To enhance mpox detection capacity and address under-reporting, the Mpox Threat Reduction Network (MPX-TRN) was launched in January 2022. This network is part of an ongoing partnership between the University of California, Los Angeles (UCLA), the DRC National Institute of Biomedical Research (INRB), and Mosaic (Cameroon) with broader objectives including: improving sequencing for detecting cross-border transmission of mpox, collecting samples with differential pox virus exposures, conducting environmental sampling for mpox, supporting surveillance in sites for improved mpox case confirmation in collaboration with the National Program for the control of Mpox and Viral Hemorrhagic Fevers (PNLMPX-VHF), and creating a regional network to enhance capacity for a sustainable biosurveillance system.

Ultimately, the final objective of the MPX-TRN is to support and strengthen regional collaboration and training in mpox surveillance. Leveraging the extensive experience of the INRB, in collaboration with the PNLMPX-VHF, the DRC team organized two events that included regional experts and partners: Mosaic, PNLMPX-VHF, the Kinshasa School of Public Health (KSPH), and the Centers for Disease Control and Prevention (CDC); the Disease Control Directorate and the Pasteur Institute of Bangui, CAR; the National Program for the Prevention and Control of Emerging and Re-emerging Zoonotic Diseases and the Military Health Research Center Cameroon; the Directorate of Disease Control and the Public Health Laboratory, ROC; the Nigeria Center for Disease Control and Prevention; and initially, Makerere University, Uganda (Fig. 1).

Map of mpox regional surveillance network countries

In August 2022, participants from seven countries, including, DRC, ROC, CAR, Cameroon, Nigeria, Uganda, and the USA assembled for a two-day meeting. Participants from each country could discuss their mpox surveillance system and key components to be included in creating a regional network (Additional file 1: Fig. S1). In November 2022, a larger two-week meeting expanded on this training, with sessions both in Kinshasa at the INRB as well as Kisangani, Tshopo province – the DRC’s first mpox sentinel surveillance site.

While in Kinshasa, the group discussed their format for case investigations, case definitions, laboratory testing, sequencing procedures and an overview of bioinformatic analysis. Operationally, the MPX-TRN framework supported regional training of best practices in mpox surveillance and control. In Kisangani, the team participated in ongoing mpox investigations, learned how surveillance and patient care is conducted in DRC health facilities, and observed how samples are collected and shipped to INRB in Kinshasa (Additional file 2: Fig. S2 A & B). The team also visited the site’s laboratory where work is ongoing to validate an mpox/orthopox GeneXpert test.