Reinforcing mpox clinical care in the Democratic Republic of the Congo

Kanyere Kalavi walks through the gates of the Virunga General Referral Hospital in Goma, North Kivu. The mother of six lives in the Buhimba camp for displaced on the outskirts of the city. When her three-year-old son Vainqueur showed all the signs of mpox, the doctors at the camp clinic referred her urgently to the Virunga hospital.

“At first, I thought it was a malaria attack, but then pimples appeared all over his body,” says Kanyere.

The current mpox epidemic in the Democratic Republic of the Congo has two main strains: clade 1a, which has regularly affected East and Central Africa since the 1970s, and Clade 1b, a new variant which appeared in September 2023 in the east of the country.

Treatment is one of the key pillars of the response to this epidemic. At the Virunga General Referral Hospital, as in all mpox treatment centres, case management follows a precise protocol.

“When a patient arrives at the hospital entrance, they are directed to the triage unit. If they have a rash, they are isolated in a room where they are consulted and a sample is taken by the laboratory technician,” explains Danny Mukawa, the nurse in charge of emergencies and isolation at Virunga Hospital. “We then draw up a list of the people with whom the patient has been in contact and place the patient under treatment.”

“So far, we have taken 13 samples, and 4 cases of mpox have been confirmed,” explains Gaspar Kambale, head of the laboratory at the same hospital. The laboratory staff and nurses rely on guidance given by the WHO teams during a briefing two months earlier, as well as on test kits provided by WHO and other partners.

“Frontline workers play an essential role in strengthening the response to this disease. By equipping them with the necessary knowledge and tools, we can better protect communities and guarantee quality care,” says Dr Richard Fotsing, the WHO’s focal point for infectious risk management in the Democratic Republic of the Congo.

Three isolation rooms have also been set up in the triage unit with the support of the WHO. This facility enables patients to be cared for in a way that is safe for other patients in the hospital, for the nursing staff, and for family members who stay at the hospital to look after their relatives like Kanyere.

“With this triage and isolation approach, and treatment with antibiotics and supportive care, all the mpox patients admitted to this hospital have regained their health,” says Mukawa. “No staff have been infected.”

In addition to providing care for patients, the WHO is supporting the health authorities to track cases of mpox in communities, helping with diagnosis and testing as well as helping to monitor the health of people who have been in contact with patients. To reinforce the monitoring, WHO has trained 343 people in North Kivu province who serve as a link between affected communities and the health system.

“When he arrived, the child’s temperature was between 38 and 39 degrees Celsius, and he was suffering from intense itching. When we started the antibiotic treatment, his condition began to improve,” recalls Mukawa, the nurse in charge of emergencies and isolation at Virunga hospital.

After 10 days in hospital and under the care of Mukawa and his team, Vainqueur fully regained health. He is no longer contagious and can now leave hospital.

“I'm delighted that little Vainqueur has recovered. When he arrived, he couldn't walk or eat. He's living up to his name. He's called Vainqueur, and he's won,” says a delighted Mukawa.

Now cured, Vainqueur is eager to be reunited with his brothers and sisters and plays with his mother on the steps of the isolation centre.

“When I first came here, I was so stressed, but now that my son has recovered, I'm happy again,” Kanyere says.