Mpox Protocol by the Nigerian Association of Dermatologists: a Resource for Appropriate Clinical and Public Health Response

Authors

  • Sebastine Oiwoh Irrua Specialist Teaching Hospital Irrua,Edo state
  • Nafisatu Abdullahi Department of Internal Medicine, Federal Teaching Hospital, Katsina
  • Nnebuogo Oyakhire Department of Internal Medicine, National Hospital, Abuja
  • Zainab Babba Department of Internal Medicine, University of Abuja Teaching Hospital Abuja
  • Abdullahi Umar Department of Internal Medicine, Ahmadu Bello University, Zaria
  • Olufolakemi Cole-Adeife Dermatology Unit, Department of Medicine, Lagos State University Teaching Hospital Ikeja
  • Perpetua Ibekwe Department of Internal Medicine, University of Abuja, Abuja
  • Tahir Mohammed Department of Internal Medicine, Ahmadu Bello University, Zaria
  • Bolaji Otike-Odibi Department of Internal Medicine, University of Port Harcourt, Port Harcourt

Abstract

Mpox, formerly known as monkeypox, is a zoonotic viral infection affecting the skin and mucous membranes. It is caused by the mpox virus, belonging to the Orthopoxvirus genus and Poxviridae family. The virus has two clades: Clade I (Central African) and Clade II (West African), with further subdivisions. Clade I is prevalent in Central Africa, especially in the Democratic Republic of Congo (Clade Ia), while Clade Ib has recently emerged in East African countries. Clade II, once common in West Africa, saw Clade IIb spread globally in 2022, with Clade IIa and IIb cases reported in Nigeria.

As of July 31, 2024, the World Health Organization (WHO) recorded 102,997 confirmed mpox cases, 186 probable cases, and 223 deaths across 121 countries. The disease's resurgence in Africa led to WHO declaring it a public health emergency of international concern (PHEIC) and Africa CDC declaring it a public health emergency of continental security.

Mpox transmission and severity are influenced by viral, human, animal, and environmental factors. Key clinical features include skin lesions, fever, lymphadenopathy, sore throat, and oral and anal ulcerations, particularly in individuals engaging in receptive intercourse. Diagnosis is confirmed through polymerase chain reaction (PCR). Clinical severity varies based on age, immune status, comorbidities, and coinfections. Since mpox can resemble other skin conditions, increased awareness is crucial in resource-poor settings with limited access to diagnostics, drugs, and vaccines.

Treatment is primarily supportive, but antivirals like tecovirimat and brincidofovir have been beneficial. Proper skin care is essential for preventing complications. The Nigerian Association of Dermatologists (NAD) has developed this protocol to aid clinicians in early diagnosis and management, supporting healthier outcomes and guiding research and policymaking on mpox and other infectious dermatoses.

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Published

2025-03-27

Issue

Vol. 13 No. 3 (2023): Nigerian Journal of Dermatology December 2023 Edition

Section

Review Articles

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