Mpox in the DRC: residents of the slum at the centre of Kinshasa’s epidemic have little chance of avoiding this major health crisis
January 24, 2025
Kinshasa, the Democratic Republic of Congo's sprawling megacity, faces a dual-strain mpox outbreak, complicating containment efforts. Clade Ia, spread through zoonotic and household transmission, and Clade Ib, linked to sexual contact, coexist in hotspots like Pakadjuma. Addressing the crisis requires tailored interventions: blanket vaccinations for high-transmission zones, community engagement to reduce stigma, and logistical support for home care. Médecins Sans Frontières triage centers and robust lab networks are pivotal, but overwhelmed resources and cultural challenges hinder progress. Without immediate action, including amplified awareness campaigns and systemic support, the epidemic risks spiraling further in this densely populated urban landscape.
Kinshasa, the Democratic Republic of Congo's capital, is grappling with an unprecedented dual-strain mpox outbreak involving clades Ia and Ib. Clade Ia, endemic to rural areas, spreads through zoonotic and household transmission, while Clade Ib, a newer strain, is linked to sexual contact and spreads predominantly in urban settings. In Pakadjuma, one of Kinshasa’s poorest neighborhoods, these strains converge, posing unique challenges to containment efforts.
The city’s population of over 17 million complicates mpox management. While Médecins Sans Frontières provides triage and the Institut National de la Recherche Biomédicale ensures timely diagnostics, overwhelmed healthcare facilities and logistical hurdles undermine response capacity. Patients, often arriving in advanced disease stages, face significant delays navigating Kinshasa’s congested roads. Social stigma further deters timely care, as many initially turn to traditional healers before seeking medical assistance.
A multifaceted approach is crucial to controlling the outbreak. Blanket vaccination campaigns in hotspots like Pakadjuma could break transmission chains while enabling high-risk groups, such as sex workers, to sustain livelihoods. Home care programs, offering food and material support, can encourage isolation and reduce household spread. Equally vital are efforts to combat stigma through community engagement and media campaigns that amplify prevention messages.
Contact tracing, a cornerstone of outbreak control, remains a significant challenge, especially in Pakadjuma’s complex social networks. However, targeted interventions, coupled with robust public awareness and vaccination efforts, offer a pathway to containment. Failure to act decisively risks an uncontrollable epidemic in Kinshasa, with devastating public health consequences.
Addressing the mpox crisis in Kinshasa requires immediate international collaboration, resource mobilization, and innovative strategies tailored to the city's unique vulnerabilities. The lessons learned here could inform global responses to similar urban health crises in the future.