SynthesisBMJ global health2026
Dynamics of global mpox epidemics, 1970-2025: a systematic review and meta-analysis of evolving transmissibility and intervention effects.
Synthesis in BMJ global health, 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2022 global mpox epidemic declined before modified Vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccines were widely deployed, contributing to the perception that transmission was self-limiting within a small high-risk population. This may have delayed global vaccine allocation and weakened responses to the resurgence that has disproportionately affected Africa since 2024. The reasons for the 2022 decline remain uncertain, and prior studies have reported widely divergent estimates of vaccination impact. We systematically reviewed and meta-analysed the evolving transmissibility of mpox clades and the effects of interventions.
methodsWe searched GenBank, PubMed and Embase through 18 May 2025, for mpox virus sequences, reproduction number (R) estimates and modelling studies evaluating intervention effectiveness. Two reviewers independently assessed eligibility, extracted data and evaluated risk of bias using a validated tool. Random-effects meta-analyses were performed.
resultsFifty-two studies reporting R estimates and 40 studies evaluating intervention effectiveness met eligibility criteria. For clade I mpox, pooled R increased from 0.71 (95% CI 0.26 to 1.17) during 1970-2017 to 1.23 (1.12-1.33) for subclades Ib/Ia after 2023 (p=0.0303). For clade II mpox, pooled R was 1.11 (0.90-1.32) during 2017-2021 and increased to 2.66 (2.31-3.00) for subclade IIb in 2022-2023 (p<0.0001). During the 2022 subclade IIb outbreak, empirical modelling studies estimated that behaviour change and vaccination together were associated with a substantial reduction in mpox cases (55%, 95% CI 37 to 73; I
conclusionsBehaviour change and vaccination likely played important roles in the decline of the 2022 mpox epidemic in many studied settings. Given the stepwise increase in human-to-human transmissibility associated with the emergence of new subclades, effective mpox epidemic control requires proactive, rapid and equitable vaccine rollout supported by culturally tailored risk communication. PROSPERO REGISTRATION NUMBER: CRD420250653072.
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.