The epidemiological and clinical differences between patients with mpox and patients without mpox among suspected cases during the recent global mpox outbreaks: a systematic review and meta-analysis

BackgroundThe recent mpox outbreaks have brought challenges to the global health system. We aimed to study the epidemiological and clinical differences between patients with mpox and patients without mpox among suspected cases during and after 2022.MethodsThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsOur meta-analysis included a total of 22 articles regarding 12,850 suspected cases of mpox. The prevalence of mpox was 54%. We found that the proportion of men among the mpox patients was much greater than that among the non-mpox patients (odds ratio (OR)=9.94, 95% confidence interval (CI): 4.37–22.58), and the same trend was also observed (OR = 11.52, 95% CI: 6.22–21.33) for men who have sex with men (MSM). Sexual intercourse (OR = 4.02, 95% CI: 2.63–6.13), multiple sexual partners (OR = 3.36, 95% CI: 1.99–5.68), and anal sex (OR = 2.40, 95% CI: 1.53–3.77) were more common among mpox patients than non-mpox patients. Sexual contact was more strongly associated with mpox infection (OR = 4.39, 95% CI: 1.77–10.92), whereas nonsexual contact (OR = 0.72, 95% CI: 0.63–0.83) and transmission through health services (OR = 0.55, 95% CI: 0.33–0.93) showed weaker associations. Furthermore, there were significant differences between the two patient groups in terms of sexually transmitted infections, symptoms, complications, lesion locations and types of lesions.ConclusionsOur findings provide a reference for clinicians in the diagnosis and differentiation of mpox. By scientifically understanding these epidemiological and clinical differences, healthcare workers can not only address this epidemic more effectively but also be more fully prepared for the inevitable challenges of future emerging infectious diseases.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251141869.