{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T11:29:39Z","timestamp":1789212579357,"version":"build-2803163510"},"reference-count":34,"publisher":"The Royal Society","issue":"216","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100021638","name":"Social Sciences and Humanities Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021638","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000193","name":"International Development Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000193","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["royalsocietypublishing.org"],"crossmark-restriction":true},"short-container-title":["J. R. Soc. Interface."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>\n                    In 2022, there was a global resurgence of mpox, with different clinical-epidemiological features compared with previous outbreaks. Sexual contact was hypothesized as the primary transmission route, and the community of men having sex with men (MSM) was disproportionately affected. Because of the stigma associated with sexually transmitted infections, the real burden of mpox could be masked. We quantified the basic reproduction number (\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>0<\/jats:sub>\n                    ) and the underestimated fraction of mpox cases in 16 countries, from the onset of the outbreak until early September 2022, using Bayesian inference and a compartmentalized, risk-structured (high-\/low-risk populations) and two-route (sexual\/non-sexual transmission) mathematical model. Machine learning (ML) was harnessed to identify underestimation determinants. Estimated\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sub>0<\/jats:sub>\n                    ranged between 1.37 (Canada) and 3.68 (Germany). The underestimation rates for the high- and low-risk populations varied between 25\u201393% and 65\u201385%, respectively. The estimated total number of mpox cases, relative to the reported cases, is highest in Colombia (3.60) and lowest in Canada (1.08). In the ML analysis, two clusters of countries could be identified, differing in terms of attitudes towards the 2SLGBTQIAP+ community and the importance of religion. Given the substantial mpox underestimation, surveillance should be enhanced, and country-specific campaigns against the stigmatization of MSM should be organized, leveraging community-based interventions.\n                  <\/jats:p>","DOI":"10.1098\/rsif.2023.0637","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T03:58:49Z","timestamp":1721793529000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Quantifying the basic reproduction number and underestimated fraction of Mpox cases worldwide at the onset of the outbreak"],"prefix":"10.1098","volume":"21","author":[{"given":"Nicola Luigi","family":"Bragazzi","sequence":"first","affiliation":[{"name":"Department of Food and Drugs, University of Parma , Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarafa Adewale","family":"Iyaniwura","sequence":"additional","affiliation":[{"name":"Theoretical Biology and Biophysics Group, Los Alamos National Laboratory , Los Alamos, NM, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Han","sequence":"additional","affiliation":[{"name":"Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC) , Toronto, Ontario, Canada"},{"name":"Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University , Toronto, Ontario, Canada"},{"name":"Artificial Intelligence and Mathematical Modelling Lab (AIMMLAb), Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woldegebriel Assefa","family":"Woldegerima","sequence":"additional","affiliation":[{"name":"Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC) , Toronto, Ontario, Canada"},{"name":"Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-5672","authenticated-orcid":true,"given":"Jude Dzevela","family":"Kong","sequence":"additional","affiliation":[{"name":"Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC) , Toronto, Ontario, Canada"},{"name":"Artificial Intelligence and Mathematical Modelling Lab (AIMMLAb), Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada"},{"name":"Global South Artificial Intelligence for Pandemic and Epidemic Preparedness and Response Network (AI4PEP), University of Toronto , Toronto, Ontario M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-147"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2021.0197"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06780-7"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.1011049"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27931"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2022.102855"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207323"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10802"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.12513"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.06.009"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/epidemiologia3030028"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28575"},{"key":"e_1_3_7_14_2","first-page":"465","article-title":"Human monkeypox: secondary attack rates","volume":"66","author":"Jezek Z","year":"1988","unstructured":"Jezek Z , Grab B , Szczeniowski MV , Paluku KM , Mutombo M . 