Evidence on mpox clade Ia and clade Ib: A rapid research needs appraisal
Bibliographic record
Abstract
OBJECTIVES: The emergence of a new mpox sub-clade Ib and changes in transmission pattern are of concern. To inform strategies to protect populations and improve outcomes, we implemented a rapid research needs appraisal (RRNA) to identify existing evidence on mpox clade I. METHODS: We searched Embase, MEDLINE, Scopus, and grey literature to 11 February 2025 for human mpox clade I studies. RESULTS: Of 79 studies identified, 2.5% (2/79) were interventional, 97.4% (77/79) observational, presenting data on 59,183 mpox cases. Most (57/79) focused on clade Ia, 16/79 clade Ib, and 6/79 unspecified sub-clade I. 90.8% were set in Africa. Studies focused on clinical characteristics (n = 55), transmission (n = 23), risk factors for disease/severe disease (n = 13), diagnostics (n = 9), social/behavioural factors (n = 6), immune response/seroprevalence (n = 5), and vaccine/treatments (n = 4). Symptoms and complications were similar for both sub-clades. Three studies reported foetal death in 8/12-8/14 pregnant women infected with clade Ib and in 3/4 of women with clade Ia. The pooled case fatality rate (CFR) was 6% (95% CI 3% to 8%) in clade Ia studies and 1% (95% CI 0% to 1%) in clade Ib studies. There were no studies on effectiveness of prevention, treatment, risk of asymptomatic infection, or immune protection over time. CONCLUSION: The identified evidence-gaps provide a baseline to inform coordinated research strategies to generate evidence for clinical and public health responses to improve outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.163 | 0.355 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.011 | 0.016 |
| Bibliometrics | 0.042 | 0.021 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.013 | 0.016 |
| Open science | 0.006 | 0.009 |
| Research integrity | 0.009 | 0.006 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".