• Post:By Aman Rana
• February 1, 2025

Introduction

Monkeypox is a rare viral Zoonotic disease which is caused by the monkeypox virus, an orthopox virus that is endemic to West and Central Africa. At present time the increased cases of monkeypox have become a major concern for Uganda. This viral infection causes painful rashes and other symptoms like myocarditis or the inflammation of the heart muscle which can lead to dilated cardiomyopathy, arrhythmia and heart failure. Uganda is a landlocked country which is located in seven of Africa’s biogeographic regions which increases the close interaction between the human population and wildlife. For this, the outbreak of Zoonotic diseases like Mpox increases in Uganda. The target population for the surge of myocarditis following monkeypox infection is not only the patients who are dealing with Mpox but also the wider community which is facing socio-economic challenges due to the outbreaks of this infectious virus. Endemic regions that are facing outbreaks of Mpox face challenges like limited access to diagnostics and vaccines, disruption in community dynamics, difficulty with contact tracing, constraints of resources, as well as appropriate information regarding transmission and prevention of mpox, can cause confusion within the society as well as exacerbate pre-existing health disparities.

The World Health Organization (WHO) in 2022 declared an international public health emergency due to the increased cases of Mpox in the African continent which is generally caused by a new strain named Clade Ib that is highly transmissible. Almost 20000 cases were recorded within the time period of Jan 1 to Aug 2023 and nearly 575 people lost their lives due to this disease.

Figure 1: The Mpox Epidemic in Africa

(Source: Statista.com, 2025)

Rationale   

The importance of this study generally arises due to gaps in the existing literature regarding the long-term impact of monkey-pox, particularly the severity of myocarditis as well as socio-economic impacts of Mpox outbreaks in endemic regions like Uganda. Mpox infrequently infects people while still maintaining a reservoir in wild animals as the virus is adaptable. In the past myocarditis was thought to be caused by smallpox which is quite similar to MPXV, however, it is much deadlier. It generally exhibits tropism for myocardial tissue as well as can present immune-mediated harm to the heart. This research mainly focuses on the clinical trials of Mpox and affected areas due to the outbreak of Mpox.

Besides that, it also focuses on finding a relation between monkey infection and its severe complications like myocarditis and socio-economic effects for producing proper public intervention strategies and policies to address its adverse effects. The global outbreak of Mpox has enhanced concerns for the need for a coordinated approach for preventing further spread of this deadly disease (Elemuwa et al. 2024). In order to address the risk of Mpox there is a need for efficient public health responses and preparedness as well as addressing discrimination and stigma against vulnerable groups by ensuring equitable access to vaccines and treatments. Healthcare systems by understanding clearly about this infectious disease and socio-economic impact can adopt targeted intervention and allocate resources more effectively.        

 Literature Review 

 Severity of myocarditis among monkeypox patients 

Figure 2: The Evaluation of Myocarditis

(Source: Iintechopen.com, 2023)

Myocarditis is a serious state of heart muscle and it is triggered through multiple viral infractions and also through monkeypox. From the figure it has narrated that, sometimes the lack of particular guidelines, healthcare system strain, delayed diagnosis and treatment and risk of chronic heart damage has raised the severity of myocarditis among monkeypox patients. The author Dumont et al. (2023) opined that among vulnerable populations with basic health conditions, weakened immune systems sometimes face greater risk of myocarditis, mainly those with comorbidities and heart disease. Besides, this individual has not fully recovered from the serious myocarditis and for the money pox patients this will emerge as a life-threatening situation. For example, Journal of Clinical Microbiology published a report during 2009 H1N1 pandemic where Vulnerable populations such as HIV-positive people have lower immune systems and after coming in contact with H1N1 influenza virus, myocarditis developed and their heart became severe (Mahmud and Tamanna, 2024).

