Evidence map›Paper›PMID 38401556›Full record

SynthesisThe Lancet. Global health2024

Paediatric, maternal, and congenital mpox: a systematic review and meta-analysis.

Nuria Sanchez Clemente, Charlotte Coles, Enny S Paixao, Elizabeth B Brickley, Elizabeth Whittaker, Tobias Alfven, Stephen Rulisa, Nelson Agudelo Higuita, Paul Torpiano, Priyesh Agravat and 4 more

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06844487 (Phase 3, Randomised Maternal and Infant), which is not on this map. Cited by 34 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 3 pooled it
17.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06844487 phase3active not recruitingnot on this mapstarted 2025, after this paper: background citation

Phase 3, Randomised Maternal and Infant (From 4 to 24 Months of Age) Safety and Immunogenicity Trial of MVA-BN® Vaccine in the Democratic Republic of the Congo

TypeinterventionalSponsorJean-Pierre Van geertruydenRan2025 to 2027Enrolled344ConditionsMpox (Monkeypox), Vaccination, Immunogenicity, SafetyArmsMVA-BN standard regimen, MVA-BN half-dose regimen
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Community transmission of mpox clade Ib not driven through sexual exposures, Uvira, eastern Democratic Republic of the Congo, June to October 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
  15. Review
  16. From neglected to notoriety: a review of Mpox clinical features, virology, epidemiology, treatment and prevention strategies.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Review
  17. Review
  18. A 2-week old infant with Mpox in Uganda: a case report.Journal of medical case reports · 2025
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 4 countries.

Nuria Sanchez ClementeCentre for Neonatal and Paediatric Infection, St George's University, London, UK; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Electronic address: nsanchez@sgul.ac.uk.
Charlotte ColesCentre for Neonatal and Paediatric Infection, St George's University, London, UK.
Enny S PaixaoHealth Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Elizabeth B BrickleyHealth Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Elizabeth WhittakerPaediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK; Section of Paediatric Infectious Diseases, Imperial College London, London, UK.
Tobias AlfvenDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm, Sweden.
Stephen RulisaSchool of Medicine and Pharmacy, University of Rwanda and University Teaching Hospital of Kigali, Kigali, Rwanda.
Nelson Agudelo HiguitaDepartment of Medicine, Section of Infectious Diseases, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras.
Paul TorpianoDepartment of Paediatrics and Adolescent Health, Mater Dei Hospital, Malta.
Priyesh AgravatCentre for Neonatal and Paediatric Infection, St George's University, London, UK.
Emma V ThorleyCentre for Neonatal and Paediatric Infection, St George's University, London, UK.
Simon B DrysdaleCentre for Neonatal and Paediatric Infection, St George's University, London, UK.
Kirsty Le DoareCentre for Neonatal and Paediatric Infection, St George's University, London, UK; Centre of Excellence in Maternal Vaccination, Makerere University, John Hopkins University, Kampala, Uganda; Pathogen Immunology Group, UK Health Security Agency, Porton Down, UK.
Jean-Jacques Muyembe TamfumFaculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
St George's, University of London · GBLondon School of Hygiene & Tropical Medicine · GBMater Dei Hospital · MTUniversity of Kigali · RWUniversity of Kinshasa · CD

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundAlthough mpox has been detected in paediatric populations in central and west Africa for decades, evidence synthesis on paediatric, maternal, and congenital mpox, and the use of vaccines and therapeutics in these groups, is lacking. A systematic review is therefore indicated to set the research agenda.

methodsWe conducted a systematic review and meta-analysis, searching articles in Embase, Global Health, MEDLINE, CINAHL, Web of Science, Scopus, SciELO, and WHO databases from inception to April 17, 2023. We included studies reporting primary data on at least one case of confirmed, suspected, or probable paediatric, maternal, or congenital mpox in humans or the use of third-generation smallpox or mpox vaccines, targeted antivirals, or immune therapies in at least one case in our population of interest. We included clinical trials and observational studies in humans and excluded reviews, commentaries, and grey literature. A pooled estimate of the paediatric case fatality ratio was obtained using random-effects meta-analysis. This study is registered with PROSPERO (CRD420223336648).

findingsOf the 61 studies, 53 reported paediatric outcomes (n=2123 cases), seven reported maternal or congenital outcomes (n=32 cases), two reported vaccine safety (n=28 recipients), and three reported transmission during breastfeeding (n=4 cases). While a subset of seven observational studies (21 children and 12 pregnant individuals) reported uneventful treatment with tecovirimat, there were no randomised trials reporting safety or efficacy for any therapeutic agent. Among children, the commonest clinical features included rash (86 [100%] of 86), fever (63 [73%] of 86), and lymphadenopathy (40 [47%] of 86). Among pregnant individuals, rash was reported in 23 (100%) of 23; fever and lymphadenopathy were less common (six [26%] and three [13%] of 23, respectively). Most paediatric complications (12 [60%] of 20) arose from secondary bacterial infections. The pooled paediatric case fatality ratio was 11% (95% CI 4-20), I

interpretationOur review highlights critical knowledge gaps in the epidemiology, prevention, and treatment of mpox in children and pregnant individuals, especially those residing in endemic countries. Increased funding, international collaboration, and equitable research is needed to inform mpox control strategies tailored for at-risk communities in endemic countries.

fundingNone. TRANSLATIONS: For the French, Spanish and Portuguese translations of the abstract see Supplementary Materials section.

Indexed as

ChildChild, PreschoolFemaleHumansInfantInfant, NewbornMpox, MonkeypoxPregnancy

Identifiers

PMID38401556
PMCPMC11519316
OpenAlexW4392091497

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.