Mpox
Conditions
Brief summary
The MPXV CARE study principally aims to use clinical and epidemiology data to target specific individuals willing and able to provide appropriate and proportionate biological samples to develop novel immune diagnostics that support models of disease burden and future vaccine utilisation.
Detailed description
Cases of Mpox in Central and East Africa have been climbing since December 2022 when Democratic Republic of Congo (DRC) declared a national outbreak of the disease. There are two strains of circulating virus, clade Ia (previously known as clade I) in northwestern DRC primarily affecting children, and a new strain clade Ib in northeastern DRC which has since spread to bordering countries. The clade Ib strain, sub-lineage A was first identified in South Kivu. This strain has been found to have a APOBEC3-type mutations allowing increased circulation between humans. This novel clade is mainly characterized by the gene insertions and deletions including the deletion on C3L gene that effect the CDC recommended Clade I-specific real-time PCR detection. The WHO Director General declared the outbreak a public health emergency on 14th August 202433 as a result of escalating case numbers of both clade I strains. As of 28July 2024, this year there have been a total of 14,250 cases in 10 African countries, with a case fatality of 3.2%. This is likely to be an underestimate given the limited testing and healthcare capacity in some of the regions affected. The clade 1b Mpox outbreak is an urgent public health emergency in need of scientific countermeasures to control the spread of disease and protect African communities. The primary clinical aim of this study to develop novel immune diagnostics to estimate Mpox's sero-prevalence and determine exposure to Mpox virus and/or previous vaccination as a tool for vaccine prioritization among at risk populations. Participants will be recruited from the following groups: * Group 1 (suspected exposure cohort): asymptomatic volunteers at risk of Mpox including: * Those who live within or adjacent to, or spend prolonged amounts of time in an epidemiologically identified region of Mpox transmission * Close contacts of those with microbiologically confirmed Mpox * Group 2 (post-exposure/vaccinated cohort): * asymptomatic volunteers who have had clinically or microbiologically confirmed Mpox infection within the last one-month (group 2a) or more than one-month ago (group 2b) * Those who have received a smallpox/MVA vaccine within the last one-month (group 2c) or more than one-month ago (group 2d) * Group 3 (control cohort): asymptomatic volunteers with no known exposure to Mpox
Interventions
DIAGNOSTIC_TESTELISA
Mpox-specific antibody ELISA
DIAGNOSTIC_TESTLateral flow assay
Dried blood spot lateral flow assay for Mpox antibody
Sponsors
Rwanda Biomedical Centre
University of Birmingham
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy males and females aged between ages 5-80 years, who are able and willing to provide informed consent and will comply with the study requirements. * Group 1 (suspected exposure cohort) only * Live within or adjacent to an epidemiologically identified region of Mpox transmission * Close contacts of those with microbiologically confirmed Mpox * Group 2 (post-exposure/vaccinated cohort) only * Previous clinically or microbiologically confirmed Mpox or confirmed previous vaccination with a smallpox/MVA vaccine * Fully recovered from Mpox infection * Group 3 (control cohort) only: * Asymptomatic with no known exposure to Mpox
Exclusion criteria
* Unwilling or unable to provide informed consent to take part * Unwilling or unable to comply with study procedures * History of any suspected or confirmed disorder of the immune system that, in the opinion of the investigators, might impair the results of the study * Have a bleeding disorder deemed significant by a member of the study team * Pregnant or breast-feeding females * Group 1 (suspected exposure cohort) only * Known history of Mpox infection * Current symptoms consistent with Mpox * Known exposure to Mpox in the last month * Group 2 (post-exposure/vaccinated cohort) only * Participants with any ongoing symptoms of Mpox, indicating incomplete recovery. * Group 3 (control cohort only) * Symptoms of Mpox * Known exposure to Mpox in the last month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Detection of anti-Mpox specific IgG antibody by ELISA | Day 1 | Number of patients in whom anti-Mpox specific IgG antibody is detected |
| The clinical diagnostic performance of the RDT for Mpox exposure confirmation | Day 1 | A blood sample will be tested on the lateral flow device which will give a positive/negative result for the presence of antibody. This will be compared to the gold standard testing modality of ELISA. The MPox POC LFT performance versus ELISA will be characterised by test sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perspectives of healthcare workers and the public on studies in response to outbreaks | Day 1 | Qualitative analysis of output from focus group discussion regarding taking part in this trial |
| Perspectives of healthcare workers and the public on the development of novel immune diagnostic tools | Day 1 | Qualitative analysis of focus groups with the healthcare workers and the public who have taken part in the study around this topic. |
| Perspectives of healthcare workers and the public on the vaccine cold-chain readiness to support public health measures | Day 1 | Qualitative analysis of focus groups with the healthcare workers and the public who have taken part in the study around this topic. |
Countries
Rwanda
Contacts
Primary ContactShema Hugor
Backup ContactKarishma Gokani
Outcome results
None listed