In that case, patients take a huge time to recover from this situation but long-term heart damage and risk of death appears as a big problem as heart failure, arrhythmias complicate the path to maintain the myocarditis. On the other hand, Ahmed et al. (2023) monkeypox patients sometimes face moderate symptoms like swollen lymph nodes, rash and fever due to myocarditis but the advances in medical care, early monitoring and detection and increased awareness lower down the effects of myocarditis. With integration of the advanced technology and the upgradation of the treatment protocols, and medical research can help the healthcare leaders to provide the supportive treatments like antivirals and corticosteroids and control the cardiac damage and myocarditis. For example, in the time pandemic, the cases of myocarditis increased and in Israel, it was found that, male patients majorly developed myocarditis with the next dose of Pfizer-BioNTech vaccine (Mevorach et al. 2021). The above mentioned cases effects were mild and with the help of the inflammatory treatment major patients fully recovered and this case shed light on the advanced medical care. 

 Healthcare burden and strain that is imposed due to outbreak of Mpox

Figure 3: Mpox and healthcare workers

(Source: Springeropen.com, 2023)

From the figure it has been narrated that Mpox brings poor outcomes and creates issues to manage the healthcare setting. It has found that, in the year 2024, 106 thousand confirmed Mpox cases emerged in the 123 territories and countries and by WHO it was renamed as a public health emergency in August 2024 (Statista.com, 2025). It has narrated that the outbreak of monkeypox emerged due to the economic costs, healthcare strain and has disrupted the healthcare routine as it has found that, during Mpox outbreak the non-urgent medical process has cancelled and also delayed. Hossain et al. (2024) stated that prioritising healthcare organisations has raised the health issues mainly for those people who majorly depend on continuous care for their chronic conditions. For example, in the year 2022, for the reason of the Mpox outbreak, hospitals give importance on the Mpox cases, as a result, the individuals with chronic conditions reschedule their treatment plans to access the care (Titanji et al. 2024).

Besides, other routine services like screening and immunisations have also been postponed and the serious patients get long term consequences. In contrast Abdulrahim et al. (2025) opined that the outbreak of the Mpox reduces the strain and burden of healthcare as it enhances the importance of global collaboration. Mpox effects prompted WHO (world health organisation) and international organisations to work effortlessly with collaboration besides the organisations sharing their resources and knowledge to improve the outcomes. And these efforts and collaborations boost global health security and prepare healthcare for future outbreaks.   

Socio-economic impact of Mpox outbreaks 

Figure 4: Monkeypox Spread

(Source: Statista.com, 2022)

From this figure, it has demonstrated that Mpox outbreaks create socio economic consequences through affecting the society and economy besides it brings economic disruptions, increased poverty and affects international trade. Ebede et al. (2025) stated that, Mpox infected people sometimes want medical attention which creates pressure on the healthcare system besides the lockdowns, travel restrictions and quarantine ruin local economies mainly in the industries like retail, hospitality and tourism.

Besides the small businesses which majorly rely on in person services have tackled major losses for example, Spain and UK, where early Mpox outbreak, face a huge decline in hotel and tourism bookings. Apart from that, the events, like larger gatherings, concerts and festivals have been cancelled which scale down the country's economics and local business. On the other hand, Ugwu et al. (2024) the Mpox outbreak enhances public health awareness mainly regarding the prevention and transmission of zoonotic diseases besides, educational campaigns have boosted the communities and they decrease the spread of viruses. Here Social Determinants of Health Theory has included as it narrates that outbreaks of Mpox disproportionately affect social factors like education and income and helps the healthcare to shape their capability to recover from the health crisis and quickly respond in the time of the crisis. 

Recommendations to integrate appropriate strategies and policies to address the outbreak of Mpox 

Figure 5: Number of confirmed Mpox cases in Europe as of July 5, 2024, by age and gender

(Source: Statista.com, 2025)

From the figure it has the effects of the Mpox was huge and found among the men, the majority of the Mpox cases emerge from the europe. Among men 10.6 thousand cases between the age of 31-40 have reported that time in comparison to 127 women. To handle the outbreak and restrict the spread, the comprehensive strategies and policies needed among them the necessary strategies are vaccination and treatment, international cooperation and community engagement.

