Clinical characteristics of suspected cases of human mpox (monkeypox) in Katako-Kombe, Democratic Republic of the Congo 2023: challenges and key responses

Objectives: This study aimed to describe the clinical and epidemiologic characteristics of suspected cases of human mpox in one of the most affected health zones, Katako-Kombe, Sankuru Province, in the Democratic Republic of the Congo. Also, to identify key challenges to prevent and improve the health of the affected community.

Methods: Between January 26, 2023 and November 30, 2023, the DRC reported its highest incidence of mpox cases,with a total of 12,569 suspected cases in 156 health zones from 22 of the 26 country's provinces. The Katako-Kombe Health Zone registered 369 suspected cases and 17 deaths, making it one of the hotspots of the outbreak.

Results: Ten villages and centres were affected, with an attack rate (AT) of 2.15‰ and a case fatality rate (CFR) of 4.6%. Epi-curves showed an increase in clinical cases from January to May 2023, followed by a decrease until August 2023 and a resurgence of cases in September 2023, with a reproduction rate of 1.29. Furthermore, the occurrence of complications appeared to increase the CFR with 7 (14%), 11 (18.03%), and 9 (23.68%) for encephalitis, anemia, and pulmonary complications, respectively.

Conclusions: AT, CFR, and transmission rate appeared to be lower in the current epidemic than in previous outbreaks and in Clade I. Critically, delayed medical care increases the incidence of complications and CFR. Therefore, mpox requires early diagnosis and prompt public health response. Including the possibility of mpox in the differential diagnosis of patients presenting with a vesicular or pustular rash is suggested.