Rodolphe Merieux INRB Goma Lab;
Amer Canc Soc;
University of Manitoba Department of Medical Microbiology and Infectious Diseases;
University of Bern Institute of Social and Preventive Medicine;
Montpellier Univ;
University of California Los Angeles Department of Epidemiology;
Minist Hlth;
Hemorrhag Fever & Monkeypox Program;
US Ctr Dis Control & Prevent;
Inst Natl Rech Biomed;
Univ Kinshasa;
Leidos Biomed Res;
KU Leuven Department of Microbiology Immunology and Transplantation;
Osaka Metropolitan University Graduate School of Medicine School of Medicine;
Interuniversity Institute for Biostatistics and Statistical Bioinformatics;
University of Antwerp Vaccine and Infectious Disease Institute;
Institute of Tropical Medicine Department of Clinical Sciences;
Univ Bern;
期刊名称：
The Lancet
i s s n：
0140-6736
年卷期：
2025 年
405 卷
10476 期
页 码：
408-419
页 码：
摘 要：
Background DR Congo has the highest global burden of mpox, a disease caused by infection with the monkeypox virus. The incidence has risen since 1980, but recent analyses of epidemiological trends are lacking. We aimed to describe trends in suspected and confirmed mpox cases in DR Congo using epidemiological and laboratory mpox surveillance data collected from 2010 to 2023, and provide insights that can better inform the targeting and monitoring of control strategies. Methods We analysed aggregated national epidemiological surveillance data and individual-level laboratory data from 2010 to 2023. We calculated incidence based on suspected cases, case-fatality ratios, and percentage of laboratory-confirmed cases and assessed geospatial trends. Demographic and seasonal trends were investigated using generalised additive mixed models. Findings Between Jan 1, 2010, and Dec 31, 2023, a total of 60 967 suspected cases and 1798 suspected deaths from mpox were reported in DR Congo (case-fatality ratio 29%). The number of reporting provinces increased from 18 of 26 provinces in 2010 to 24 of 26 provinces in 2023. The annual incidence increased from 297 per 100 000 in 2010 to 1146 per 100 000 in 2023. The highest incidence (4638 per 100 000) and case-fatality ratio (60%) were observed in children younger than 5 years. Incidence was higher in rural compared with urban areas. PCR testing was performed for 7438 suspected cases (122%), with 4248 (571%) of 7438 samples testing positive. Median age of confirmed cases (130 years [IQR 60-250]) remained stable, although the 95th percentile of age increased over time. Interpretation The incidence and geographical distribution of suspected mpox cases have increased substantially since 2010. Improvements in surveillance and decentralised testing are essential to monitor mpox trends and direct interventions effectively, to address the public health emergency declarations issued in August, 2024. Funding Belgian Directorate-General Development Cooperation and Humanitarian Aid; European and Developing Countries Clinical Trials Partnership; Research Foundation-Flanders; European Civil Protection and Humanitarian Aid Operations; Department of Economy, Science, and Innovation of the Flemish Government; Canadian Institutes of Health Research; and the International Development Research Centre. Copyright (c) 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.
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