{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:13:12Z","timestamp":1790881992147,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mpox, caused by the monkeypox virus (MPXV), is primarily recognized for its dermatologic and systemic symptoms. However, emerging evidence suggests a significant prevalence of gastrointestinal (GI) manifestations, particularly proctitis, diarrhea, nausea, vomiting, and abdominal pain. Despite the growing clinical recognition of these symptoms, their epidemiology and impact remain poorly understood. This systematic review and meta\u2010analysis aim to quantify the prevalence of GI manifestations in Mpox patients and assess their clinical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review following PRISMA guidelines was conducted across PubMed, Embase, and Web of Science, including quantitative studies published up until October 2024 that reported GI manifestations in Mpox patients. Screening and data extraction were performed using Nested Knowledge software, and study quality was assessed using the Newcastle\u2013Ottawa Scale. Meta\u2010analysis was conducted using R version 4.4, with heterogeneity evaluated via the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic. Sensitivity analyses and publication bias were assessed using Doi plots and the Luis Furuya\u2010Kanamori (LFK) index.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 1229 records, 33 studies met the eligibility criteria, yielding a pooled prevalence of proctitis in Mpox patients at 24.75% (95% CI: 18.93%\u201331.04%) across 5878 participants, with high heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200994.8%). The prediction interval for proctitis ranged from 1.46% to 61.76%. The pooled prevalence of other GI manifestations was 30.45% (95% CI: 18.27%\u201344.14%) across 2237 participants, with significant heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200995.2%) and a prediction interval ranging from 0.00% to 85.28%. Sensitivity analyses confirmed the stability of these estimates, while publication bias was indicated by LFK index values exceeding 2.77.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta\u2010analysis highlights the substantial burden of GI manifestations in Mpox, particularly proctitis, with considerable variability across studies. The findings underscore the need for standardized diagnostic criteria and increased clinical recognition of GI symptoms in Mpox management. Further research into the underlying pathophysiology and integrating GI symptom assessment into Mpox surveillance and treatment strategies could enhance diagnostic accuracy and patient care outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70190","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T08:38:36Z","timestamp":1748421516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Proctitis and Other Gastrointestinal Manifestations in Mpox Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"given":"Prakasini","family":"Satapathy","sequence":"first","affiliation":[{"name":"Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences Saveetha University  Chennai India"},{"name":"Faculty of Data Science and Information Technology INTI International University  Nilai Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay M.","family":"Gaidhane","sequence":"additional","affiliation":[{"name":"Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health Datta Meghe Institute of Higher Education  Wardha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasir","family":"Vadia","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Marwadi University Research Center, Faculty of Health Sciences Marwadi University  Rajkot Gujarat India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumya V.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Biochemistry, School of Sciences JAIN (Deemed to Be University)  Bangalore Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kattela","family":"Chennakesavulu","sequence":"additional","affiliation":[{"name":"Department of Chemistry Sathyabama Institute of Science and Technology  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajashree","family":"Panigrahi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, IMS and SUM Hospital Siksha \u2018O\u2019 Anusandhan (Deemed to Be University)  Bhubaneswar Odisha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5017-083X","authenticated-orcid":false,"given":"Sanjit","family":"Sah","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Dr. D. Y. Patil Medical College Hospital and Research Centre Dr. D. Y. Patil Vidyapeeth (Deemed\u2010to\u2010Be\u2010University)  Pune Maharashtra India"},{"name":"Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital Dr. D.Y. Patil Vidyapeeth (Deemed\u2010to\u2010Be\u2010University)  Pune Maharashtra India"},{"name":"SR Sanjeevani Hospital  Siraha Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Centre for Research Impact and Outcome, Chitkara University Institute of Engineering and Technology Chitkara University  Rajpura Punjab India"},{"name":"Division of Research and Innovation Uttaranchal University  Dehradun India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Govinda","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Data Science Gokaraju Rangaraju Institute of Engineering and Technology  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khang Wen","family":"Goh","sequence":"additional","affiliation":[{"name":"Faculty of Data Science and Information Technology INTI International University  Nilai Malaysia"},{"name":"Faculty of Mathematics and Natural Sciences Universitas Negeri Padang  Padang Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Mehta","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, RDC Manav Rachna International Institute of Research and Studies  Faridabad Haryana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed","family":"Shabil","sequence":"additional","affiliation":[{"name":"University Center for Research and Development Chandigarh University  Mohali Punjab India"},{"name":"Medical Laboratories Techniques Department AL\u2010Mustaqbal University  Hillah Babil Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Graphic Era (Deemed to Be University)  Dehradun India"},{"name":"Graphic Era Hill University  Dehradun India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Bushi","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Sciences Lovely Professional University  Phagwara India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_11_2_1","article-title":"Mpox (Monkeypox): A Comprehensive Updated of Current Epidemic Evidence","author":"Hossain A.","year":"2024","journal-title":"Science in One Health"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad034"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17269"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000227"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12030914"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2541"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"e_1_2_11_9_1","volume-title":"The Newcastle\u2010Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta\u2010Analyses","author":"Wells G. 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