Management of Genital Involvement in Monkeypox (MPOX), DRC, April–June 2025

Introduction: Monkeypox (MPOX) currently constitutes a major public health concern in the Democratic Republic of Congo (DRC), where the disease remains endemic. Although the generalized cutaneous manifestations of MPOX are relatively well documented in the scientific literature, genital involvement remains insufficiently described, despite its significant clinical, nutritional, psychosocial, and community-related implications. This study aims to describe the clinical, nutritional, and psychosocial characteristics of patients affected by MPOX presenting genital lesions in the Sankuru province.

Methods and Materials: This is a descriptive cross-sectional case series conducted in the Democratic Republic of Congo, in the Sankuru province, between April and June 2025. Sociodemographic, clinical, nutritional, therapeutic, and psychosocial data were collected from eight patients with confirmed genital involvement of MPOX. Patients were selected through an exhaustive approach among cases admitted to the Monkeypox Treatment Centers (CTM) in Lodja.

The collected information was analyzed to describe the clinical presentation of the disease, the probable transmission routes, and the modalities of integrated patient management.

Results: A total of eight patients were included in the study, including five men (62.5%) and three women (37.5%), with a mean age of 31 years (standard deviation: 9.6 years; range: 18–49 years). Genital lesions exhibited significantly slower healing compared to cutaneous lesions located on other body areas, with a mean healing time of 21 ± 3.2 days versus 13 ± 2.8 days for peripheral lesions (p < 0.05).

Secondary bacterial superinfections were observed in 62.5% of patients. Additionally, two patients (25%) presented severe malnutrition (BMI < 16 kg/m²), which was associated with a significantly longer healing duration, averaging 24 ± 2 days compared to 19 ± 3 days in patients with normal nutritional status (p = 0.04).

The probable modes of transmission included sexual transmission (37.5%), intrafamilial transmission (25%), community transmission during social gatherings (25%), and direct spousal transmission (12.5%). A holistic management approach combining medical treatment, nutritional support, and psychosocial care resulted in complete recovery in 87.5% of patients, while adherence to preventive measures was observed in 75% of patients during post-hospital follow-up.

Conclusion: Genital involvement in MPOX represents a significant clinical manifestation in the Sankuru province, characterized by slower healing and an increased risk of local complications.

These findings highlight the necessity of integrated management combining medical care, nutritional support, psychosocial interventions, and community engagement. Integrating these approaches into public health strategies may contribute to improving the clinical prognosis of patients, reducing disease transmission, and promoting the social and familial reintegration of affected individuals.