Observational studyThe Lancet. Infectious diseases2026
Case presentation of patients hospitalised with mpox (subclade Ib/2023sh) including children, adolescents, and adults in South Kivu, Democratic Republic of the Congo: an observational cohort study.
Observational study in The Lancet. Infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMpox is a public health concern in eastern DR Congo. It continues to cause substantial numbers of hospital admissions, with changing demographics including children and adolescents, requiring comprehensive clinical and epidemiological investigation. In this study, we aim to describe the clinical characteristics of hospitalised participants infected with monkeypox virus (MPXV) subclade Ib/2023sh in the Kabare Territory in South Kivu, DR Congo.
methodsThis observational cohort study included patients admitted with suspected mpox to the reference centre of mpox treatment at Lwiro Hospital, South Kivu, DR Congo. Eligible participants must have had, at the time of inclusion, skin lesions compatible with the infection. Individuals who did not present lesions compatible with MPXV infection were also eligible if they had at least one of the following symptoms: fever, cervical lymphadenopathy, or pharyngitis, provided they had been in contact with someone with suspected mpox within the last 21 days. Data from hospital records and standardised clinical forms captured demographics, presenting symptoms and signs, outcomes, and general clinical characteristics. Descriptive analyses and statistics summarised the clinical and epidemiological profiles of participants with molecular confirmation of MPXV subclade Ib/2023sh.
findingsBetween Aug 3, 2024, and Feb 8, 2025, MPXV subclade Ib/2023sh was detected in 494 (77%) of 643 participants with a median age of 9 years (IQR 2-24). Participants who were positive for MPXV subclade Ib/2023sh infection were more often female (290 [59%]) and were generally older (median 16 years [4-25]) than male participants (204 [41%]; median age 4 years [1-14]). 300 (61%) of 494 participants were aged 15 years or younger. Fever (444 [90%]), skin lesions or rash (391 [79%]), and dysphagia (279 [56%]) were the most prevalent symptoms. Children aged 0-5 years had a higher frequency of lesions on the head (84 [41%] of 203), face (67 [33%]), neck (23 [11%]), back (27 [13%]), arm (35 [17%]), palm of hand (35 [17%]), chest (46 [23%]), posterior aspect of thighs (40 [20%]), legs (25 [12%]), dorsal foot (45 [22%]), and oral cavity (37 [18%]). 117 (24%) participants had lesions in the oral cavity. Oral cavity and oropharynx swabs were able to detect MPXV subclade Ib/2023sh in the absence of assayable skin lesions.
interpretationThe high proportion of children and adolescents (aged ≤15 years) differentiates our cohort from other clinical descriptions of the novel MPXV subclade Ib/2023sh. Given that, we hypothesise a demographic shift in the target population that contributes to the community spread of mpox in the South Kivu region of DR Congo. Targeted public health measures should consider ways to reduce transmission among children and adolescents.
fundingCanadian Institutes of Health Research (CIHR), Canadian Foundation for Innovation, Research Nova Scotia, Dalhousie Medical Foundation, Moderna, Li-Ka Shing Foundation, European & Developing Countries Clinical Trials Partnership (EDCTP). TRANSLATIONS: For the French, Swahili and Mashi translations of the abstract see Supplementary Materials section.
Indexed as
Identifiers
What OpenQuestion holds
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.