Epidemiological characteristics of monkeypox virus infection: a systematic review and meta-analysis

Monkeypox (MPX) is a zoonotic disease caused by the monkeypox virus (MPXV). In recent years, its epidemiological characteristics have changed, shifting from regional outbreaks to a global public health threat. Currently, systematic reviews on infection risks among different populations, transmission routes, and clinical manifestations remain insufficient. This work aimed to comprehensively evaluate the global epidemiological characteristics of monkeypox virus infection through a Meta-analysis (MA) approach. Eight electronic databases (PubMed, Web of Science, Cochrane Library, Embase, MEDLINE, CNKI, Wanfang Data, VIP Database) were systematically searched. Observational studies reporting the epidemiological characteristics of monkeypox were included and a Meta-analysis was conducted. Thirteen articles were included. The infection risk was higher in males than in females odds ratio (OR) = 518.58, 95% CI: 196.23-1370.43, P < 0.00001; the infection risk was higher in men who have sex with men (MSM) than in other populations (OR = 20.00, 95% CI: 2.06-194.05, P = 0.01); HIV infection status was not epidemiologically associated with disease incidence (OR = 1.33, 95% CI: 0.78–2.28, P = 0.30); the main clinical symptoms were fever (OR = 3.07, 95% CI: 2.14–4.41, P < 0.00001) and generalized rash (OR = 334.92, 95% CI: 16.13-6955.43, P = 0.0002), with no statistical difference observed for lymphadenopathy (P = 0.62). The current monkeypox outbreak predominantly affects males, with sexual contact being the main transmission route. Fever and rash are the primary clinical manifestations, albeit with some variability. The findings provide evidence-based support for optimizing surveillance strategies and prevention and control measures. Not applicable.