Risk profile and mode of transmission of Mpox: a rapid review and individual patient data meta-analysis of case studies

Since May 2022, an outbreak of monkeypox in non-endemic countries has become a potential public health threat. The objective of this rapid review was to examine the risk profile and modes of transmission of monkeypox. PubMed, Web of Science, and Scopus were searched from inception through July 30 to collect case reports/series on patients with monkeypox infection. For meta-analysis, data on the total number of participants and deaths by binary categories of exposure (age, sex, country, other co-infections or existing conditions, and mode of contagion) were used. A total of 62 studies (4659 cases) were included. Most cases came from Africa (84.3%), followed by Europe (13.9%). In 63.6% of the cases, the mode of contagion was human contact, while 22.8% of the cases were by animal contact, and 13.5% were unknown or not reported. The mortality rate was 6.5% throughout these studies. The risk of mortality was higher in the younger age group (risk difference: 0.19; 95% CI: 0.02–0.36), in cases with other co-infections or current chronic conditions (risk difference: 0.03; 95% CI: 0.01–0.05) and in the category of low- and middle-income countries (risk difference: 0.06; 95% CI: 0.05–0.08). There were no significant differences with respect to sex or mode of contagion. These results help to understand the major infection pathways and mortality risk profiles of monkeypox and underscores the importance of preventing outbreaks in specific settings, especially in settings densely populated by children, such as day care centres and schools