Community-based monitoring of Mpox and co-occurring sexually transmitted infections (STIs)

Abstract

The global resurgence of Mpox has underscored the interconnected nature of emerging zoonotic infections and sexually transmitted infections (STIs), particularly within community transmission networks shaped by social, behavioral, and structural determinants. Clinical surveillance systems alone often fail to capture the true burden of Mpox and co-occurring STIs due to stigma, limited healthcare access, and asymptomatic infections. Community-based monitoring approaches, ranging from environmental sampling and discarded condom surveillance to participatory reporting and decentralized testing, offer innovative, privacy-preserving alternatives for understanding transmission dynamics at the population scale. This chapter reviews advances in community-level monitoring of Mpox and co-occurring STIs, emphasizing methodological frameworks, analytical strategies, ethical considerations, and public health applications. We examine how integrated surveillance of Mpox, bacterial and viral STIs, and antimicrobial resistance markers can provide early warning, identify high-risk networks, and inform targeted interventions. Finally, we propose a scalable, One Health–aligned model for community-based surveillance that complements traditional healthcare systems while addressing equity and sustainability challenges.