Periodic Reporting for period 1 - MPOX-PROBE (Strengthening epidemiological, genomic and community surveillance of Mpox virus (MPXV) at the Congo River border for DRC and RoC)
Periodo di rendicontazione: 2024-10-01 al 2025-09-30
The Democratic Republic of Congo (DRC) and the Republic of Congo (RoC) experience frequent viral outbreaks, including the ongoing Mpox (MPXV) epidemic. The two countries share the Congo River as a long border, with significant exchanges (human, animal, etc.) and intense cross-river movement of people, animals, and goods, making coordinated surveillance essential. Despite the high epidemiological burden, significant knowledge gaps persist regarding MPXV reservoirs, environmental circulation, human behavioral drivers, and the comparative dynamics of Clade I and II transmission. The MPOX-PROBE project adopts a One Health approach, that integrates epidemiology, environmental surveillance, genomic sequencing, socio-behavioral sciences, and mathematical modelling to identify transmission routes, supporting public health initiatives.
Key objectives are:
(1) improving Mpox epidemiological surveillance through new diagnostics and sampling in high-risk areas;
(2) strengthening diagnostic and research capacities;
(3) Understanding community knowledge, attitudes, perceptions, and practices (KAP) related to Mpox, including among healthcare workers and exposed populations;
(4) analyze the spatial and temporal trends of Mpox epidemics.
Key objectives are:
(1) improving Mpox epidemiological surveillance through new diagnostics and sampling in high-risk areas;
(2) strengthening diagnostic and research capacities;
(3) Understanding community knowledge, attitudes, perceptions, and practices (KAP) related to Mpox, including among healthcare workers and exposed populations;
(4) analyze the spatial and temporal trends of Mpox epidemics.
The study investigates MPXV transmission and reservoirs by analyzing human, animal, and environmental samples. It also explores community knowledge and behaviors through questionnaires and focus groups. Conducted in Maï-Ndombe (DRC), Mossaka, and Impfondo (RoC), it includes individuals with MPXV symptoms and their contacts, including vulnerable groups, health workers, and community leaders. Samples from animals, air and wastewaters are collected to trace MPXV spread. Human blood and saliva are analyzing via RT-PCR and immunological assays. Metagenomics identifies MPXV clades and mutations. Environmental monitoring includes wastewater, air particles from hospitals and homes, and surface samples from hospital benches.
More than 250 human blood samples were collected from suspected individuals in DRC and RoC, 95 animal samples (across six species mainly bats and squirrels), 75 wastewater samples and 18 air samples. RT-PCR testing of human samples identified 54 positives, while air samples yielded 9 positives (50% positivity), indicating environmental contamination. Analyses of wastewater samples and further metagenomic sequencing are ongoing to determine clade identity.
For the KAP studies, 2,366 quantitative respondents and 50 qualitative participants across Brazzaville, Plateaux, Cuvette, Likouala and additional 63 participants in Mbomo responded to the KAP questionnaires in the Republic of the Congo. The KAP studies were conducted in 3 health zones of Maï-Ndombe where more than 300 community members and 46 key informants participated. In DRC, insights reveal major knowledge gaps, strong cultural interpretations of disease, high willingness to vaccinate, and varied adoption of preventive practices. A geospatial database integrating epidemiological, environmental, climatic, and demographic data was successfully developed. Mapping of potential MPXV reservoir habitats has been completed. Early-stage mathematical and spatio-temporal models established for MPXV spread are still undergoing.
Looking at the results so far, the project is generating several novel contributions. The simultaneous collection of humans, animal, environmental, and behavioral data at shared geographic sites is unprecedented in the Congo Basin. This provides a unique foundation for cross-sectoral transmission analysis. The detection of MPXV in 50% of air samples from hospital settings represents new evidence with implications for nosocomial transmission and IPC guidelines. Large-scale KAP datasets from remote and peri-urban communities offer the most comprehensive Mpox behavioral evidence available in Central Africa, enabling culturally adapted risk communication. The modelling infrastructure enables future risk forecasting, integration of climatic trends, and simulation of cross-border transmission influenced by mobility along the Congo River. Training in RT-PCR, metagenomics, sample collection, REDCap use, and GCP/GCLP standards enhances long-term national research capacity. These innovations lay the groundwork for improved surveillance, earlier outbreak detection, and more effective public health strategies.
The results obtained from this project are expected to contribute to the gap of epidemiological data, better understanding of transmission, improved diagnostics and surveillance, adapting preventive communication messages to the target populations in DRC and RoC and strengthening public health response and research capacity.
For the KAP studies, 2,366 quantitative respondents and 50 qualitative participants across Brazzaville, Plateaux, Cuvette, Likouala and additional 63 participants in Mbomo responded to the KAP questionnaires in the Republic of the Congo. The KAP studies were conducted in 3 health zones of Maï-Ndombe where more than 300 community members and 46 key informants participated. In DRC, insights reveal major knowledge gaps, strong cultural interpretations of disease, high willingness to vaccinate, and varied adoption of preventive practices. A geospatial database integrating epidemiological, environmental, climatic, and demographic data was successfully developed. Mapping of potential MPXV reservoir habitats has been completed. Early-stage mathematical and spatio-temporal models established for MPXV spread are still undergoing.
Looking at the results so far, the project is generating several novel contributions. The simultaneous collection of humans, animal, environmental, and behavioral data at shared geographic sites is unprecedented in the Congo Basin. This provides a unique foundation for cross-sectoral transmission analysis. The detection of MPXV in 50% of air samples from hospital settings represents new evidence with implications for nosocomial transmission and IPC guidelines. Large-scale KAP datasets from remote and peri-urban communities offer the most comprehensive Mpox behavioral evidence available in Central Africa, enabling culturally adapted risk communication. The modelling infrastructure enables future risk forecasting, integration of climatic trends, and simulation of cross-border transmission influenced by mobility along the Congo River. Training in RT-PCR, metagenomics, sample collection, REDCap use, and GCP/GCLP standards enhances long-term national research capacity. These innovations lay the groundwork for improved surveillance, earlier outbreak detection, and more effective public health strategies.
The results obtained from this project are expected to contribute to the gap of epidemiological data, better understanding of transmission, improved diagnostics and surveillance, adapting preventive communication messages to the target populations in DRC and RoC and strengthening public health response and research capacity.