EPIDEMIOLOGICAL SITUATION OF MPOX IN THE DRC
As of 1 October 2024 (Epidemiological Week 40), mpox transmission remains significant across 23 of the country's 26 provinces, which have reported at least one confirmed case, according to the Ministry of Public Health. Since the start of the year, DRC has recorded 31,350 suspected cases, 5,629 confirmed cases and 992 deaths. The case fatality rate stands at 3.1 per cent. Laboratory testing continues to be challenging due to delays in case confirmation and insufficient test kits in some zones. The testing rate stands at 37.6 per cent (11,784 samples analysed out of 31,350 notified cases) and the positivity rate stands at 47.8 per cent (5,629 positive samples out of 11,784 samples analysed). The five provinces with the highest number of suspected cases over the past four weeks are: South Kivu, Equateur, Sankuru,
Tshopo, and South -Ubangi.
Children who are already vulnerable, including children living in the streets or children in temporary care, face extra risks if they or family members or caregivers are affected by mpox. Disadvantaged children may face delays in getting treatment or they may be hospitalized alongside adults. Those suffering from malnutrition or have undiagnosed or undertreated HIV may suffer more sever mpox outcomes.
In DRC's eastern provinces, case numbers are trending upward, and new chains of transmission are appearing. South Kivu remains the province most affected, with 32 of 34 health zones affected. The case fatality rate has increased from August 30th to September 30th, from 1.8 to in 2.6 per cent in South Kivu, and from 0 and 2.5 per cent in North Kivu. This rising case fatality rate in North Kivu can be attributed to several risk factors, including a concentration of displaced people in overcrowded sites with grossly inadequate WASH infrastructure in addition to extensive movement of people and trade with South Kivu across the border with neighbouring countries also affected by mpox.
New hotspots are also appearing elsewhere, for example in hard-to-reach areas in Haut Uele, Ituri and Tanganyika provinces.
In Sankuru province, new mpox cases are quite localized and are affecting children and young adults the most. This trend could be attributed to the fact that Sankuru province is landlocked and densely populated. The on-going rapid qualitative assessment with remote support from the research team seeks to provide a better understanding of the trends in the province. Also, in Sankuru, the fatality rate varies but and increases if people are malnourished people or there are complications such as bacterial superinfections.
Tshopo province has the fifth highest number of cases and the highest number of deaths due to mpox in DRC. All 23 health zones in the province have reported at least one suspected case of mpox, and 20 of the 23 health zones at least one confirmed case. The most affected health zones are Yahuma, Yalimbogo, Yakusu, Makiso Kisangani and Basoko. Since the beginning of 2024, Tshopo has reported 1,620 cases, including 79 deaths, with a case fatality rate of 4.9 per cent. Out of 380 samples taken, 242 were positive and eight undetermined, (63.6 per cent positivity rate). As a result of combined efforts of multiple partners, nine mpox treatment centres are now operational in Tshopo.
UNICEF'S RESPONSE
UNICEF aims to contribute to the reduction of morbidity and mortality attributable to mpox in affected communities across 12 priority provinces (Equator, South Kivu, Sankuru, Tshuapa, Tshopo, Kinshasa, South Ubangi, North Kivu, Mongala, Mai-Ndombe, Maniema, and Kwango), with a focus on children under 15.
UNICEF's response is fully aligned with the DRC Government's National Preparedness and Response Plan which is to be implemented in close partnership with relevant authorities and partners. UNICEF's interventions focus on i) prevention through informative and preventive messages regarding mpox and health services; infection prevention and control measures including water, sanitation, and hygiene services; supporting vaccination services while ensuring that communities, particularly children, are at the center of response interventions, ii) case management through facilitating immediate access to essential services including primary health care and nutritional support; mental health and psychosocial support; and iii) support to research contributing to health information management system (quality and quantity) and prevention of risks of sexual exploitation and abuse related to the presence of humanitarian workers in the mpox response. This approach is designed to ensure that the preventive measures put in place effectively contribute to stopping the spread of mpox, while also building resilience within the community to improve the response to future crises in the affected provinces. The response specifically targets 56 Category A health zones (i.e., health zones that have reported at least one suspected case successively and/or one confirmed case in the last three weeks).