Background: The mpox (formerly monkeypox) outbreak was declared a public health emergency of international concern on July 23, 2022, by the World Health Organization after outbreaks were identified in several non-endemic countries. Mpox virus is an orthopoxvirus that causes mild to severe disease in humans, including a pox rash and lymphadenopathy that can cause severe pain and discomfort. During the outbreak, there was an urgent need to have up-to-date evidence on mpox to inform public health decision-making.
Objectives: Develop and maintain a living evidence profile (LEP) on mpox literature during the 2022 outbreak.
Methods: A LEP was prioritized to systematically identify, classify, and synthesize new literature to provide updated evidence on epidemiological parameters including transmissibility, clinical outcomes, and protective immunity on mpox. A comprehensive search in Pubmed, Scopus, Europe PubMed Central (PMC), and grey literature sources was conducted twice weekly. Primary evidence on mpox from January 2022 onward was included. Study selection and data extraction were conducted by one reviewer and spot checked by a senior reviewer. Results were synthesized descriptively, and a confidence level was reported for each outcome. Case reports without new information and historical evidence were included in an accessible dataset, but not the LEP.
Results: The LEP framework was established based on principles of risk assessment, epidemiological parameters for infectious disease modelling, and consultation with experts. Between June 1 and December 15, 2022, a continuous cycle of literature searches and data extraction were fed into 23 weekly LEPs that were disseminated to global health organizations. As of December 15, 2022, there were 2287 articles on mpox; 687 were primary research studies or surveillance reports on the 2022 outbreak, and 496 were included in the profile. The presentation will highlight key features of the mpox LEP, which mapped evidence to 33 different outcomes and topic areas.
Conclusions: This new evidence synthesis framework employed during the 2022 mpox outbreak describes a way to systematically identify and organize emerging evidence to inform what is known and highlight knowledge gaps for decision-making during a public health emergency. Patient involvement: The LEP contributes to methods that result in comprehensive up-to-date evidence for patients.