Outbreak of Monkeypox in South East Asia; Spotlight on Bangladesh, Pakistan and India

Knowledge regarding human monkeypox among a sample of undergraduate and post-graduate students from selected tertiary institutions in Bangladesh: An online-based cross-sectional study

BACKGROUND

The recent human monkeypox (mpox) outbreak in 2022 has become a serious concern due to its rapid expansion to various non-endemic countries. There is limited information about the knowledge regarding mpox among the Bangladeshi population. Therefore, this study's objectives were to: (i) determine the level of knowledge regarding mpox among undergraduate and post-graduate students in Bangladesh, and (ii) assess the determinants of knowledge regarding mpox among the study sample.

METHODS

An online-based cross-sectional study was conducted among 879 tertiary-level students from selected tertiary institutions (n = 13) in Bangladesh. The structured questionnaire consisted of two parts: (i) socio-demographic information and (ii) an assessment of knowledge regarding mpox. The Kruskal-Wallis test, Mann-Whitney test, and multivariable quantile regression model were employed.

RESULTS

The median age of the study participants was 23 years (IQR: 25-22). Low knowledge of mpox was found among study participants (20.7%, 23.2% and 56.1% had good, moderate and poor knowledge, respectively). The overall median knowledge score for mpox was 11 (IQR: 16-6). The median knowledge score of mpox significantly differed by participants' gender, study major, and academic education about mpox. In the quantile regression analysis, the association between gender and mpox knowledge was observed at the 25th (β = 1.343), 50th (β = 2.00) and 75th (β = 1.59) quantiles with females having more knowledge compared to males. The effects of study group were significant at 25th (β = 1.746), 50th (β = 1.5), 75th (β = 1.361) and 90th (β = 1.248) quantiles. Thus, those in medical or public health programs were likely to have more knowledge about mpox relative to those who were in non-medical related study groups. Students who received information about mpox during their education were more knowledgeable compared to those who had not, with statistical significance occurring at 10th (β = 3.711), 25th (β = 6.656), 50th (β = 5.75), 75th (β = 3.404) and 90th (β = 2.592) quantiles.

CONCLUSION

These findings imply that educational interventions about mpox should consider the gender dynamics and program of study among the students in Bangladesh.

Monitoring and evaluation practices and operational research during public health emergencies in southeast Asia region (2012-2022) - a systematic review

This systematic review aimed to explore the monitoring and evaluation (M&E) and operational research (OR) practices during public health emergencies (PHE) in the southeast Asian region (SEAR) over the last decade. We searched electronic databases and grey literature sources for studies published between 2012 and 2022. The studies written in English were included, and a narrative synthesis was undertaken. A total of 29 studies were included in this review. Among these 25 studies documented M&E and four studies documented OR practices. The majority of the studies were from India and Bangladesh, with no evidence found from Sri Lanka, Bhutan, Myanmar, and Timor-Leste. M&E of surveillance programs were identified among which PHE due to COVID-19 was most prevalent. M&E was conducted in response to COVID-19, cholera, Nipah, Ebola, Candida auris, and hepatitis A. OR practice was minimal and reported from India and Indonesia. India conducted OR on COVID-19 and malaria, whereas Indonesia focused on COVID-19 and influenza. While most SEAR countries have mechanisms for conducting M&E, there is a noticeable limitation in OR practices. There is a compelling need to develop a standard framework for M&E. Additionally, enhancing private sector engagement is crucial for strengthening preparedness against PHE. Furthermore, there is a necessity to increase awareness about the importance of conducting M&E and OR during PHE.

Uncovering the knowledge gaps: A survey on human monkeypox infection among men who have sex with men in Nepal

The monkeypox virus (MPOX) poses a major threat to the health of people, particularly among men who have sex with men (MSM). However, the knowledge regarding MPOX among MSM in Nepal is poorly understood. Therefore, the present study aimed to assess the knowledge of human monkeypox among Nepalese MSM. A cross-sectional face-to-face survey was conducted among purposively selected 250 participants (mean age 27.6 ± 8.9 years) in Nepal between October and December 2022. The questionnaire consisted of informed consent along with questions covering age, education, and MPOX. The findings demonstrated that the majority of MSM in Nepal had poor knowledge of MPOX. Around 87% of participants had no idea whether MPOX is contagious or not. However, the results call for immediate action to improve knowledge of MSM through health education programs and appropriate interventions to spread awareness of MPOX.

