspected cases, case-fatality ratios, and percentage of laboratory-confirmed cases and assessed geospatial trends. Demographic and seasonal trends were investigated using generalised additive mixed models.
Between Jan 1, 2010, and Dec 31, 2023, a total of 60 967 suspected cases and 1798 suspected deaths from mpox were reported in DR Congo (case-fatality ratio 2·9%). The number of reporting provinces increased from 18 of 26 provinces in 2010 to 24 of 26 provinces in 2023. The annual incidence increased from 2·97 per 100 000 in 2010 to 11·46 per 100 000 in 2023. The highest incidence (46·38 per 100 000) and case-fatality ratio (6·0%) were observed in children younger than 5 years. Incidence was higher in rural compared with urban areas. PCR testing was performed for 7438 suspected cases (12·2%), with 4248 (57·1%) of 7438 samples testing positive. Median age of confirmed cases (13·0 years [IQR 6·0-25·0]) remained stable, although the 95th percentile of age increased over time.
The incidence and geographical distribution of suspected mpox cases have 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.
Belgian Directorate-General Development Cooperation and Humanitarian Aid; European and Developing Countries Clinical Trials Partnership; 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 the International Development Research Centre.
刚果民主共和国是全球猴痘负担最重的国家，猴痘是一种由猴痘病毒感染引起的疾病。自1980年以来，发病率一直在上升，但缺乏对流行病学趋势的最新分析。我们旨在利用2010年至2023年收集的流行病学和实验室猴痘监测数据，描述刚果民主共和国疑似和确诊猴痘病例的趋势，并提供见解，以便更好地为控制策略的目标设定和监测提供信息。
我们分析了2010年至2023年的国家汇总流行病学监测数据和个体层面的实验室数据。我们根据疑似病例计算发病率、病死率以及实验室确诊病例的百分比，并评估地理空间趋势。使用广义相加混合模型研究人口统计学和季节性趋势。
2010年1月1日至2023年12月31日期间，刚果民主共和国共报告了60967例疑似猴痘病例和1798例疑似猴痘死亡病例（病死率2.9%）。报告省份的数量从2010年26个省份中的18个增加到2023年26个省份中的24个。年发病率从2010年的每10万人2.97例增加到2023年的每10万人11.46例。5岁以下儿童的发病率最高（每10万人46.38例），病死率最高（6.0%）。农村地区的发病率高于城市地区。对7438例疑似病例进行了PCR检测（12.2%），7438份样本中有4248份（57.1%）检测呈阳性。确诊病例的中位年龄（13.0岁[IQR 6.0 - 25.0]）保持稳定，尽管年龄的第95百分位数随时间增加。
自2010年以来，疑似猴痘病例的发病率和地理分布大幅增加。加强监测和分散检测对于监测猴痘趋势和有效指导干预措施至关重要，以应对2024年8月发布的公共卫生紧急声明。
比利时发展合作与人道主义援助总局；欧洲和发展中国家临床试验伙伴关系；弗拉芒研究基金会；欧洲民事保护和人道主义援助行动；弗拉芒政府经济、科学和创新部；加拿大卫生研究院；以及国际发展研究中心。
