Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil

BACKGROUND: 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. METHODS: This was a single-...

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Detalles Bibliográficos
Autores principales: Silva, Mayara Secco Torres, Coutinho, Carolina, Torres, Thiago Silva, Peixoto, Eduardo, Ismério, Ronaldo, Lessa, Flavia, Nunes, Estevão Portela, Hoagland, Brenda, Echeverria Guevara, Amanda Dolores, Bastos, Matheus Oliveira, Ferreira Tavares, Isabel Cristina, Diniz Ribeiro, Maria Pia, Meneguetti Seravalli Ramos, Maria Roberta, Andrade, Hugo Boechat, Lovetro Santana, Ana Paula, Santini-Oliveira, Marilia, Santos Netto, Juliana Barbosa, Reges, Paula, Magalhães, Monica Avelar, Silva Rosadas, Leonardo Azevedo, Nazer, Sandro, Velasque, Luciane, Cardoso, Sandra Wagner, da Silva, Edson Elias, Veloso, Valdilea Gonçalves, Wakimoto, Mayumi Duarte, Grinsztejn, Beatriz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Articles
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904017/
https://www.ncbi.nlm.nih.gov/pubmed/36776570
http://dx.doi.org/10.1016/j.lana.2022.100406
Descripción
Sumario:BACKGROUND: 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. METHODS: 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. FINDINGS: 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). INTERPRETATION: 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. FUNDING: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

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