Mpox, declared a Public Health Emergency of International Concern (PHEIC) in 2022, had its epicenter in the Northern Region of Brazil in an Amazonian state responsible for 64.9% of regional cases. This study aimed to describe the epidemiological profile of the disease from 2022 to 2024, with emphasis on sexual transmission, coinfections, and challenges to health equity. Descriptive, retrospective study using secondary data from FVS. Sociodemographic (sex, age, race/skin color, education), behavioral (sexual orientation, risk practices), and clinical (symptoms, coinfections, outcomes) variables were analyzed. Descriptive analysis with absolute and relative frequencies was performed using Excel v.16.0. A total of 1,128 cases were reported (436 confirmed by laboratory or clinical-epidemiological criteria), with 96.8% concentrated in the state capital and expansion to 7 inland municipalities in 2024. There was a peak in 2022 (343 cases), a sharp decline in 2023 (10 cases), and an increase in 2024 (83 cases). The predominant profile consisted of men (95%), young adults aged 20–39 (84%), self-identified as mixed race (72.9%), and with higher educational levels (83.1% high school/university). Sexual transmission was the main route (50.7%), with HIV coinfection in 53.2% and other STIs in 52.4%. Frequent symptoms included fever (79%), rash (64%), and genital/perianal lesions (47%). Hospitalization occurred in only 4.3%. The outbreak reflects regional inequalities and overlapping vulnerabilities among urban young men who have sex with men (MSM) and people living with HIV. Urgent strategies include: (1) integration of rapid Mpox testing into STI/HIV services; (2) provider training to reduce stigma; (3) strengthened surveillance in remote areas through mobile units; (4) partnerships with LGBTQIA+ dating apps for combined prevention. Coordinated actions between surveillance and clinical care are essential to reduce health disparities in the Brazilian Amazon.
Santos et al. (Sun,) studied this question.
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