Published in the Lancet Global Health, the review, conducted by a team including several researchers from LSHTM, examined the current evidence around mpox cases in children and pregnant women in both endemic and non-endemic countries. 

The findings highlight the devastating impacts of mpox infection on children and pregnant women in these regions and lays bare the existing critical knowledge gaps surrounding mpox infections among these vulnerable populations. The review found some initial limited evidence of antiviral, immunological treatment and third generation vaccine use in childhood and pregnancy based on a small number of studies conducted in the US and UK.

The review examined the largest collection of paediatric and maternal mpox cases to date from 61 studies across 16 countries including 2,123 paediatric cases and 32 maternal cases, focusing particularly on Central and West Africa where mpox is endemic. Thanks to its scope, the review aims to guide and shape the research agenda in an equitable way by raising awareness of the needs of at-risk populations in endemic countries in which public health funding and preventative resources for local communities are limited.

Dr Nuria Sanchez, lead author and Assistant Professor in Infectious Disease Epidemiology at LSHTM said:

“There has been a renewed interest in mpox, fuelled by recent outbreaks in high-income countries. However, as case numbers in Europe and North America decline, it is important to remember the potentially serious effects of mpox infection in children and pregnant women in endemic countries where the virus continues to circulate today.”

There are widespread concerns among public health professionals about the impacts of climate change, human migration and increasing human-animal interactions due to habitat encroachment on infectious disease outbreaks like mpox. Coupled with the current lack of effective treatments and preventative measures in these countries, there is a risk of increased mpox cases in endemic countries. 

As such, the authors call for scaled up funding for mpox surveillance systems and free mpox testing by governments. Finally, in terms of setting the future research agenda, the researchers hope that their review emphasises that clinical trials for mpox must include adults, children and pregnant women from endemic countries to ensure treatments are safe for the most at-risk global populations. 

Read the full paper here: Paediatric, maternal, and congenital mpox: a systematic review and meta-analysis