Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo.
Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility...
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ftdoajarticles:oai:doaj.org/article:7b2cce809c7a41518c2ed8cb3ffee412 2023-05-15T15:15:17+02:00 Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. Lynda Osadebe Christine M Hughes Robert Shongo Lushima Joelle Kabamba Beatrice Nguete Jean Malekani Elisabeth Pukuta Stomy Karhemere Jean-Jacques Muyembe Tamfum Emile Wemakoy Okitolonda Mary G Reynolds Andrea M McCollum 2017-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005857 https://doaj.org/article/7b2cce809c7a41518c2ed8cb3ffee412 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5593177?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005857 https://doaj.org/article/7b2cce809c7a41518c2ed8cb3ffee412 PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005857 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005857 2022-12-31T14:52:19Z Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility of two surveillance case definitions for MPX and specific clinical characteristics associated with laboratory-confirmed MPX cases.Data from a cohort of suspect MPX cases (identified by surveillance over the course of a 42 month period during 2009-2014) from DRC were used; real-time PCR diagnostic test results were used to establish MPX and VZV diagnoses. A total of 333 laboratory-confirmed MPX cases, 383 laboratory-confirmed VZV cases, and 36 cases that were determined to not be either MPX or VZV were included in the analyses. Significant (p<0.05) differences between laboratory-confirmed MPX and VZV cases were noted for several signs/symptoms including key rash characteristics. Both surveillance case definitions had high sensitivity and low specificities for individuals that had suspected MPX virus infections. Using 12 signs/symptoms with high sensitivity and/or specificity values, a receiver operator characteristic analysis showed that models for MPX cases that had the presence of 'fever before rash' plus at least 7 or 8 of the 12 signs/symptoms demonstrated a more balanced performance between sensitivity and specificity.Laboratory-confirmed MPX and VZV cases presented with many of the same signs and symptoms, and the analysis here emphasized the utility of including 12 specific signs/symptoms when investigating MPX cases. In order to document and detect endemic human MPX cases, a surveillance case definition with more specificity is needed for accurate case detection. In the absence of a more specific case definition, continued emphasis on confirmatory laboratory-based diagnostics is warranted. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 9 e0005857 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Lynda Osadebe Christine M Hughes Robert Shongo Lushima Joelle Kabamba Beatrice Nguete Jean Malekani Elisabeth Pukuta Stomy Karhemere Jean-Jacques Muyembe Tamfum Emile Wemakoy Okitolonda Mary G Reynolds Andrea M McCollum Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility of two surveillance case definitions for MPX and specific clinical characteristics associated with laboratory-confirmed MPX cases.Data from a cohort of suspect MPX cases (identified by surveillance over the course of a 42 month period during 2009-2014) from DRC were used; real-time PCR diagnostic test results were used to establish MPX and VZV diagnoses. A total of 333 laboratory-confirmed MPX cases, 383 laboratory-confirmed VZV cases, and 36 cases that were determined to not be either MPX or VZV were included in the analyses. Significant (p<0.05) differences between laboratory-confirmed MPX and VZV cases were noted for several signs/symptoms including key rash characteristics. Both surveillance case definitions had high sensitivity and low specificities for individuals that had suspected MPX virus infections. Using 12 signs/symptoms with high sensitivity and/or specificity values, a receiver operator characteristic analysis showed that models for MPX cases that had the presence of 'fever before rash' plus at least 7 or 8 of the 12 signs/symptoms demonstrated a more balanced performance between sensitivity and specificity.Laboratory-confirmed MPX and VZV cases presented with many of the same signs and symptoms, and the analysis here emphasized the utility of including 12 specific signs/symptoms when investigating MPX cases. In order to document and detect endemic human MPX cases, a surveillance case definition with more specificity is needed for accurate case detection. In the absence of a more specific case definition, continued emphasis on confirmatory laboratory-based diagnostics is warranted. |
format |
Article in Journal/Newspaper |
author |
Lynda Osadebe Christine M Hughes Robert Shongo Lushima Joelle Kabamba Beatrice Nguete Jean Malekani Elisabeth Pukuta Stomy Karhemere Jean-Jacques Muyembe Tamfum Emile Wemakoy Okitolonda Mary G Reynolds Andrea M McCollum |
author_facet |
Lynda Osadebe Christine M Hughes Robert Shongo Lushima Joelle Kabamba Beatrice Nguete Jean Malekani Elisabeth Pukuta Stomy Karhemere Jean-Jacques Muyembe Tamfum Emile Wemakoy Okitolonda Mary G Reynolds Andrea M McCollum |
author_sort |
Lynda Osadebe |
title |
Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
title_short |
Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
title_full |
Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
title_fullStr |
Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
title_full_unstemmed |
Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo. |
title_sort |
enhancing case definitions for surveillance of human monkeypox in the democratic republic of congo. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005857 https://doaj.org/article/7b2cce809c7a41518c2ed8cb3ffee412 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005857 (2017) |
op_relation |
http://europepmc.org/articles/PMC5593177?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005857 https://doaj.org/article/7b2cce809c7a41518c2ed8cb3ffee412 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005857 |
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PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
9 |
container_start_page |
e0005857 |
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