Syndemic Challenges: Addressing the Resurgence of Mpox Amidst Concurrent Outbreaks in the DRC

Abstract

The Democratic Republic of Congo (DRC) faces a syndemic of infectious diseases, including monkeypox (mpox), cholera, measles, anthrax, and plague, worsening public health challenges and socioeconomic disparities. This review synthesizes and discusses epidemiological data and consequences of simultaneous outbreaks in the DRC between January 2023 and March 2024. The findings highlight a 6.7% fatality rate and 3319 confirmed cases of mpox, with significant outbreaks in Kinshasa and 22 other provinces. Anthrax occasionally surfaced among cattle-raising villages, measles affected fewer than five children susceptible to the disease, and cholera outbreaks persisted in North Kivu, South Kivu, and Tanganyika. Plague incidences, mostly bubonic, have been reported in Ituri province. Vulnerable groups, including children, mothers, the elderly, and those with compromised immune systems, face increased risks due to poor healthcare access, hunger, and underlying medical conditions. Cultural beliefs, healthcare system issues, and socioeconomic instability impede effective response tactics. This strain on the fragile healthcare system highlights the need for increased surveillance, immunization efforts, and community involvement. To mitigate the effects of syndemic outbreaks, strengthening the DRC's health systems through international cooperation, integrated public health initiatives, and improved access to healthcare is crucial.

Keywords: Democratic Republic of Congo; anthrax; cholera; epidemiology; measles; monkeypox; mpox; plague; syndemic.

Figure 1

Comparison of mpox case fatality rates over different periods. DRC, Democratic Republic of Congo; mpox, monkeypox.

Figure 2

Trends in mpox cases and deaths over time. DRC, Democratic Republic of Congo; mpox, monkeypox.