Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics

Introduction: Multiple aspects of the epidemics of mpox during 2022-2024 have been explored, including clinical features, diagnostic aspects, therapies and vaccines. However, factors associated with reporting of cases and death of Mpox have been poorly assessed. No studies regarding the relationship...

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Main Authors: Prof A Rodríguez-Morales, Dr D. Katterine Bonilla-Aldana, Dr Jaime A. Cardona-Ospina
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224004971
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author Prof A Rodríguez-Morales
Dr D. Katterine Bonilla-Aldana
Dr Jaime A. Cardona-Ospina
author_facet Prof A Rodríguez-Morales
Dr D. Katterine Bonilla-Aldana
Dr Jaime A. Cardona-Ospina
author_sort Prof A Rodríguez-Morales
collection DOAJ
description Introduction: Multiple aspects of the epidemics of mpox during 2022-2024 have been explored, including clinical features, diagnostic aspects, therapies and vaccines. However, factors associated with reporting of cases and death of Mpox have been poorly assessed. No studies regarding the relationships between the LGBT+ rights and the morbidity and mortality from Mpox have been published yet. Methods: An ecological study for 106 countries was done using the LGBT+ rights index (LGBT-RI) per country that were obtained from the State Sponsored Homophobia Reports produced by ILGA, LexisNexis, Factiva, Amnesty International, Human Rights Watch, the U.S. State Department, and Velasco report (2020), from Our World in Data, and the cases, calculating the incidence rates (cases per 100,000 pop.), from the U.S. Centers for Disease Control (CDC) and the World Health Organization (WHO). Also, mortality rates (cases per 100,000 pop.) and case fatality rates (deaths per 100 cases, %CFR) were calculated. The annual variation of the variables was assessed, and non-linear regression models (exponential) were done at Stata/MP® v.14.0. Results: The non-linear regression models revealed significant findings. The relationship between epidemiological factors and LGBT-RI was found to be significant. During this epidemic, there was a positive relationship between LGBT-RI and reported of Mpox cases (r2=0.1006; p=0.0040), countries with higher LGBT-RI had higher Mpox cases. Similarly, higher LGBT-RI values were also significantly associated with higher Mpox incidence rates (cases/100,000 pop) (r2=0.5062; p<0.0001). Number of deaths notified were also associated with the LGBT-RI (r2=0.0636; p=0.0328). Consistently, the Mpox mortality rate was also associated with the LGBT-RI (r2=0.1390; p=0.0005). Finally, the %CFR, as expected, this variable was not associated with LGBT-RI (r2=0.0216; p=0.3287). Discussion: These findings underscore the significant influence of stigma and discrimination that may be associated with Mpox. In particular, the LGBT+ rights allow trust in the health system, diagnostic and management. At the same, the proper notification of a Mpox case and its associated outcomes. Even in 2024, there are 88 countries or territories, specially in Africa, Middle East, and Asia, that have not reported yet, even a single case of Mpox. Even in Latin American and the Caribbean, ten countries are included in that list. Despite the epidemics of 2022-2024, Mpox remains a neglected condition worldwide, with a resurgence in countries like the Democratic Republic of Congo in 2023-2024. The need for further studies on multiple epidemiological factors of Mpox is therefore paramount. Conclusion: Sexual rights still influence not just HIV and other sexually transmitted infections epidemiology, but also of the reemerging/emerging Mpox globally.
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spelling doaj-art-0c3a8fe840424456bb26b76890b4508e2025-08-20T02:00:43ZengElsevierInternational Journal of Infectious Diseases1201-97122025-03-0115210742210.1016/j.ijid.2024.107422Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemicsProf A Rodríguez-Morales0Dr D. Katterine Bonilla-Aldana1Dr Jaime A. Cardona-Ospina2Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Colombia; Masters of Climate Change and Clinical Epidemiology and Biostatistics Program, Universidad Científica del Sur, Lima, Peru; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, LebanonResearch Unit, Universidad Continental, Huancayo, PeruFaculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, ColombiaIntroduction: Multiple aspects of the epidemics of mpox during 2022-2024 have been explored, including clinical features, diagnostic aspects, therapies and vaccines. However, factors associated with reporting of cases and death of Mpox have been poorly assessed. No studies regarding the relationships between the LGBT+ rights and the morbidity and mortality from Mpox have been published yet. Methods: An ecological study for 106 countries was done using the LGBT+ rights index (LGBT-RI) per country that were obtained from the State Sponsored Homophobia Reports produced by ILGA, LexisNexis, Factiva, Amnesty International, Human Rights Watch, the U.S. State Department, and Velasco report (2020), from Our World in Data, and the cases, calculating the incidence rates (cases per 100,000 pop.), from the U.S. Centers for Disease Control (CDC) and the World Health Organization (WHO). Also, mortality rates (cases per 100,000 pop.) and case fatality rates (deaths per 100 cases, %CFR) were calculated. The annual variation of the variables was assessed, and non-linear regression models (exponential) were done at Stata/MP® v.14.0. Results: The non-linear regression models revealed significant findings. The relationship between epidemiological factors and LGBT-RI was found to be significant. During this epidemic, there was a positive relationship between LGBT-RI and reported of Mpox cases (r2=0.1006; p=0.0040), countries with higher LGBT-RI had higher Mpox cases. Similarly, higher LGBT-RI values were also significantly associated with higher Mpox incidence rates (cases/100,000 pop) (r2=0.5062; p<0.0001). Number of deaths notified were also associated with the LGBT-RI (r2=0.0636; p=0.0328). Consistently, the Mpox mortality rate was also associated with the LGBT-RI (r2=0.1390; p=0.0005). Finally, the %CFR, as expected, this variable was not associated with LGBT-RI (r2=0.0216; p=0.3287). Discussion: These findings underscore the significant influence of stigma and discrimination that may be associated with Mpox. In particular, the LGBT+ rights allow trust in the health system, diagnostic and management. At the same, the proper notification of a Mpox case and its associated outcomes. Even in 2024, there are 88 countries or territories, specially in Africa, Middle East, and Asia, that have not reported yet, even a single case of Mpox. Even in Latin American and the Caribbean, ten countries are included in that list. Despite the epidemics of 2022-2024, Mpox remains a neglected condition worldwide, with a resurgence in countries like the Democratic Republic of Congo in 2023-2024. The need for further studies on multiple epidemiological factors of Mpox is therefore paramount. Conclusion: Sexual rights still influence not just HIV and other sexually transmitted infections epidemiology, but also of the reemerging/emerging Mpox globally.http://www.sciencedirect.com/science/article/pii/S1201971224004971
spellingShingle Prof A Rodríguez-Morales
Dr D. Katterine Bonilla-Aldana
Dr Jaime A. Cardona-Ospina
Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
International Journal of Infectious Diseases
title Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
title_full Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
title_fullStr Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
title_full_unstemmed Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
title_short Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022-2024 epidemics
title_sort impact of the lgbt rights on reporting cases and deaths of mpox globally relationships with the lgbt rights index during 2022 2024 epidemics
url http://www.sciencedirect.com/science/article/pii/S1201971224004971
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