Relationships between morbidity and mortality from Mpox and the human development index (HDI) globally during 2022-2024 epidemics

Abstract

INTRODUCTION: Multiple aspects of Mpox epidemics during 2022-2023 were explored, including clinical features, diagnostic aspects, therapies and vaccines. However, socioeconomical aspects have been poorly assessed regarding the epidemiological associated factors. No studies were published on the relationships between the human development index (HDI) and its morbidity and mortality. METHODS: An ecological study for 104 countries was done using HDI data that were obtained from the UN Development Program (UNDP), and the cases, calculating the incidence rates (cases per 100,000 pop.), from the US CDC and the WHO. Also, mortality rates (cases per 100,000 pop.) and case fatality rates (deaths per 100 cases, %CFR) were calculated. The annual variation of the variables was assessed, and non-linear regression models (exponential) were done at Stata/MP® v.14.0. RESULTS: The non-linear regression models revealed significant findings. The relationship between epidemiological factors and HDI was found to be significant. During this epidemic, a higher incidence was observed in countries with high HDI (r2=0.4132;p<0.0001), while mortality rates were significantly lower in these countries (r2=0.1317;p=0.0007). Conversely, the case fatality rate (%CFR) was significantly higher in countries with lower HDI (r2=0.1595;p=0.0001). Discussion/CONCLUSIONS: These findings underscore the significant influence of socioeconomic indicators such as the HDI on the Mpox incidence and mortality rates and on %CFR globally, particularly in endemic countries. Despite the epidemics of 2022-2024, Mpox remains a neglected condition worldwide, with a resurgence in countries like the Democratic Republic of Congo in 2023-2024. Therefore, the need for further studies on multiple epidemiological factors of Mpox is paramount.

Keywords

• Mpox
• Epidemiology
• HDI
• social factors
• Global