Mbote-SK

The MBOTE-SK project was initiated in response to the emergence of a new Clade Ib lineage of the monkeypox virus in South Kivu, DRC. Unlike previous outbreaks, this one is marked by sustained human-to-human transmission, including through sexual contact, in a densely populated and highly mobile setting. This raised concerns about a potential wider spread beyond the region.

The project brings together partners with experience in mpox and outbreak response to better understand and control this new situation. It combines epidemiological surveillance, clinical research, genomic analysis, and community-based work to address both the scientific and operational aspects of the outbreak. Surveillance activities have been strengthened through improved case investigation, contact tracing, and the introduction of digital tools for data collection and monitoring. These systems allow real-time tracking of cases and support decision-making by health authorities. At the same time, diagnostic capacity has been reinforced locally, reducing delays in confirming cases and improving patient management.

A key part of the project is a prospective clinical study, which is generating detailed data on how Clade Ib mpox presents and evolves in patients. This is complemented by support to clinical care, including adapted treatment protocols and infection prevention measures, which have contributed to better patient outcomes and reduced transmission in healthcare settings. Genomic surveillance is used to monitor the evolution and spread of the virus. By implementing sequencing capacity both centrally and closer to affected areas, the project has improved turnaround times and enabled rapid sharing of data with the international research community.

Community engagement is another important component. Through surveys and outreach activities, the project explores issues such as vaccine acceptance, stigma, and risk behaviours, particularly among vulnerable groups. These activities also help build trust and improve the uptake of public health measures. Finally, the project supports the rollout and evaluation of vaccination strategies by providing data to help target interventions and assess their impact.

Overall, MBOTE-SK contributes to a better understanding of Clade Ib mpox while strengthening the capacity to respond to the outbreak. The approach developed can also inform responses to future epidemics in similar settings.

Expected outcome

The project is expected to generate robust evidence on the transmission dynamics, clinical characteristics, and evolution of Clade Ib mpox, addressing key knowledge gaps identified at the start of the outbreak. This includes improved understanding of human-to-human transmission, identification of risk factors, and documentation of clinical outcomes in affected populations. Operationally, the project strengthens outbreak response capacity through the implementation of integrated surveillance systems, decentralized diagnostics, and genomic monitoring. These systems enable faster detection of cases, improved patient management, and more effective control of transmission.

The project also contributes to informing public health strategies, particularly vaccination approaches, by providing data on target populations, vaccine uptake, and effectiveness. Community-based research further supports the design of tailored interventions by addressing stigma, risk behaviours, and barriers to healthcare access.

At a broader level, the project generates tools, protocols, and approaches that can be adapted to other settings and future outbreaks. By combining research and field implementation, MBOTE-SK contributes to both immediate outbreak control and longer-term strengthening of public health systems. Overall, the project has the potential to significantly improve the understanding and management of mpox and to reduce the risk of wider regional or global spread.