Clinical and epidemiological characteristics among probable and confirmed patients with mpox in Sierra Leone reported from January to May 2025

ABSTRACT We analyzed available mpox cases reports in Sierra Leone from January to June 2025 following a historic increase in mpox cases across multiple urban and rural regions in the country. Here, we assessed demographic and clinical data from 187 case reports. Mpox case reports in this study were primarily from Bo (86/187; 46.0%) and Freetown (48/124; 25.7%). Most case reports were from male patients (101/187; 54.0%) as compared to females (86/187; 46.0%), with an overall median age of 26 years (IQR 22-34). The median age was higher among males (30 years; IQR 25-39) then females (24 years; IQR 21-27). Rash, fever, headache, lesions, and generalized pain were reported for all patients, where data was reported. Lymphadenopathy, muscle pain, sore throat, and cough were reported less commonly. Age- and sex-specific interventions, as well as community engagement that includes historically stigmatized groups are critical for mpox containment and mitigation measures in Sierra Leone. Competing Interest Statement The authors have declared no competing interest. Funding Statement This work was funded by the Canadian Institutes of Health Research (Grant no. PJT-175098). a Tier 2 Canada Research Chair in the Molecular Pathogenesis of Emerging and Re-Emerging Viruses for J.K. provided by the Canadian Institutes of Health Research (Grant no. 950-231498); the International Mpox Research Consortium (IMReC), jointly funded by the Canadian Institutes of Health Research and International Development Research Centre (grant nos. MRR-184813); Department of Defense, Defense Threat Reduction Agency, Monkeypox Threat Reduction Network (HDTRA1-21-1-0040); USDA Non-Assistance Cooperative Agreement no. 20230048; Belgian Directorate-general Development Cooperation and Humanitarian Aid and the Research Foundation-Flanders (FWO, grant number G096222 N to L.L.); US NIAID/NIH grant number U01AI151799 through the Center for Research in Emerging Infectious Disease-East and Central Africa (CREID-ECA). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Sierra Leone Ethics and Scientific Review Committee (SLERC No. 010/05/2025) and the Health Research Ethics Board at the University of Manitoba, Canada (Opinion No. HS25837) approved this study. We were waived from obtaining informed consent from mpox patients on confidentiality purpose because we were analyzing facility-based aggregated medical records, as well as anonymized patient data. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes This revision includes the integration of case report data from 26 additional mpox patients and the inclusion of two additional authors. Data Availability All data produced in the present work are contained in the manuscript