Hoang Thi Ngoc Anh, Hoang Van Ngoc, Dinh Thi Thu Trang, Vu Ngoc Long, Quach Ha Linh
Faculty of Public Health, PHENIKAA University, Hanoi, Vietnam.
Viet Nam Administration of Disease Prevention, Ministry of Health, Hanoi, Vietnam.
Epidemiol Infect. 2025 Aug 4;153:e89. doi: 10.1017/S0950268825100356.
Investigating risk factors for mpox's infectious period is vital for preventing this emerging disease, yet evidence remains scarce. This study aimed to identify risk factors associated with the duration of mpox infectiousness among mpox cases in Vietnam. The primary outcome was the duration of the mpox infectiousness, defined between symptom onset and the first negative test result for the mpox virus. Fine and Gray's regression models were employed to assess the associations between the infectious period and several risk factors while accounting for competing risks of death by mpox. Most mpox cases recovered within 30 days. Patients with HIV or treated at multiple facilities for mpox had lower incidence rates of cleared infection compared to those who were HIV-negative or treated at a single facility. In regression models, patients with mpox symptoms of rash or mucosal lesions (sub-distribution hazard ratios = 0.62, 95% confidence interval = 0.46-0.83), ulcers (0.57, 0.41-0.80), or fever (0.62, 0.46-0.83) had significantly prolonged infectious periods than those without such symptoms. Our findings provided insights for managing mpox cases, especially those vulnerable to prolonged infectious periods in settings with sporadic cases reported.
调查猴痘传染期的风险因素对于预防这种新兴疾病至关重要，但相关证据仍然匮乏。本研究旨在确定越南猴痘病例中与猴痘传染性持续时间相关的风险因素。主要结局是猴痘的传染期持续时间，定义为症状出现至猴痘病毒首次检测呈阴性结果之间的时间段。采用Fine和Gray回归模型评估传染期与若干风险因素之间的关联，同时考虑猴痘导致死亡的竞争风险。大多数猴痘病例在30天内康复。与HIV阴性或在单一机构接受治疗的患者相比，HIV患者或在多个机构接受猴痘治疗的患者清除感染的发病率较低。在回归模型中，出现皮疹或黏膜病变（亚分布风险比=0.62，95%置信区间=0.46-0.83）、溃疡（0.57，0.41-0.80）或发热（0.62，0.46-0.83）等猴痘症状的患者，其传染期明显长于无此类症状的患者。我们的研究结果为管理猴痘病例提供了见解，尤其是在报告有散发病例的环境中那些容易出现传染期延长的病例。
