Clinical characterization and Disease Severity of Mpox Cases in Sierra Leone 2025 Outbreak

Authors

  • Mohamed Boie Jalloh Directorate of Planning, Policy and Research, National Public Health Agency, Free town, Sierra Leone
  • Abdulai Alpha Jalloh Directorate of Planning, Policy and Research, National Public Health Agency, Free town, Sierra Leone
  • James Sylvester Squire Directorate of Surveillance and Epidemiology, National Public Health Agency, Free town Sierra Leone
  • Ibrahim Kamara Directorate of Planning, Police and Research, National Public Health Agency, Free town, Sierra Leone
  • Ian Njeru Department of Emergency, Preparedness and Response World Health Organization, Freetown, Sierra Leone
  • Victor Caulker Department of Emergency, Preparedness and Response World Health Organization, Freetown, Sierra Leone
  • George Ameh World Health Organization, Freetown, Sierra Leone
  • Alhaji U. N'jai University of Sierra Leone, Freetown, Sierra Leone and Koinadugu College, Kabala, Sierra Leone, and California University of Science and Medicine, Colton, California
  • Mohamed Alex Vandi National Public Health Agency, Free town, Sierra Leone
  • Mustapha Jalloh Directorate of Surveillance and Epidemiology, National Public Health Agency, Free town Sierra Leone
  • Foday Sahr National Public Health Agency, Free town, Sierra Leone

DOI:

https://doi.org/10.4314.3.4

Abstract

Mpox presents with a wide range of clinical manifestations, yet limited evidence exists on clinical characteristics and disease severity in African outbreak settings. This study aimed to describe the clinical presentation and severity of mpox cases in Sierra Leone and assess differences by immunosuppression status.

Methods:
A retrospective analysis was conducted among confirmed mpox cases. Clinical symptoms, lymphadenopathy, and disease severity were assessed using descriptive statistics. Severity was categorized into mild, moderate, and severe, and a severity score was computed. Associations between immunosuppression status and clinical features were evaluated using Fisher’s exact test.

Results:
A total of 201 mpox cases were included. Fever (93%), skin or mucosal lesions (75%), headache (76%), fatigue (74%), and muscle pain (73%) were the most commonly reported symptoms. Gastrointestinal symptoms such as vomiting (4.6%) and diarrhea (3.9%) were uncommon. Localized lymphadenopathy was reported in 23% of cases and generalized lymphadenopathy in 15%. Clinical features were broadly similar across immunosuppression groups, with no statistically significant differences observed (p > 0.05). However, a higher proportion of severe disease was observed among immunosuppressed individuals (86%) compared to non-immunosuppressed individuals (44%). Mean severity scores were also higher among immunosuppressed individuals (mean = 6.0) compared to non-immunosuppressed individuals (mean = 5.14).

Conclusion:
Mpox cases in Sierra Leone were characterized by classical symptoms, including fever and rash, with consistent clinical presentation across groups. Although immunosuppression was not significantly associated with clinical features, a trend toward increased severity was observed. These findings highlight the need for close monitoring of vulnerable populations and improved clinical management strategies.

Keywords: clinical manifestation; mpox; Sierra Leone; immunosuppression

 

 

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Published

2026-06-12

Issue

Vol. 16 No. 3 (2026): May 2026

Section

Original Articles

License

Submission of manuscripts to the Sierra Leone Journal of Biomedical Research is of the understanding that the article either in part or whole is not under consideration for publication in any other Journal. Accepted papers become the permanent property of Sierra Leone Journal of Biomedical Research but unrestricted use, distribution, and reproduction in any medium is permitted, provided the original work is properly cited.