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spelling Silva, Mayara Secco TorresCoutinho, CarolinaTorres, Thiago SilvaPeixoto, EduardoIsmério, RonaldoLessa, FlaviaNunes, Estevão PortelaHoagland, BrendaEcheverria Guevara, Amanda DoloresBastos, Matheus OliveiraTavares, Isabel Cristina FerreiraRibeiro, Maria Pia DinizRamos, Maria Roberta Meneguetti SeravalliAndrade, Hugo BoechatSantana, Ana Paula LovetroSantini-Oliveira, MariliaSantos Netto, Juliana BarbosaReges, PaulaMagalhães, Monica AvelarRosadas, Leonardo Azevedo SilvaNazer, SandroVelasque, LucianeCardoso, Sandra WagnerSilva, Edson Elias daVeloso, Valdiléa G.Wakimoto, Mayumi DuarteGrinsztejn, Beatriz2023-07-06T14:52:58Z2023-07-06T14:52:58Z2023SILVA, Mayara Secco Torres et al. Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil. The Lancet Regional Health, v. 17, p. 1-15, 2023.2667-193Xhttps://www.arca.fiocruz.br/handle/icict/5944010.1016/j.lana.2022.100406engElsevierAmbulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática e Estatística. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities.MpoxOutbreaksSTIHIVPre-exposure prophylaxis (PrEP)Men who have sex with menLatin AmericaBrazilPublic healthinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/59440/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALva_Silva_Mayara Secco Torres_etal_ICICT_2023.pdfva_Silva_Mayara Secco Torres_etal_ICICT_2023.pdfapplication/pdf2027576https://www.arca.fiocruz.br/bitstream/icict/59440/2/va_Silva_Mayara%20Secco%20Torres_etal_ICICT_2023.pdf0f5e4cbd92862dc54555ce9bc999ad94MD52icict/594402023-10-27 14:19:12.904oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-10-27T17:19:12Repositório Institucional da FIOCRUZ (ARCA) - 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dc.title.en_US.fl_str_mv Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
title Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
spellingShingle Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
Silva, Mayara Secco Torres
Mpox
Outbreaks
STI
HIV
Pre-exposure prophylaxis (PrEP)
Men who have sex with men
Latin America
Brazil
Public health
title_short Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
title_full Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
title_fullStr Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
title_full_unstemmed Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
title_sort Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil
author Silva, Mayara Secco Torres
author_facet Silva, Mayara Secco Torres
Coutinho, Carolina
Torres, Thiago Silva
Peixoto, Eduardo
Ismério, Ronaldo
Lessa, Flavia
Nunes, Estevão Portela
Hoagland, Brenda
Echeverria Guevara, Amanda Dolores
Bastos, Matheus Oliveira
Tavares, Isabel Cristina Ferreira
Ribeiro, Maria Pia Diniz
Ramos, Maria Roberta Meneguetti Seravalli
Andrade, Hugo Boechat
Santana, Ana Paula Lovetro
Santini-Oliveira, Marilia
Santos Netto, Juliana Barbosa
Reges, Paula
Magalhães, Monica Avelar
Rosadas, Leonardo Azevedo Silva
Nazer, Sandro
Velasque, Luciane
Cardoso, Sandra Wagner
Silva, Edson Elias da
Veloso, Valdiléa G.
Wakimoto, Mayumi Duarte
Grinsztejn, Beatriz
author_role author
author2 Coutinho, Carolina
Torres, Thiago Silva
Peixoto, Eduardo
Ismério, Ronaldo
Lessa, Flavia
Nunes, Estevão Portela
Hoagland, Brenda
Echeverria Guevara, Amanda Dolores
Bastos, Matheus Oliveira
Tavares, Isabel Cristina Ferreira
Ribeiro, Maria Pia Diniz
Ramos, Maria Roberta Meneguetti Seravalli
Andrade, Hugo Boechat
Santana, Ana Paula Lovetro
Santini-Oliveira, Marilia
Santos Netto, Juliana Barbosa
Reges, Paula
Magalhães, Monica Avelar
Rosadas, Leonardo Azevedo Silva
Nazer, Sandro
Velasque, Luciane
Cardoso, Sandra Wagner
Silva, Edson Elias da
Veloso, Valdiléa G.
Wakimoto, Mayumi Duarte
Grinsztejn, Beatriz
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Silva, Mayara Secco Torres
Coutinho, Carolina
Torres, Thiago Silva
Peixoto, Eduardo
Ismério, Ronaldo
Lessa, Flavia
Nunes, Estevão Portela
Hoagland, Brenda
Echeverria Guevara, Amanda Dolores
Bastos, Matheus Oliveira
Tavares, Isabel Cristina Ferreira
Ribeiro, Maria Pia Diniz
Ramos, Maria Roberta Meneguetti Seravalli
Andrade, Hugo Boechat
Santana, Ana Paula Lovetro
Santini-Oliveira, Marilia
Santos Netto, Juliana Barbosa
Reges, Paula
Magalhães, Monica Avelar
Rosadas, Leonardo Azevedo Silva
Nazer, Sandro
Velasque, Luciane
Cardoso, Sandra Wagner
Silva, Edson Elias da
Veloso, Valdiléa G.
Wakimoto, Mayumi Duarte
Grinsztejn, Beatriz
dc.subject.en.en_US.fl_str_mv Mpox
Outbreaks
STI
HIV
Pre-exposure prophylaxis (PrEP)
Men who have sex with men
Latin America
Brazil
Public health
topic Mpox
Outbreaks
STI
HIV
Pre-exposure prophylaxis (PrEP)
Men who have sex with men
Latin America
Brazil
Public health
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-07-06T14:52:58Z
dc.date.available.fl_str_mv 2023-07-06T14:52:58Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv SILVA, Mayara Secco Torres et al. Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil. The Lancet Regional Health, v. 17, p. 1-15, 2023.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/59440
dc.identifier.issn.en_US.fl_str_mv 2667-193X
dc.identifier.doi.none.fl_str_mv 10.1016/j.lana.2022.100406
identifier_str_mv SILVA, Mayara Secco Torres et al. Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil. The Lancet Regional Health, v. 17, p. 1-15, 2023.
2667-193X
10.1016/j.lana.2022.100406
url https://www.arca.fiocruz.br/handle/icict/59440
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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https://www.arca.fiocruz.br/bitstream/icict/59440/2/va_Silva_Mayara%20Secco%20Torres_etal_ICICT_2023.pdf
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