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. 2023 Jan 20:68:1605426.
doi: 10.3389/ijph.2023.1605426. eCollection 2023.

Global Epidemiological Features of Human Monkeypox Cases and Their Associations With Social-Economic Level and International Travel Arrivals: A Systematic Review and Ecological Study

Min Du  1 , Huimin Sun  1 , Shimo Zhang  1 , Jie Yuan  1 , Wenxing Yan  1 , Qiao Liu  1 , Chenyuan Qin  1 , Min Liu  1   2 , Jue Liu  1   2   3
Affiliations

Global Epidemiological Features of Human Monkeypox Cases and Their Associations With Social-Economic Level and International Travel Arrivals: A Systematic Review and Ecological Study

Min Du et al. Int J Public Health. .

Abstract

Objectives: We aimed to evaluate global epidemiological features of human monkeypox (mpox) cases and their associations with social-economic level and international travel arrivals. Methods: We estimated the pooled value by random-effects models. Then, we conducted an ecological study to evaluate the relationship of confirmed cases with social-economic indices and international travel arrivals using correlation analyses. Results: The average age (2022: 35.52, 95% CI [28.09, 42.94] vs. before 2022: 18.38, 95% CI [14.74, 22.02]) and comorbidity rate (2022: 15.7%, 95% CI [8.9%, 22.4%] vs. before 2022: 14.9%, 95% CI [8.5%, 21.3%]) of mpox cases in the 2022 human mpox outbreak were significantly higher than those of cases before 2022. During the 2022 mpox outbreak, the proportion of men who have sex with men (MSM) was high (79.8%, 95% CI [65.5%, 94.2%]). The number of confirmed mpox cases in 2022 significantly correlated with high social-economic levels and international travel arrivals (all p < 0.05). Conclusion: Our findings highlighted the importance of early surveillance and timely detection in high-risk populations, including older people, MSM, and travelers, which is crucial to curb the wide transmission of mpox.

Keywords: disparities; epidemiology; mpox; systematic review; travel.

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Conflict of interest statement

The authors declare that they do not have any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the selection process. Global epidemiological features of human monkeypox cases and their associations with social-economic level and international travel arrivals: a systematic review and ecological study (Global. 2022).
FIGURE 2
FIGURE 2
Mpox confirmed cases at the country and territorial levels. Global epidemiological features of human monkeypox cases and their associations with social-economic level and international travel arrivals: a systematic review and ecological study (Global. 2022). Confirmed mpox cases were reported by the WHO and CDC on 27 June 2022. The size of the circles increased with the population. The ρ indices and p values were derived from Pearson correlation analysis. (A) correlation between confirmed mpox cases and HAQ by WHO region; (B) correlation between confirmed mpox cases and HAQ by income level; (C) correlation between confirmed mpox cases and HDI by WHO region; (D) correlation between confirmed mpox cases and HDI by income level; (E) correlation between confirmed mpox cases and SDI by WHO region; (F) correlation between confirmed mpox cases and SDI at income level. CDC, center for disease control and prevention; HAQ, healthcare access and quality index; HDI, human development index; SDI, sociodemographic index; WHO, World Health Organization.
FIGURE 3
FIGURE 3
Mpox confirmed cases at the country and territorial levels. Global epidemiological features of human monkeypox cases and their associations with social-economic level and international travel arrivals: a systematic review and ecological study (Global. 2022). Confirmed mpox cases were reported by the WHO and CDC on 27 June 2022. The size of the circles increased with the population. The ρ indices and p values were derived from Pearson correlation analysis. (A) correlation between confirmed mpox cases and international travel arrivals by WHO region; (B) correlation between confirmed mpox cases and international travel arrivals by income level. CDC, center for disease control and prevention; WHO, World Health Organization.
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