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Peer-reviewedCC BYBulletin of the National Research Centre/Bulletin of the National Research Center

Mpox severity and mortality in the DRC: a systematic review and meta-analysis (1970–2024)

  • Fabrice Zobel Lekeumo Cheuyem1
  • Armel Zemsi2
  • Jonathan Hangi Ndungo3
  • Chabeja Achangwa4
  • Davy Romeo Takpando-le-grand5
  • Jessy Goupeyou-Youmsi6
  • Solange Dabou6
  • Mohamadou Adama1
  • Ariane Nouko1
  • Marie Angèle Mbang7
  • Edwige Omona Guissana8
  • Rick Tchamani9
4 more authors
  • Vanessa Monique Mballa Assiene10
  • Ethel Ambo Eno
  • Constantine Tanywe Asahngwa
  • Saralees Nadarajah11
11 affiliations
  1. 1Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaounde, Cameroon;
  2. 2MRCG at LSHTM, Banjul, The Gambia;
  3. 3Higher Institute of Medical Techniques, Bunia, Democratic Republic of Congo;
  4. 4Department of Public Health, Faculty of Medical Sciences, University of West Indies, Cave Hill, Barbados;
  5. 5Field Coordinator Frontline Field Epidemiology Training Program, Bangui, Central African Republic;
  6. 6Division of Health Policy and Research, Nkafu Policy Institute, Denis and Lenora Foretia Foundation, Yaounde, Cameroon;
  7. 7Division of Vaccination, Department of Family Health, Ministry of Public Health, Yaounde, Cameroon;
  8. 8Department of Family Health, Ministry of Public Health, Yaounde, Cameroon;
  9. 9Rosiere Higher School of Health Sciences, Yaounde, Cameroon;
  10. 10Public Health Operations Coordination Centre, Yaounde, Cameroon;
  11. 11Department of Mathematics, University of Manchester, Manchester, UK
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Abstract

Background Mpox, caused by the Mpox virus, is a zoonotic disease historically endemic in Central and West Africa. Despite the Democratic Republic of Congo (DRC) carrying the highest Mpox burden, the literature lacks comprehensive data on long-term trends and geographic disparities inMpox% disease severity and mortality, highlighting a significant research gap. Understanding severity and mortality trends is critical for global control efforts. Methods This systematic review and meta-analysis followed PRISMA guidelines to synthesize evidence on Mpox severity and mortality in the DRC from 1970 to 2024. We searched PubMed, ScienceDirect, Scopus, Web of Science. Random-effects models addressed high heterogeneity, and subgroup analyses examined temporal trends, regional differences, and healthcare settings. Meta-regression explored sources of heterogeneity for both severity and case fatality rate, adjusting for study year, region, and setting. Results We included a total of 19 study reports. The pooled severity rate among 3,280 confirmed cases was 39.47% (95% confidence interval [CI] 29.11–50.86). Case fatality rates (CFRs) were 1.70% (95% CI 0.72–3.95) among 3152 suspected cases and 2.46% (95% CI 0.65–8.85) for 2239 confirmed cases. Meta-regression revealed that study year, region and setting were significant sources of heterogeneity of case fatality rates among confirmed mpox cases. Conclusion Mpox continues to impose a substantial burden in the DRC, with a high severity and moderate mortality rates. Targeted interventions, including vaccination in high-risk areas, community education, and healthcare system strengthening are warranted.

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Cite

BibTeXRIS
BibTeX
@article{cheuyem2026mpox,
  title = {{Mpox severity and mortality in the DRC: a systematic review and meta-analysis (1970–2024)}},
  author = {Fabrice Zobel Lekeumo Cheuyem and Armel Zemsi and Jonathan Hangi Ndungo and Chabeja Achangwa and Davy Romeo Takpando-le-grand and Jessy Goupeyou-Youmsi and Solange Dabou and Mohamadou Adama and Ariane Nouko and Marie Angèle Mbang and Edwige Omona Guissana and Rick Tchamani and Vanessa Monique Mballa Assiene and Ethel Ambo Eno and Constantine Tanywe Asahngwa and Saralees Nadarajah},
  journal = {Bulletin of the National Research Centre/Bulletin of the National Research Center},
  year = {2026},
  month = jul,
  doi = {10.1186/s42269-026-01457-0},
  url = {https://doi.org/10.1186/s42269-026-01457-0},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Mpox severity and mortality in the DRC: a systematic review and meta-analysis (1970–2024)
AU  - Fabrice Zobel Lekeumo Cheuyem
AU  - Armel Zemsi
AU  - Jonathan Hangi Ndungo
AU  - Chabeja Achangwa
AU  - Davy Romeo Takpando-le-grand
AU  - Jessy Goupeyou-Youmsi
AU  - Solange Dabou
AU  - Mohamadou Adama
AU  - Ariane Nouko
AU  - Marie Angèle Mbang
AU  - Edwige Omona Guissana
AU  - Rick Tchamani
AU  - Vanessa Monique Mballa Assiene
AU  - Ethel Ambo Eno
AU  - Constantine Tanywe Asahngwa
AU  - Saralees Nadarajah
PY  - 2026
DA  - 2026/07/01
JO  - Bulletin of the National Research Centre/Bulletin of the National Research Center
DO  - 10.1186/s42269-026-01457-0
UR  - https://doi.org/10.1186/s42269-026-01457-0
AB  - Background Mpox, caused by the Mpox virus, is a zoonotic disease historically endemic in Central and West Africa. Despite the Democratic Republic of Congo (DRC) carrying the highest Mpox burden, the literature lacks comprehensive data on long-term trends and geographic disparities inMpox% disease severity and mortality, highlighting a significant research gap. Understanding severity and mortality trends is critical for global control efforts. Methods This systematic review and meta-analysis followed PRISMA guidelines to synthesize evidence on Mpox severity and mortality in the DRC from 1970 to 2024. We searched PubMed, ScienceDirect, Scopus, Web of Science. Random-effects models addressed high heterogeneity, and subgroup analyses examined temporal trends, regional differences, and healthcare settings. Meta-regression explored sources of heterogeneity for both severity and case fatality rate, adjusting for study year, region, and setting. Results We included a total of 19 study reports. The pooled severity rate among 3,280 confirmed cases was 39.47% (95% confidence interval [CI] 29.11–50.86). Case fatality rates (CFRs) were 1.70% (95% CI 0.72–3.95) among 3152 suspected cases and 2.46% (95% CI 0.65–8.85) for 2239 confirmed cases. Meta-regression revealed that study year, region and setting were significant sources of heterogeneity of case fatality rates among confirmed mpox cases. Conclusion Mpox continues to impose a substantial burden in the DRC, with a high severity and moderate mortality rates. Targeted interventions, including vaccination in high-risk areas, community education, and healthcare system strengthening are warranted.
SN  - 1110-0591
SN  - 2522-8307
ER  -