ArticlePLoS neglected tropical diseases2024
Challenges in clinical diagnosis of Clade I Mpox: Highlighting the need for enhanced diagnostic approaches.
Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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Who cites it
12 citing papers in PubMed.
- Monkeypox Virus (MPXV) Transmission Dynamics in Neighboring Countries as a Potential Threat to Kazakhstan.Viruses · 2026Review
- Mpox coinfections and clinical manifestation in Africa: a systematic review and meta-analysis.Frontiers in systems biology · 2026Review
- A Multisectoral Study of Mpox Epidemiology, Resistance Surveillance, and Policy Gaps: Toward a One Health Framework.Clinical reviews in allergy & immunology · 2025Review
- Comparative analysis of Mpox clades: epidemiology, transmission dynamics, and detection strategies.BMC infectious diseases · 2025Review
- Clinical Characterization and Outcomes of Human Clade IIb Mpox Virus Disease: A European Multicenter Mpox Observational Cohort Study (MOSAIC).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Observational
- Mpox virus (MPXV): comprehensive analysis of pandemic risks, pathophysiology, treatments, and mRNA vaccine development.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Personalized immunization against Mpox Clades I and Ib: Strategies to combat the emerging epidemic.Infectious medicine · 2025Review
- A label-free optical biosensor-based point-of-care test for the rapid detection of Monkeypox virus.Biosensors & bioelectronics · 2025Article
- Mpox: An emerging or re-emerging infection with a potential colossal burden on healthcare globally.African journal of laboratory medicine · 2025Review
- The resurgence of monkeypox: Epidemiology, clinical features, and public health implications in the post-smallpox eradication era.New microbes and new infections · 2024Review
- A Label-free Optical Biosensor-Based Point-of-Care Test for the Rapid Detection of Monkeypox Virus.medRxiv : the preprint server for health sciences · 2024Article
- Clade Ib: a new emerging threat in the Mpox outbreak.Frontiers in pharmacology · 2024Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundDue to limited diagnostic capacity and availability of point-of-care tests, diagnosis of Clade I mpox in the geographical regions most affected is usually on clinical grounds. This may be complicated due to the similarity between mpox and varicella (chickenpox) lesions. Visual assessment of lesions is also used for determining clinical progress and to assess patient outcomes in clinical trials. However, there has been no investigation into whether clinicians can (i) identify Clade I mpox compared to other viral lesions (ii) differentiate between Clade I mpox lesion stages. METHODOLOGY/PRINCIPLE
findingsThe objective of this study was to evaluate inter-rater reliability and agreement between clinicians assessing lesions in patients with Clade I mpox. We presented experienced clinicians with 17 images of Clade I mpox or varicella and asked them to independently indicate the most likely diagnosis-mpox or varicella-and to categorise the lesions according to their stage. When selecting the most likely diagnosis, accuracy varied across all images, the inter-rater reliability was poor (κ = 0.223; z = 10.1) and agreement was moderate (Po = 68%). When categorising lesions according to their type, if a single lesion type was present in the image, inter-rater reliability was moderate (κ = 0.671, z = 40.6) and agreement was good (Po = 78%), but when multiple lesion types were shown in an image, both inter-rater reliability (κ = 0.153, z = 10.5) and agreement (Po = 29%) decreased substantially.
conclusionsThis study demonstrates that there are presently limitations in using visual assessment to diagnose Clade I mpox and evaluate lesion stage and treatment outcomes, which have an impact on clinical practice, public health and clinical trials. More robust indicators and tools are required to inform clinical, public-health, and research priorities, but these must be implementable in countries affected by mpox.
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