Mpox seroprevalence among sex workers and men who have sex with men preceding sustained urban outbreak in the Democratic Republic of the Congo

Résumé fourni par la source

Abstract Mpox has evolved into a global public health concern following rapid geographic expansion and altered clinical and epidemiological characteristics. The 2022 outbreak of monkeypox virus (MPXV) marked the first widespread expansion to non-endemic regions, particularly among men who have sex with men (MSM). In the Democratic Republic of the Congo (DRC), where Clade I MPXV is endemic, data on urban exposures are limited. We evaluated serologic evidence of exposure using a four-plex MPXV assay among 1,823 participants from two major DRC cities, Kinshasa and Goma, between April and June 2024. Of these participants, 523 (28.7%) self-identified as MSM, 498 (27.3%) as professional sex workers (SW), 107 (5.9%) as MSM and SW, and 695 (38.1%) as other at-risk individuals. Overall, 2.9% of participants were seroreactive. By subpopulation, 4.8%, 2.1%, and 1.7% of at-risk, MSM, and SW participants were seroreactive ( p = 0.0086). Classification tree modelling identified age as the strongest predictor of reactivity, with higher MPXV seroreactivity in older participants. These data provide evidence of mpox seroreactivity prior to sustained human-to-human transmission in urban settings. Understanding exposure dynamics is critical for anticipating re-emergence of mpox in global cities where interpersonal networks may sustain transmission even in the absence of zoonotic spillover.

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