pp 1–12 | Cite as

Temporal and Spatial Dynamics of Monkeypox in Democratic Republic of Congo, 2000–2015

  • Bien-Aimé Makasa MandjaEmail author
  • Alice Brembilla
  • Pascal Handschumacher
  • Didier Bompangue
  • Jean-Paul Gonzalez
  • Jean-Jacques Muyembe
  • Frédéric Mauny
Original Contribution


Monkeypox is a viral disease with a clinical presentation resembling that of smallpox. Although monkeypox is considered to be an important zoonotic viral disease, its epidemiology remains poorly understood, especially the spatial and temporal distribution of the disease. The present study examined weekly reports of monkeypox cases collected from 2000 to 2015 at the health zone scale in the Democratic Republic of Congo. SaTScan® was performed to identify spatial and temporal clusters of monkeypox cases. Significant primary spatial clusters were detected in the districts of Sankuru and Tshuapa. A centrifugal pattern was found, with significant primary spatial clusters extending over time from Sankuru and Tshuapa to several neighboring districts. Peaks of cases occurred from July to September for the 2000–2002 and 2003–2009 sub-periods and from January to March for the 2010–2015 sub-period. Despite the lack of additional data for confirmation, the increasing of monkeypox reported incidence was observed in the Democratic Republic of Congo during 2000–2015 period and this increase cannot be explain only by the improvements of surveillance systems. The detected spatial clusters were located in the dense rainforest of the Congo basin. The reasons for the excess incidence of monkeypox cases in the central region of the country are unknown, and the relative influence of ecological, environmental, and human factors on the mechanism of emergence of monkeypox has yet to be identified.


Monkeypox Emerging infectious disease Surveillance data SaTScan Spatio-temporal clusters Democratic Republic of Congo 



We thank all the members of the Research and Training Unit on the Ecology and Control of Infectious Diseases of the University of Kinshasa and all the members of the Clinical Methodology Center of CHU Besançon in France for helping to the drafting of this article. We also thank the Direction of Disease Control and the National Institute for Biomedical Research for making the data available for this study.


The Project was funded by the PICS CNRS France 2015 (Grant Number 263320).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Copyright information

© EcoHealth Alliance 2019

Authors and Affiliations

  1. 1.Service de Microbiologie, Faculté de MédecineUniversité de KinshasaKinshasaDemocratic Republic of the Congo
  2. 2.Laboratoire Chrono-Environnement, UMR 6249, CNRSUniversité de Bourgogne Franche-ComtéBesançonFrance
  3. 3.UMR 1252 SESSTIM, INSERM, IRDUniversité d’Aix MarseilleStrasbourgFrance
  4. 4.Department of Microbiology and Immunology, Division of Biomedical Graduate Research OrganizationGeorgetown University School of MedicineWashingtonUSA
  5. 5.Institut National de Recherche BiomédicaleGombe, KinshasaDemocratic Republic of the Congo
  6. 6.Centre Hospitalier Universitaire de BesançonBesançonFrance

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