Epidemiological and Clinical Profile of Mpox Diagnosed at the National Laboratory of Clinical Biology of Public Health in Bangui, Central African Republic

Abstract

Introduction : Monkeypox (MPXV) epidemics historically result from the zoonotic spread of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to sexual transmission. It is in this context that this study was conducted to determine the prevalence of MPXV at the Bangui National Laboratory. Methodology: This was a prospective, multicenter analytical study. Skin, blood, and oropharyngeal swabs were collected from suspected MPXV patients. A total of 50 samples were recorded during this study. Diagnosis was performed using real-time PCR. The study received approval from the Research Ethics Committee of the Doctoral School of Human and Veterinary Health Sciences, University of Bangui (ESP/CE/78/2024). Participants gave verbal consent for data collection. Results: The mean age of patients was 29.20 years with a standard deviation of ±19.07 and the median age of individuals was 25.50 years with a male predominance of 22.73%. Out of 50 patients suspected of Mpox, 30% of patients had muscle pain followed by intense fever with lymphadenopathy and 20% were confirmed positive by polymerase chain reaction. The most dominant age group was between 11 and 20 years with a rate of 0.30% of positive cases for Mpox. The difference in patients infected with Mpox is not significant with a p ≤ 0.70 and the male gender is the most dominant with a rate of 22.73% of cases of positivity to Mpox with a p-value of 0.46. Conclusion: This study shows that molecular diagnostics identified mutations characteristic of clade I, with a strong signal of APOBEC3 mutation pressure, suggesting active human-to-human transmission in CAR. Enhanced surveillance and an early diagnostic strategy would be necessary to eradicate the Mpox epidemic in CAR.