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Assessment of mpox severity and associated factors in Uganda, November 2024-February 2025
Emmanuel Mfitundinda1, Richard Migisha1, Joyce Owens Kobusingye1
1Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda.
Objective:
In this study, we characterized the clinical severity of laboratory-confirmed mpox case-patients admitted in Mpox isolation and treatment units (MTUs) and identified factors associated with severity in Uganda from November 2024 to February 2025.
Methods:
We used the mpox severity scoring system (MPSSS) tool to assess severity, a 7-parameter tool with each question assigned scores of 0-4 and summed up with totals ranging from 1 to 23. Total scores ≥10 indicated "severe disease." We fitted modified Poisson regression to identify factors associated with severe disease.
Results:
Among the 244 case-patients, 128 (52%) were male, and the median age was 29 years. In total, 148 (61%) presented with severe disease, and 74 (30%) had underlying conditions; 65 (88%) had HIV. Among those with HIV, 58 (89%) had severe disease compared to 73 (47%) without HIV (adjusted prevalence ratio = 2.3, 95% CI = 1.6-3.3) after adjusting for age and pregnancy.
Conclusion:
The majority of mpox case-patients and nearly all with HIV admitted to MTUs had severe mpox disease. Case-patients with underlying conditions, especially, HIV, could be considered for inpatient care and mpox vaccination to optimize their care and protect them from severe disease.
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