Background
This study aims to comparatively analyze clinical features, treatment and patient outcomes between the previous and the 2022 mpox (monkeypox) outbreaks.
Methods
Five bibliographic databases were searched for studies reporting clinical features, management and patient outcomes of mpox. Systematic review and meta-analysis were performed.
Results
In total, 73 studies were included in the systematic review, of which 33 studies were subjected to meta-analysis. Previous outbreaks substantially affected children, whereas the 2022 outbreak primarily affected male adults, of which 94.66% (95% confidence interval (CI), 88.03-98.95) were men who have sex with men. Furthermore, 72.47% (95%CI, 51.04-89.71) performed high-risk sexual activity and the overall HIV prevalence was 37.65% (95%CI, 30.09-45.50). Skin lesions remain the typical symptom, however their anatomic distribution differs. Systemic manifestations are common, but rectal pain was unique to the 2022 outbreak. The estimated overall fatality during past outbreaks in Africa is 4.61% (95%CI, 2.39-7.35), whereas 6.34% (95%CI, 3.35-10.10) patients from the 2022 outbreak required hospitalization. Antiviral treatment in particular tecovirimat has been prescribed for a subset of patients, but the efficacy remains inconclusive.
Conclusions
These findings are important for better understanding the disease and guiding adequate response to mpox outbreaks.
Epicentres are the focus of COVID‐19 research, whereas emerging regions with mainly imported cases due to population movement are often neglected. Classical compartmental models are useful, however, likely oversimplify the complexity when studying epidemics. This study aimed to develop a multi‐regional, hierarchical‐tier mathematical model for better understanding the complexity and heterogeneity of COVID‐19 spread and control. By incorporating the epidemiological and population flow data, we have successfully constructed a multi‐regional, hierarchical‐tier SLIHR model. With this model, we revealed insight into how COVID‐19 was spread from the epicentre Wuhan to other regions in Mainland China based on the large population flow network data. By comprehensive analysis of the effects of different control measures, we identified that Level 1 emergency response, community prevention and application of big data tools significantly correlate with the effectiveness of local epidemic containment across different provinces of China outside the epicentre. In conclusion, our multi‐regional, hierarchical‐tier SLIHR model revealed insight into how COVID‐19 spread from the epicentre Wuhan to other regions of China, and the subsequent control of local epidemics. These findings bear important implications for many other countries and regions to better understand and respond to their local epidemics associated with the ongoing COVID‐19 pandemic.
Contributors QP and QZ contributed to project conceptualisation. QZ, QP and XW built the model. QZ, QP, XW, CB and MZ designed the scenario settings. QZ, QP, CB and XW performed effectiveness analysis. QZ wrote the manuscript. QP, XW, CB and MZ edited the manuscript. QP and MZ supervised the project. All authors approved the manuscript.
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