Epidemiological characteristics and transmission dynamics of mpox in Bujumbura, Burundi, 2024

In Africa, the transmission of Monkeypox (mpox), especially in countries that were initially unaffected, including Burundi, is still inefficiently reported. This study has analyzed various demographics and cases, alongside the transmission pathways and risk factors to apprise effective, setting-specific control strategies for mitigation of mpox outbreaks while also guiding prospective responses to similar outbreaks in resource-restricted contexts.

To effectively characterize the transmission patterns of clade Ib monkeypox virus, the study evaluated the laboratory-confirmed mpox cases in Bujumbura, Burundi, alongside their contacts, as from 25th July 2024-26 th October 2024. Collection of data was mainly done via patient interviews, national surveillance data, and electronic health records.

A total of 850 laboratory-confirmed mpox cases alongside 7773 acknowledged contacts were included in the study. The average age of the patients was 20.3 (interquartile range: 22.0; range: 3 months-71 years), while a larger proportion of the patients (71.9%) comprised children aged < 5 years and younger adults aged between 16 years and 29 years. Sexual contact (58.6%) and household exposure (38.6%) were found to be the primary transmission routes. The basic reproduction number was 1.21 (95% CI (confidence interval): 1.11-1.31), with 14.0% secondary attack rates (95% CI: 12.1-15.9) among sexual contacts, as well as 13.0% (95% CI: 11.2-14.8) among household contacts. The average incubation period was found to be 9.5 days (95% CI: 7.5-11.4), while the serial interval was 15.5 days (95% CI: 12.4-18.7).

To effectively control and manage mpox outbreak in resource-restricted contexts, the study findings have stressed on the requirement for targeted interventions to tackle sexual contact networks alongside household transmissions.