By Michael Gwarisa
Efforts to curb the spread of Mpox among African Union member states remain a challenge due to widespread and interconnected sexual networks, HealthTimes has learned.
Uganda currently leads in new Mpox cases, accounting for 50% of all recorded infections in Africa over the past six weeks. The majority of cases in Uganda stem from the Clade 1B strain, which is sexually transmitted. Uganda, Burundi, and the Democratic Republic of Congo (DRC) have collectively recorded 94% of confirmed cases since the beginning of the year.
Speaking during the weekly press briefing, Africa Centres for Disease Control and Prevention (Africa CDC) Director General Professor Jean Kaseya—represented by Professor Yap Boum II, the Deputy Incident Manager for Mpox at Africa CDC—highlighted the challenges of contact tracing in high-risk populations.
Mpox, specifically the Clade 1B strain, is sexually transmissible. Yesterday, Uganda’s incident manager informed us that there are sex workers who have up to 10 clients per day. She has no idea who these individuals are. How do you trace them?” said Professor Boum II.
An average of 3,000 suspected Mpox cases have been reported weekly in Africa in 2025. However, testing remains limited, with fewer than half of suspected cases being confirmed. The first quarter of 2025 has already recorded more than half the total Mpox cases seen in 2024.
“Sexual networks remain the key driver of the outbreak, with cases spreading in slums, semi-urban, and urban areas. Last week, Mbarara City and Masaka City accounted for 50% of daily incidence,” Boum II noted.
In Uganda, the number of new confirmed cases rose from 190 in epidemiological (Epi) week 12 to 247 in Epi week 13—a 30% increase. However, new confirmed deaths declined from four in Epi week 12 to zero. Males account for 56.1% of confirmed cases, all linked to the Clade 1B variant.
Uganda has maintained a 100% testing rate, with a positivity rate of 60%. Of the country’s 146 districts, 95 have reported cases, with 63 districts currently experiencing active outbreaks. There are 53 active Mpox cases. To bolster response efforts, Uganda recently received 100,000 doses of the Mpox vaccine and has already vaccinated 20,000 individuals within a week.
Meanwhile, the combination of strong sexual networks and ongoing conflict has hampered contact tracing in the DRC, where Mpox remains a significant public health threat.
“We have only two out of every 10 suspected cases actually tested for Mpox, which means the majority go unconfirmed. This is mainly because contact tracing is not properly conducted at the community level. To address this, we have started intensifying the deployment of community health workers in Kinshasa,” added Professor Boum II.
Community health workers play a crucial role in raising awareness and educating communities through simple yet effective communication strategies.
“When they visit households, they bring maps and images of Mpox symptoms to educate people and identify potential cases. Once a suspected case is identified, they can raise an alert, collect samples with district support, send them to laboratories, and trace contacts of confirmed cases,” he explained.
Health officials aim to identify at least 20 contacts per confirmed case. Initially, contact tracing efforts in the DRC identified only 1.7 contacts per case, making vaccination among contacts ineffective.
“This was one of the reasons why the vaccination strategy for contacts failed—we were identifying too few individuals. However, with increased tracing efforts, last week the Ministry of Health reported an average of 10 contacts per case, which is already an improvement. If we maintain this momentum, we could reach even higher numbers,” Boum II added.
