# The epidemiological and clinical differences between patients with mpox and patients without mpox among suspected cases during the recent global mpox outbreaks: a systematic review and meta-analysis

## TL;DR

This study compares people with and without mpox among suspected cases to identify key differences in risk factors and symptoms, aiding diagnosis and outbreak response.

## Contribution

The study systematically reviews and meta-analyzes epidemiological and clinical data to highlight significant differences in mpox transmission and presentation.

## Key findings

- Men and men who have sex with men are significantly overrepresented among mpox patients.
- Sexual contact is strongly associated with mpox, while nonsexual and healthcare-related transmission are less common.
- Mpox patients show distinct symptom patterns and lesion characteristics compared to non-mpox patients.

## Abstract

The recent mpox outbreaks have brought challenges to the global health system. We aimed to study the epidemiological and clinical differences between patients with mpox and patients without mpox among suspected cases during and after 2022.

This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Our meta-analysis included a total of 22 articles regarding 12,850 suspected cases of mpox. The prevalence of mpox was 54%. We found that the proportion of men among the mpox patients was much greater than that among the non-mpox patients (odds ratio (OR)=9.94, 95% confidence interval (CI): 4.37–22.58), and the same trend was also observed (OR = 11.52, 95% CI: 6.22–21.33) for men who have sex with men (MSM). Sexual intercourse (OR = 4.02, 95% CI: 2.63–6.13), multiple sexual partners (OR = 3.36, 95% CI: 1.99–5.68), and anal sex (OR = 2.40, 95% CI: 1.53–3.77) were more common among mpox patients than non-mpox patients. Sexual contact was more strongly associated with mpox infection (OR = 4.39, 95% CI: 1.77–10.92), whereas nonsexual contact (OR = 0.72, 95% CI: 0.63–0.83) and transmission through health services (OR = 0.55, 95% CI: 0.33–0.93) showed weaker associations. Furthermore, there were significant differences between the two patient groups in terms of sexually transmitted infections, symptoms, complications, lesion locations and types of lesions.

Our findings provide a reference for clinicians in the diagnosis and differentiation of mpox. By scientifically understanding these epidemiological and clinical differences, healthcare workers can not only address this epidemic more effectively but also be more fully prepared for the inevitable challenges of future emerging infectious diseases.

https://www.crd.york.ac.uk/prospero/, identifier CRD420251141869.