# Monkeypox: A comprehensive review with a focus on the Middle East and North Africa (MENA) region

## TL;DR

This paper reviews monkeypox spread and response in the Middle East and North Africa, highlighting low case numbers but potential underreporting and public health challenges.

## Contribution

The paper provides a comprehensive review of monkeypox epidemiology and public health responses specific to the MENA region.

## Key findings

- The MENA region reported 857 confirmed monkeypox cases by August 2024, with Saudi Arabia and UAE having the highest numbers.
- New cases emerged in Morocco and Jordan in September 2024 after WHO declared monkeypox a global health emergency.
- Case numbers may be underestimated due to underreporting, stigma, and limited resources in the region.

## Abstract

Background: Monkeypox (Mpox) was identified as a virus endemic to Central and Western Africa. Since 2022, the virus has gained global attention due to increasing cases in non-endemic countries among patients having no link to travel to endemic areas. The virus is primarily transmitted through animal-to-human contact but has increasingly spread via human-to-human transmission. A comprehensive understanding of the epidemiology of Mpox in the Middle East and North Africa (MENA) region is essential for effective disease prevention, diagnosis, surveillance, and control.

Methods: This review investigates historical data and recent global and regional epidemiological trends of Mpox. The review discusses the clinical features, public health challenges, and preventive measures relevant to the MENA region using updated data from World Health Organization (WHO) reports, national health statistics, and additional relevant resources.

Results: Mpox cases significantly spread globally during the 2022–2024 period. The MENA region has a relatively low number of documented cases, with 857 confirmed cases by August 2024. Saudi Arabia and the United Arab Emirates (UAE) reported the highest case numbers, reflecting effective surveillance and case detection. However, new cases of Mpox were announced in September 2024 in Morocco and Jordan following the WHO’s declaration of Mpox as a public health emergency of international concern.

Conclusion: The current number of cases in the MENA region could be underestimated due to underreporting, stigmatization, limited resources, and ongoing conflicts in several countries. It is essential to prioritize the containment of the outbreak, exploring all possible strategies to protect vulnerable communities.