{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:46:54Z","timestamp":1762429614762,"version":"build-2065373602"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Mpox (formerly monkeypox) is a zoonotic disease caused by the Mpox virus. Although the disease is endemic in several Central and West African countries, it has recently emerged in Europe and the United States and was declared a public health event of international concern. This study aimed to evaluate Mpox surveillance in Sudan and provide insights for better epidemic preparedness.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Mpox surveillance was evaluated based on Centers for Disease Control and Prevention guidelines. The targeted attributes were flexibility, sensitivity, usefulness, representativeness, timeliness, and data quality (data completeness and adequacy of variables). To evaluate the qualitative attributes (flexibility, usefulness, and representativeness), interviews were conducted with key informants, supported by records and reports review. The national surveillance line-list was obtained for evaluation of the quantitative attributes: timeliness, data quality, and sensitivity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The surveillance system was flexible enough to integrate Mpox within a short time. A technical committee was formulated, and a preparedness and response plan developed. The case definition was adapted and reporting activated through different surveillance types. Surveillance was useful in detecting Mpox, generating epidemiologic indicators, and guiding preparedness and response interventions. The system showed representativeness geographically and through multiple reporting sources. The case definition was broadly sensitive as it detected Mpox cases and other dermatological conditions, with proven detection capacity by different surveillance types. The line-list lacked important data on medical history and exposure. The timeliness of reporting was good; however, the testing capacity was limited.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The surveillance system demonstrated high flexibility in rapidly integrating Mpox, with sensitivity in detecting cases and representative reporting sources. It was useful in detecting Mpox, generating epidemiologic indicators, and informing actions. Improvement in data quality and completeness is required for in-depth analysis. Rapid response teams\u2019 training and sustainable financing for their operations are highly recommended and crucial for timely investigation, quality data, and specimen collection. Expanding molecular-testing capacity to regional laboratories and strengthening specimen-transport networks are critical, together with shifting to a One Health approach.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1669389","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T06:22:47Z","timestamp":1762410167000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sudan\u2019s Mpox surveillance system during the 2022 pandemic: a retrospective evaluation"],"prefix":"10.3389","volume":"13","author":[{"given":"Ahmad","family":"Izzoddeen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Elbadri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magam","family":"Musa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa Hamed","family":"Dafaalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazza","family":"Abasher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Magbol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muntasir M. O.","family":"Elhasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Nageeb","family":"Abdalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/cid\/cit703","article-title":"Human Mpox","volume":"58","author":"McCollum","year":"2014","journal-title":"Clin Infect Dis"},{"year":"2022","author":"Spickler","key":"ref2"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.virol.2005.05.030","article-title":"Virulence differences between monkeypox virus isolates from West Africa and the Congo basin","volume":"340","author":"Chen","year":"2005","journal-title":"Virology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1038\/s41591-022-01907-y","article-title":"Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus","volume":"28","author":"Isidro","year":"2022","journal-title":"Nat Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1093\/infdis\/jiaa559","article-title":"Exportation of Mpox virus from the African continent","volume":"225","author":"Mauldin","year":"2022","journal-title":"J Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1086\/505880","article-title":"Clinical manifestations of human Mpox influenced by route of infection","volume":"194","author":"Reynolds","year":"2006","journal-title":"J Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s00705-023-05848-w","article-title":"Mpox: a review of laboratory detection techniques","volume":"168","author":"Zhou","year":"2023","journal-title":"Arch Virol"},{"volume-title":"Multi-country Mpox outbreak, situation report","year":"2022","key":"ref8"},{"volume-title":"Epidemiological update: monkeypox multi-country outbreak","year":"2022","key":"ref9"},{"volume-title":"Monkeypox. Our World in Data","year":"2022","author":"Mathieu","key":"ref10"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1186\/1471-2458-10-S1-S5","article-title":"Strengthening public health surveillance and response using the health systems strengthening agenda in developing countries","volume":"10","author":"Nsubuga","year":"2010","journal-title":"BMC Public Health"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/S1473-3099(19)30294-4","article-title":"Outbreak of human Mpox in Nigeria in 2017\u201318: a clinical and epidemiological report","volume":"19","author":"Yinka-Ogunleye","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1016\/j.jiph.2020.07.019","article-title":"Epidemiologic surveillance for controlling Covid-19 pandemic: types, challenges and implications","volume":"13","author":"Ibrahim","year":"2020","journal-title":"J Infect Public Health"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"382","DOI":"10.34172\/hpp.2021.49","article-title":"COVID-19 surveillance systems in African countries","volume":"11","author":"Adebisi","year":"2021","journal-title":"Health Promot Perspect"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"393","DOI":"10.2471\/BLT.20.274308","article-title":"Community surveillance of COVID-19 by village health volunteers, Thailand","volume":"99","author":"Kaweenuttayanon","year":"2021","journal-title":"Bull World Health Organ"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1186\/s12879-024-09802-2","article-title":"Evaluation of the Mpox surveillance system in Cameroon from 2018 to 2022: a laboratory cross-sectional study","volume":"24","author":"Djuicy","year":"2024","journal-title":"BMC Infect Dis"},{"volume-title":"Monkeypox strategic preparedness, readiness, and response plan (SPRP)","year":"2022","key":"ref17"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2457","DOI":"10.1186\/s12889-024-19058-9","article-title":"Monkeypox pandemic in Sudan, surveillance epidemiologic report, 2022","volume":"24","author":"Izzoddeen","year":"2024","journal-title":"BMC Public Health"},{"key":"ref19","first-page":"13","article-title":"Updated guidelines for evaluating public health surveillance systems; recommendations from the guidelines working group","volume-title":"Evaluation of usefulness","author":"German","year":"2025"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-023-15708-6","article-title":"COVID-19 surveillance in Democratic Republic of Congo, Nigeria, Senegal and Uganda: strengths, weaknesses and key lessons","volume":"23","author":"Fawole","year":"2023","journal-title":"BMC Public Health"},{"key":"ref21","first-page":"1","article-title":"Sensitivity and predictive value positive measurements for public health surveillance systems","volume":"22","author":"German","year":"2000","journal-title":"Epidemiology"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.ijid.2022.06.060","article-title":"Enhanced surveillance of monkeypox in bas-U\u00e9l\u00e9, Democratic Republic of Congo: the limitations of symptom-based case definitions","volume":"122","author":"Mande","year":"2022","journal-title":"Int J Infect Dis"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1669389\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:36:41Z","timestamp":1762429001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1669389\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":22,"alternative-id":["10.3389\/fpubh.2025.1669389"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1669389","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"article-number":"1669389"}}