In 2024, World Health Organization (2024) stated that the availability of the JYNNEOS like vaccine and the tecovirimat like antiviral treatment give an efficient therapeutic and preventive strategy in high-risk areas, and can decrease the disease burden. In contrast Elemuwa et al. (2024) opined that, the outbreak of misinformation has created challenges and complicated the efforts to manage the outbreak as it has found the false claims about the disease transmission, and nature has reduced the public trust. Here Health Belief Model has been included as it provides recommendations about increasing awareness, encouraging vaccination, and giving clear guidance through offering actionable advice to stop the close contact with the affected people. 

 Aim and Objectives

Aim

The aim of this study is to find out the relationship between the monkeypox and the surge of myocarditis following this infection as well as socio-economic impact due to this outbreak in the endemic region.   

Objectives

●      To assess the socio-economic impact of Mpox outbreaks in Uganda

●      To provide recommendations to integrate appropriate strategies and policies to address the outbreak of Mpox 

Study design and methods

Research design

This research on ‘The Surge of Myocarditis Following Monkey Pox Infection’ will choose interpretivism philosophy due to its benefits. This study will impose interpretivism philosophy as this philosophy aims to understand the social experiences as well as lives of individuals rather than aiming for universal law (Thomas, 2021). Besides that, this research method aids to produce valid data through concentrating on personal meaning and motivation. These methods will assist this study to evaluate how the outbreak of monkey pox has influenced the socio-economic condition in Endemic regions like Uganda. On the other flip, this study will utilise an inductive approach as a research approach as it permits to develop new theories on the basis of the empirical data rather than just testing the existing theory (Nayak and Singh, 2021). This research approach will aid this study to gain a deep understanding of how the outbreak of monkey pox affected the socio-economic circumstances in the endemic region through considering the nuances of their experiences.  

Data collection:

This current study will utilise secondary qualitative data collection methods to collect data on the impact of monkey pox outbreaks in the endemic regions. Secondary data collection refers to a procedure of leveraging data which has already been gathered for other purposes. This study will utilise secondary data collection methods as secondary data offers a time-efficient and easy to obtain source of information compared to primary data collection procedures (Pandey and Pandey, 2021).

Besides that, as this method quickly collects data, the study will get more time to focus on the analysis.  Through leveraging existing databases, this research will get access to data regarding the outbreaks of monkey pox which would not be possible to collect data (Islam et al., 2022). Mohamed Abdoul-Latif et al., (2024) has utilised secondary data collection method in their study and it assisted them to assemble authentic information regarding their topic from more credible sources. This study will utilise different search engines like Google Scholar and ProQuest to gather data. Besides that, this study will collect data from the sciencedirect.com, mdpi.com, springer.com, database engine to gather data on monkey pox outbreaks.

This study will search data using Boolean operators like ‘monkey pox outbreaks’ AND ‘its socioeconomic impact’, ‘monkey pox virus’ OR ‘multifaceted evaluation of preparedness in endemic regions’. These data collection methods will also help this public health research to recognise gaps and inefficiencies in the collected data and also understand what additional information requires to be gathered to make sound findings.

Data analysis:

The study will impose thematic analysis to identify the nuances in the gathered data. Thematic analysis refers to qualitative research methods which detect and represent patterns and themes in data. This study will utilise thematic analysis as this data analysis method provides a structured approach through breaking down the complex data into manageable themes and subthemes (Saha and Paul, 2023). Through developing main themes and subthemes and interpreting the patterns these data evaluation procedures will assist this research to uncover the nuances which might otherwise be overlooked. Besides that, these data evaluation procedures can provide a step by step approach which can boost the transparency of this evaluation.

Time plan:

Figure 6: Gantt Chart

(Source: Self-developed)

Eligibility criteria

Table 1: Inclusion and exclusion criteria

(Source: Self-developed)

Recruitment and Sampling procedures

Sampling refers to a procedure in statistical analysis in which researchers take a predetermined number of observations from a larger population. This study aims to choose secondary Qualitative data collection methods therefore no sampling procedures will be utilised here.

