title: Presumptive risk factors for monkeypox in rural communities in the Democratic Republic of the Congo.
abstract: Monkeypox virus (MPXV), a close relative of Variola virus, is a zoonotic virus with an unknown reservoir. Interaction with infected wildlife, bites from peri-domestic animals, and bushmeat hunting are hypothesized routes of infection from wildlife to humans. Using a Risk Questionnaire, performed in monkeypox-affected areas of rural Democratic Republic of the Congo, we describe the lifestyles and demographics associated with presumptive risk factors for MPXV infection. We generated two indices to assess risk: Household Materials Index (HMI), a proxy for socioeconomic status of households and Risk Activity Index (RAI), which describes presumptive risk for animal-to-human transmission of MPXV. Based on participant self-reported activity patterns, we found that people in this population are more likely to visit the forest than a market to fulfill material needs, and that the reported occupation is limited in describing behavior of individuals may participate. Being bitten by rodents in the home was commonly reported, and this was significantly associated with a low HMI. The highest scoring RAI sub-groups were 'hunters' and males aged ≥ 18 years; however, several activities involving MPXV-implicated animals were distributed across all sub-groups. The current analysis may be useful in identifying at-risk groups and help to direct education, outreach and prevention efforts more efficiently.
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States of America.|US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Claire A
authors.identifier: http://orcid.org/0000-0003-4419-1542
authors.initials: CA
authors.lastname: Quiner
authors.affiliation: International Conservation Education Fund, Washington, D.C., United States of America.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Moses
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Monroe
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakazawa
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Doty
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Hughes
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: McCollum
authors.affiliation: International Conservation Education Fund, Washington, D.C., United States of America.
authors.forename: Saturnin
authors.initials: S
authors.lastname: Ibata
authors.affiliation: University of Kinshasa, Department of Biology, Kinshasa, Democratic Republic of Congo.
authors.forename: Jean
authors.initials: J
authors.lastname: Malekani
authors.affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo.
authors.forename: Emile
authors.initials: E
authors.lastname: Okitolonda
authors.affiliation: International Conservation Education Fund, Washington, D.C., United States of America.
authors.forename: Darin S
authors.initials: DS
authors.lastname: Carroll
authors.affiliation: US Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, Georgia, United States of America.
authors.forename: Mary G
authors.initials: MG
authors.lastname: Reynolds
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000835:Animals, Wild / Q000821:virology; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D054884:Host-Pathogen Interactions; D006801:Humans; D008019:Life Style; D008297:Male; D045908:Mpox, Monkeypox / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D008993:Monkeypox virus / Q000502:physiology; D009790:Occupations; D018570:Risk Assessment; D012307:Risk Factors; D012377:Rodentia / Q000821:virology; D012423:Rural Health / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult