Journal article
Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
Lancet Regional Health - Americas (Online), Vol.17, p.100406
01/2023
DOI: 10.1016/j.lana.2022.100406
PMCID: PMC9904017
PMID: 36776570
Abstract
By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil.
This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis.
Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058).
Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities.
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).
Details
- Title: Subtitle
- Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
- Creators
- Mayara Secco Torres Silva - Fundação Oswaldo CruzCarolina Coutinho - Fundação Oswaldo CruzThiago Silva Torres - Fundação Oswaldo CruzEduardo Peixoto - Fundação Oswaldo CruzRonaldo Ismério - Fundação Oswaldo CruzFlavia Lessa - Fundação Oswaldo CruzEstevão Portela Nunes - Fundação Oswaldo CruzBrenda Hoagland - Fundação Oswaldo CruzAmanda Dolores Echeverria Guevara - Fundação Oswaldo CruzMatheus Oliveira Bastos - Fundação Oswaldo CruzIsabel Cristina Ferreira Tavares - Fundação Oswaldo CruzMaria Pia Diniz Ribeiro - Fundação Oswaldo CruzMaria Roberta Meneguetti Seravalli Ramos - Fundação Oswaldo CruzHugo Boechat Andrade - Fundação Oswaldo CruzAna Paula Lovetro Santana - Fundação Oswaldo CruzMarilia Santini-Oliveira - Fundação Oswaldo CruzJuliana Barbosa Santos Netto - Fundação Oswaldo CruzPaula Reges - Fundação Oswaldo CruzMonica Avelar Magalhães - Fundação Oswaldo CruzLeonardo Azevedo Silva Rosadas - Fundação Oswaldo CruzSandro Nazer - Fundação Oswaldo CruzLuciane Velasque - Universidade Federal do Estado do Rio de JaneiroSandra Wagner Cardoso - Fundação Oswaldo CruzEdson Elias da Silva - Fundação Oswaldo CruzValdilea Gonçalves Veloso - Fundação Oswaldo CruzMayumi Duarte Wakimoto - Fundação Oswaldo CruzBeatriz Grinsztejn - Fundação Oswaldo CruzAndré Miguel JapiassuMarcel TrepowItalo Guariz Ferreira - Fundação Oswaldo CruzLarissa VillelaRafael Teixeira FragaMariah Castro de Souza PiresRodrigo Otavio da Silva EscadaLeonardo Paiva de SousaGabriela Lisseth Umaña RobledaDesirée Vieira Santos - Fundação Oswaldo CruzLuiz Ricardo Siqueira CamachoPedro AmparoJoão Victor Jaegger de FrançaFelipe de Oliveira Heluy CorreaBruno Ivanovinsky Costa de SousaBernardo Vicari do ValleJoão Paulo Bortot SoaresLivia Cristina Fonseca FerreiraPedro da Silva MartinsMaira Braga MesquitaJosé Ricardo Hildebrant CoutinhoRaissa de Moraes PerlingeiroPriscila Peixoto de Castro OliveiraHugo Perazzo Pedroso BarbosaAndré Figueiredo AccettaMarcelo CunhaRosangela Vieira EirasTiciana Martins dos SantosWladmyr Davila da SilvaMonique do Vale SilveiraTania de Souza BrumGuilherme Amaral CalvetRodrigo Caldas MenezesSandro Antônio PereiraInstituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz) Mpox Study Group
- Resource Type
- Journal article
- Publication Details
- Lancet Regional Health - Americas (Online), Vol.17, p.100406
- DOI
- 10.1016/j.lana.2022.100406
- PMID
- 36776570
- PMCID
- PMC9904017
- NLM abbreviation
- Lancet Reg Health Am
- ISSN
- 2667-193X
- eISSN
- 2667-193X
- Publisher
- Elsevier Ltd
- Grant note
- Fundação Oswaldo Cruz (INI-Fiocruz) Instituto Nacional de Infectologia Evandro Chagas
- Language
- English
- Date published
- 01/2023
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984771653002771
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