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Review
. 2022 Dec 6;10(12):2083.
doi: 10.3390/vaccines10122083.

Potentially Asymptomatic Infection of Monkeypox Virus: A Systematic Review and Meta-Analysis

Prakasini Satapathy  1 , Parimala Mohanty  2 , Subhanwita Manna  3 , Muhammad A Shamim  4 , Priyanka Prasad Rao  5 , Arun Kumar Aggarwal  6 , Jagdish Khubchandani  7 , Aroop Mohanty  8 , Behdin Nowrouzi-Kia  9 , Vijay Kumar Chattu  9   10   11 , Bijaya Kumar Padhi  6 , Alfonso J Rodriguez-Morales  12   13   14 , Ranjit Sah  15   16   17
Affiliations
Review

Potentially Asymptomatic Infection of Monkeypox Virus: A Systematic Review and Meta-Analysis

Prakasini Satapathy et al. Vaccines (Basel). .

Abstract

Background: Monkeypox is a global public health concern, given the recent outbreaks in non-endemic countries where little scientific evidence exists on the disease. Specifically, there is a lack of data on asymptomatic monkeypox virus infection. This study aims to evaluate the overall prevalence of asymptomatic monkeypox virus infection. Methods: In this systematic review and meta-analysis, we performed an extensive literature search in PubMed, Scopus, Web of Science, ProQuest, EMBASE, EBSCOHost, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessed all published articles till September 2022. Primary studies reporting monkeypox infections among asymptomatic participants were included after quality assessment. The characteristics of the study and information on the number of cases and symptomatic status were extracted from the included studies. The heterogeneity between studies was assessed using the I2 statistic. Publication bias was analyzed using funnel plots and Egger regression tests. The primary outcome was the pooled prevalence of asymptomatic infections within the examined population. Results: A total of 16 studies were included for qualitative synthesis, while five studies, including 645 individuals, were included for quantitative synthesis. There was substantial heterogeneity between studies (I2 = 94.86%; p < 0.01), with a pooled percentage of asymptomatic infections in the studied population of 10.2% (95%CI, 2.5−17.9%). Conclusion: This meta-analysis suggests that many people infected with the monkeypox virus are asymptomatic and difficult to detect. Therefore, prompt detection of these cases of monkeypox virus and appropriate subsequent management is of utmost importance to global public health.

Keywords: asymptomatic; infection; meta-analysis; monkeypox; transmission.

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Conflict of interest statement

None of the authors has declared any competing interest.

Figures

Figure 1
Figure 1
PRISMA flowchart for included studies in systematic review and meta-analysis of asymptomatic infection and transmission of monkeypox virus.
Figure 2
Figure 2
Pooled prevalence forest plot of asymptomatic monkeypox [11,12,13,14].
Figure 3
Figure 3
Bubble plot based on the percentage of asymptomatic monkeypox cases.
See this image and copyright information in PMC

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