Blockchain-enabled healthcare monitoring system for early Monkeypox detection

The recent emergence of monkeypox poses a life-threatening challenge to humans and has become one of the global health concerns after COVID-19. Currently, machine learning-based smart healthcare monitoring systems have demonstrated significant potential in image-based diagnosis including brain tumor identification and lung cancer diagnosis. In a similar fashion, the applications of machine learning can be utilized for the early identification of monkeypox cases. However, sharing critical health information with various actors such as patients, doctors, and other healthcare professionals in a secure manner remains a research challenge. Motivated by this fact, our paper presents a blockchain-enabled conceptual framework for the early detection and classification of monkeypox using transfer learning. The proposed framework is experimentally demonstrated in Python 3.9 using a monkeypox dataset of 1905 images obtained from the GitHub repository. To validate the effectiveness of the proposed model, various performance estimators, namely accuracy, recall, precision, and F1-score, are employed. The performance of different transfer learning models, namely Xception, VGG19, and VGG16, is compared against the presented methodology. Based on the comparison, it is evident that the proposed methodology effectively detects and classifies the monkeypox disease with a classification accuracy of 98.80%. In future, multiple skin diseases such as measles and chickenpox can be diagnosed using the proposed model on the skin lesion datasets.

Mitigation Measures to Control the Expected Mpox Outbreak in a Developing Country-Pakistani Scenario

Mpox (previously named Monkeypox) is one of the neglected viral infectious diseases that remained silent for a long period before finally emerging as a threat to the healthcare system in endemic regions of the world in recent years. It has been mostly centered in African countries but has now been reported in other non-endemic regions as well. While keeping a strict eye on COVID pandemic handling, there is a need to remain concerned and alert about viral threats such as Mpox infections in the future. This situation has altered the healthcare system of endemic regions, including Pakistan, to stay vigilant against the expected Mpox outbreaks in the coming months. Though no specific cases have been reported in Pakistan, the healthcare system needs to take mitigation measures to tackle an expected threat before it arrives. This is important in order to avoid another major shock to the health care system of Pakistan. Moreover, since no specific treatment is available for Mpox, we can only rely upon mitigation measures, involving preventive and treatment strategies devised around some already in-use antiviral agents against Mpox viruses. Moreover, there is an imperative need to proactively prepare the healthcare system against Mpox outbreaks, spread awareness, and involve the public in a participatory approach to stay well prepared against any such infection. Moreover, there is a need to utilize financial sources, aids, and funds wisely, to create awareness in the public about such expected healthcare outbreaks in the future.

The study of human monkeypox disease in 2022 using the epidemic models: herd immunity and the basic reproduction number case

As of May 2022, a new outbreak of the human monkeypox (MPOX) disease appeared in multiple countries, where the 2022 human MPOX disease spread to more than 109 cases, excluding the suspected cases up to the end of 2022. The deaths of the 2022 human MPOX exceeded 200 cases up to the same date. The human MPOX is not a new disease, this disease was once endemic in some countries on the African continent. Despite this, this disease began to spread in a number of countries around the world in 2022. The first case of the 2022 human MPOX was recorded in the United Kingdom in May. After that date, this disease began to become a pandemic in a number of other countries, such as the United States, Spain, and Brazil. The 2022 human MPOX is a type of viral disease caused by a viral virus, the MPOX virus, and this virus causes rashes and lesions over the skin of the patient, as well as in the mouth of the patient. Multiple effective indicators are employed for the study of the 2022 of the human MPOX, such as the herd immunity of the human MPOX (HIhMPOX), the basic reproduction number of the human MPOX (BRNhMPOX), and the infection period of the human MPOX. This study focuses on the study of the herd immunity of, and the basic reproduction number of the 2022 outbreak of human MPOX in multiple countries around the world. This study employed the semianalytical method of the Susceptible compartment S, Infectious compartment I, Recovered compartment R (SIR) pandemic model including the mortality for the study of the herd immunity, and the basic reproduction number of the 2022 human MPOX disease. It is found that the average value of the herd immunity for the human MPOX disease in 2022 equals to 0.2194, that is, 21.94% for multiple countries, and equals to 35.52% for the United States, and 30.99% for Spain. Also, it is found that the average value of the basic reproduction number of the 2022 human MPOX disease equals to 1.2810 for multiple countries. It is concluded from these values that 21.94% of the total susceptible population has to be immunized in an effective way to prevent the spreading of the disease. Also, based on the previous values, it is concluded that the status of the 2022 MPOX disease is spreading as a pandemic.