Mpox outbreak associated with multiple sexual partnerships and HIV coinfection in Masaka District, Uganda, February–April 2025

Résumé fourni par la source

Background Uganda experienced a substantial increase in mpox cases in early 2025, with notable clustering in central regions. Masaka district reported approximately 4,800 confirmed mpox cases and 37 deaths, contributing approximately 3% of the national burden. We investigated an outbreak in Masaka District to describe its epidemiology and identify associated risk factors. Methods We conducted an outbreak investigation with a descriptive epidemiological analysis and an unmatched case–control study. A suspected case was defined as onset of rash with fever and at least one additional symptom (lymphadenopathy, headache, myalgia, back pain, or fatigue) in a Masaka District resident during February–April 2025. Confirmed cases were PCR-positive. We enrolled 86 confirmed cases and 172 neighborhood controls (1:2 ratio). Data on sociodemographic characteristics, care-seeking behavior, and potential exposures were collected using structured questionnaires. Multivariable logistic regression identified independent risk factors. Results Of the 86 confirmed cases, 45 (52.3%) were male and 41 (47.7%) were female. The most affected age group was 25-34 years (24 per 10,000 population), and residents of Bukakata Sub-county, a fisherfolk community, had the highest attack rate (5 per 10,000). Over half (56%) were HIV positive. Independent risk factors included HIV infection (aOR: 5.4; 95% CI: 2.3–12.5), having multiple sexual partners (aOR: 7.3; 95% CI: 3.5–15.3), and close contact with an individual with a rash (aOR: 3.2; 95% CI: 1.4–6.9). Conclusion The Mpox outbreak affected young adults, driven by high-risk sexual networks and underlying HIV infection. Strengthening integration of Mpox screening, prevention, and care within HIV programs targeting sexual networks could interrupt transmission and mitigate future outbreaks.

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