Nkengurutse Liliane, Otshudiema John O, Kamwenubusa Godefroid, Diallo Issa, Nsavyimana Odette, Mbonicura Jean Claude, Nkurunziza Jean Claude, Cishahayo Fidèle, Niyongere Dieudonné, Havyarimana Bonite, Simbarariye Déo, Nimburanira Marc, Ntiranyibagira Bosco, Nzeyimana Senya Diane, Ndelema Brigitte, Nkezimana Denise, Shingiro Parfait, Sibomana Aimable, Nduwimana Stany, Nyabenda Freddy, Niyomwungere Alexis, Zongo Mamadou, Bousso Abdoulaye, Boland Samuel, Ndayisenga Jeanine, Nizigiyimana Dionis, Nyandwi Joseph, Zumla Alimuddin, Lewis Rosamund F, Harakandi Stanislas
Centre des Opérations d'Urgence de Santé Publique (COUSP/PHEOC Burundi), Rohero I, Bujumbura Mairie, Bujumbura J978+9V4, Burundi.
World Health Organization, WHO Burundi, 4 Avenue Muramwya, Rohero I, Bujumbura Mairie, Bujumbura J978+9V4, Burundi.
Viruses. 2025 Mar 27;17(4):480. doi: 10.3390/v17040480.
(1) Objectives: Studies on mpox patterns, severity predictors, and public health impacts in Burundi remain limited. Therefore, we aimed to identify the clinical predictors and determinants of mpox complications among hospitalized patients in Bujumbura, Burundi, during an active outbreak. (2) Methods: We conducted a prospective cohort study of laboratory-confirmed mpox cases across three treatment centers (July-October 2024). Clinical characteristics and outcomes were assessed through a systematic review of medical and laboratory records supplemented by structured interviews with patients or caregivers. Risk factors for disease complications were evaluated using multivariate Firth penalized logistic regression. (3) Results: Complications developed in 3.1% of 850 patients (54.4% male; median age, 20.3 years). Conjunctivitis (odds ratio [OR]: 27.30; 95% confidence interval [CI], 7.67-122.23) and sore throat (OR: 12.63; 95% CI, 5.78-30.21) were significant predictors of severe disease progression. Conversely, generalized rash (OR, 0.10; 95% CI, 0.04-0.24) and lymphadenopathy (OR, 0.24; 95% CI, 0.08-0.62) were associated with a mild disease course. Sexual transmission was the predominant route of infection (58.6%). (4) Conclusions: Noncutaneous manifestations, particularly conjunctivitis and sore throat, are early indicators of mpox severity. These findings inform clinical risk stratification in resource-limited settings and highlight the need for further investigation of pathophysiological mechanisms.
（1）目的：关于布隆迪猴痘的发病模式、严重程度预测因素及公共卫生影响的研究仍然有限。因此，我们旨在确定布隆迪布琼布拉在猴痘疫情活跃期间住院患者中猴痘并发症的临床预测因素和决定因素。（2）方法：我们在三个治疗中心对实验室确诊的猴痘病例进行了前瞻性队列研究（2024年7月至10月）。通过对医疗和实验室记录进行系统回顾，并辅以对患者或护理人员的结构化访谈，评估临床特征和结局。使用多变量费思惩罚逻辑回归评估疾病并发症的危险因素。（3）结果：850例患者中有3.1%出现并发症（男性占54.4%；中位年龄20.3岁）。结膜炎（比值比[OR]：27.30；95%置信区间[CI]，7.67 - 122.23）和咽痛（OR：12.63；95%CI，5.78 - 30.21）是严重疾病进展的显著预测因素。相反，全身性皮疹（OR，0.10；95%CI，0.04 - 0.24）和淋巴结病（OR，0.24；95%CI，0.08 - 0.62）与疾病病程较轻相关。性传播是主要的感染途径（58.6%）。（4）结论：非皮肤表现，尤其是结膜炎和咽痛，是猴痘严重程度的早期指标。这些发现为资源有限环境下的临床风险分层提供了信息，并强调了进一步研究病理生理机制的必要性。
