Characterizing transmission dynamics and evaluating medical countermeasures to inform the clinical and public health response to monkeypox

Outbreaks of monkeypox in Nigeria since 2017 and the 2022 global emergence of monkeypox in previously non-endemic regions, such as Canada, point to a need to characterize and compare the transmission dynamics in endemic and non-endemic regions. A critical aspect of the global outbreak has been transmissions in the context of sexual networks of gay, bisexual and other men who have sex with men (GBM). This project aims to characterize and compare monkeypox transmission dynamics across two diverse epidemic contexts; evaluate the role of antivirals in the treatment of human monkeypox (clinical trial); and evaluate the role of vaccination in the prevention of human monkeypox (real-world effectiveness). IDRC funds will only go to the African co-lead in Nigeria. Research methodology for the Nigeria work will include a mix of a prospective cohort study of suspected Monkeypox cases in two cities in Nigeria; surveillance study of subclinical infection among GBM; and formative research on trial readiness and vaccine acceptability in Nigeria. Comparative research in Canada (and internationally) will be funded through CIHR funds. A global research consortium will be carrying out this research and the Nigerian principal applicant is the Nigerian Institute of Medical Research. Results include rapid evidence on the transmission dynamics of monkeypox in the endemic and non-endemic regions to guide urgent policy decisions, clinical and public health program implementation surrounding medical and other countermeasures. The collective research infrastructure and multidirectional capacity building will provide a foundation to further expand and pivot to emergent monkeypox research questions as the epidemic re-shapes and unfolds over the next two years in Canada, Nigeria, and globally across diverse epidemic contexts.