Estimating the burden of mpox among MSM in South Africa

This article has been Reviewed by the following groups

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Despite seeing few cases during the 2022-23 mpox global outbreak, recent reports of 22 cases among men-who-have-sex-with-men (MSM) in South Africa, including three deaths, have raised concerns about underreported community transmission. We used a Monte Carlo simulation model to estimate the true epidemic size, considering increased severity of mpox among MSM living with advanced HIV (MSMLAHIV), documented overrepresentation of people living with HIV (PLHIV) among mpox cases, and HIV prevalence in South Africa. We estimate there have been between 220-450 cases among MSM LHIV in South Africa, implying a total of 290-560 cases among all MSM. We provide an upper bound of 750-1,600 cases as a sensitivity analysis where the prevalence of HIV among mpox patients is the same as population prevalence among MSM in South Africa. Estimates in both scenarios suggest a substantial number of undetected cases, with case ascertainment rates estimated between 1% and 8%. Our findings underscore the need for enhanced surveillance, targeted public health interventions, and awareness campaigns to mitigate the outbreak’s impact at a population-level.

Article activity feed

  1. Jing Huang

    Review 2: "Estimating the Burden of Mpox Among MSM in South Africa"

    While the reviewers commend the study’s rigorous approach and use of local and global data, they recommend clarifying data sources and assumptions, particularly regarding case fatality rates, advanced HIV estimates, and vaccination impacts. 

  2. Sungmok Jung

    Review 1: "Estimating the Burden of Mpox Among MSM in South Africa"

    While the reviewers commend the study’s rigorous approach and use of local and global data, they recommend clarifying data sources and assumptions, particularly regarding case fatality rates, advanced HIV estimates, and vaccination impacts.