Containment and response strategies for mpox outbreaks: a systematic review
摘要
Mpox, primarily endemic to Central and West Africa, has seen a concerning global rise in recent years. There is a critical need to synthesize evidence on successful strategies that have been used to contain and respond to mpox globally to inform policy and best practices.
MethodsA systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Four databases were searched for publications between 2017 to August 2024. Articles were included if they reported on mpox response and containment strategies.
ResultsA total of 72 studies were included in this systematic review. During mpox outbreaks, screening was primarily conducted at sexual health clinics, including Sexually Transmitted Infections and PrEP (Pre-exposure prophylaxis) clinics. PCR (Polymerase chain reaction) testing was the most commonly reported diagnostic method. Three treatment options were identified: Tecovirimat, Vaccinia Immune Globulin, and Cidofovir. Additionally, vaccines were classified into two main categories: (i) JYNNEOS (also known as MVA-BN and IMVANEX) and (ii) ACAM2000. Studies highlighted several challenges associated with isolation measures, including difficulties in maintaining consistent follow-up, ensuring patient compliance, and managing large-scale isolation logistics. Surveillance strategies emphasized effective data collection, case investigations, and public health coordination to strengthen outbreak response. Pre-emergency preparedness efforts focused on international collaboration, the development of distribution networks, models of care for Mpox treatment, and the analysis of past outbreaks to improve future response strategies.
ConclusionThis review synthesized strategies for mpox outbreak response and containment, highlighting the need to expand vaccine access beyond GBMSM/LGBTQIA + populations, integrate screening into routine sexual health services, adopt alternative delivery and diagnostic approaches, strengthen surveillance and pre-emergency preparedness, and promote context-specific research in low- and middle-income countries to inform evidence-based policy and practice.