1988 Human monkeypox: secondary attack rates. Bull. World Health Organ. 66 , 465\u2013470.","journal-title":"Bull. World Health Organ."},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-5564(02)00108-6"},{"key":"e_1_3_7_16_2","unstructured":"World Health Organization . Monkeypox: key facts. See https:\/\/www. who.int\/news-room\/fact-sheets\/detail\/monkeypox (accessed 26 August 2022)."},{"key":"e_1_3_7_17_2","unstructured":"Centers for Disease Control and Prevention . Impact of monkeypox outbreak on select behaviors. See https:\/\/archive.cdc.gov\/www_cdc_gov\/poxvirus\/mpox\/response\/2022\/amis-select-behaviors.html."},{"key":"e_1_3_7_18_2","unstructured":"Government of Canada . Monkeypox (orthopoxvirus simian). See https:\/\/www.canada.ca\/en\/public-health\/services\/diseases\/monkeypox.html (accessed 26 August 2022)."},{"key":"e_1_3_7_19_2","unstructured":"Mathieu E Spooner F Dattani S Ritchie H Roser M . 2022 Monkeypox. Our World in Data. See https:\/\/ourworldindata.org\/monkeypox."},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.2196\/27385"},{"key":"e_1_3_7_21_2","unstructured":"Statistics Canada . A statistical portrait of Canada\u2019s diverse LGBTQ2+ communities. See https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/210615\/dq210615a-eng.htm (accessed 24 August 2022)."},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-919"},{"key":"e_1_3_7_23_2","unstructured":"World Health Organization (WHO) and the joint United Nations Programme on HIV\/AIDS (UNAIDS) . 2020 Key populations strategic information: recommended population size estimates of men who have sex with men. See https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2020-recommended-population-size-estimates-of-men-who-have-sex-with-men_en.pdf."},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pcbi.1009098"},{"key":"e_1_3_7_25_2","unstructured":"Stan Development Team . 2020 RStan: the R interface to stan. R package version 2.21.2. See https:\/\/mc-stan.org\/rstan\/."},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1178654"},{"key":"e_1_3_7_27_2","unstructured":"Equaldex . LGBT rights by country & travel guide. See https:\/\/www.equaldex.com."},{"key":"e_1_3_7_28_2","unstructured":"Crabtree S . 2010 Religiosity highest in world\u2019s poorest nations. United States is among the rich countries that buck the trend. See https:\/\/news.gallup.com\/poll\/142727\/Religiosity-Highest-World-Poorest-Nations.aspx (accessed 31 August 2010)."},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.add4507"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-38816-8"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad091"},{"key":"e_1_3_7_32_2","first-page":"2023","article-title":"Early underdetected dissemination across countries followed by extensive local transmission propelled the 2022 mpox epidemic","author":"Paredes MI","year":"2023","unstructured":"Paredes MI , Ahmed N , Figgins M , Colizza V , Lemey P , McCrone JT , M\u00fcller N , Tran-Kiem C , Bedford T . 2023 Early underdetected dissemination across countries followed by extensive local transmission propelled the 2022 mpox epidemic. medRxiv 2023. (doi:10.1101\/2023.07.27.23293266)","journal-title":"medRxiv"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10122083"},{"key":"e_1_3_7_34_2","unstructured":"Mathieu E Spooner F Dattani S Ritchie H Roser M . 2022 Mpox. See https:\/\/ourworldindata.org\/mpox."},{"key":"e_1_3_7_35_2","doi-asserted-by":"crossref","unstructured":"Bragazzi N Iyaniwura SA Han Q Woldegerima WA Kong JD . 2024 Supplementary material from: Quantifying the basic reproduction number and underestimated fraction of Mpox cases worldwide at the onset of the outbreak. Figshare. (doi:10.6084\/m9.figshare.c.7355000)","DOI":"10.1098\/rsif.2023.0637"}],"container-title":["Journal of The Royal Society Interface"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/royalsocietypublishing.org\/doi\/pdf\/10.1098\/rsif.2023.0637","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/royalsocietypublishing.org\/doi\/full-xml\/10.1098\/rsif.2023.0637","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/royalsocietypublishing.org\/doi\/pdf\/10.1098\/rsif.2023.0637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T12:53:32Z","timestamp":1722603212000},"score":1,"resource":{"primary":{"URL":"https:\/\/royalsocietypublishing.org\/doi\/10.1098\/rsif.2023.0637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":34,"journal-issue":{"issue":"216","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1098\/rsif.2023.0637"],"URL":"https:\/\/doi.org\/10.1098\/rsif.2023.0637","relation":{},"ISSN":["1742-5662"],"issn-type":[{"value":"1742-5662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2023-10-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"20230637"}}