Ethical consideration

Concerns about secondary data utilisation mostly revolve around possible harm to individual subjects and issue of return for consent. This study will follow all the guidelines of the Arden University and conduct this study in accordance with the guidelines. As this study aims to collect secondary data this research will follow the General Data Protection Regulation (GDPR) to protect the data from any kind of harm. Besides that, this study will strictly follow the Data Protection Act 2018 while assembling and safeguarding the data. This study will not utilise articles that are published before 2021 to avoid any data updating issue.  This research project will also avoid any kind of academic misconduct regarding studies’ relevancy, year and language biasness in order to sustain the reliability of this study as per chosen objectives. Moreover, this research will cite the existing literature properly to showcase acknowledgement towards the authors. The collected data will only be utilised for conducting this public health research and the study will be deleted permanently from the university storage after 6 months.

Discussion

The severity of myocarditis among monkeypox patients in Uganda

The impact of Mpox outbreaks highlights the significant viral infections such as smallpox which is relevant to monkeypox and has not been explored. The event regarding myocarditis within the individuals monkeypox-infected needs to be explored more due to it being rare and occurring in major patients. The study of Ahmed et al. (2023) mentioned that the event regarding myocarditis in patients highlights that monkeypox is not explored properly due to its free pieces of information. Alternatively, most of the case reports and existing studies about Mpox outbreaks navigate its effective complication which is rare in crucial cases throughout the individuals. Jaiswal et al. (2023) asserted that most of the patients come with important symptoms such as shortness of breath, chest pain, and arrhythmias due to myocarditis and it can complicate Mpox which is difficult to diagnose at an early stage. However, major risk factors that make myocarditis per the infection of monkeypox which can show its previous stage to individuals regarding inflammation in the heart.

Figure 7: Monkeypox-Induced Myocarditis

(Source: Jaiswal et al. 2023)

It observed that the individuals who compromise their immune system by highlighting severe health conditions including HIV in Uganda. Kasujja et al. (2021) remarked that the lack of accessibility to effective healthcare services in Uganda’s rural areas can hinder the process of treatment and diagnosis. It is required to concentrate on finding the probable outcomes and events of myocarditis which is viral infections such as Covid-19 across Mpox patients through partnerships with international health organisations and gathering worthy pieces of information from local healthcare facilities leading towards enhanced patient care. Therefore, it needs to understand the effectiveness of enhancing the outcomes and public health responses in future situations.

Identifying the healthcare burden and strain that imposed the outbreak of Mpox

It observed that the monkeypox outbreak in different regions of Uganda highlights the concerns regarding healthcare systems specifically where major resources are restricted. Euchi (2021) proclaimed that the infrastructure of healthcare is overcome through the increasing requirements of quarantine measures, medical services, diagnosis, and treatment during outbreaks which lead towards significant challenges for healthcare workers and patients. Alternatively, the Mpox outbreak raised the burden on healthcare facilities where the majority of clinics and hospitals are overwhelmed with major cases by distracting attention from other requirements.

Alum et al. (2023) expressed that specialized care is important regarding isolation units to restrict the spread of the virus which poses an increased burden on hospitals. Therefore, it faced difficulty with improper personnel, space, and equipment. Hence, a lack of useful resources including effective diagnostic tools such as rapid antigen tests and real-time PCR tests regarding a diagnosis of Mpox where healthcare infrastructure is in the development stage and is beneficial for managing the outbreak. However, the outbreak of Mpox needs effective public health interventions including community education efforts, contact tracing, and quarantine regarding disclosed individuals.

Jackson-Gibson et al. (2021) confirmed that effective challenges within public health agencies in the locality are due to a lack of financial resources and staff to drive control measures effectively. Conversely, healthcare workers suffer from increased stress and risk of burnout due to the probable outcome of viruses and raised workload. The study by Davis et al. (2022) mentioned that the socioeconomic effect of an outbreak poses increased pressure throughout the healthcare system and leads towards restricted accessibility to care. In addition, the majority of the population in health can decline due to the significant delays in regular healthcare services and Mpox treatment.

The socio-economic impact of Mpox outbreaks in Uganda

This outbreak of Mpox in Uganda highlights the socio-economic consequences which make an impact on larger communities and individuals. It affects the disruption of local economies where useful public health measures, travel restrictions, and quarantines can play an important role in managing the outbreaks in different businesses. The study of Ghadami et al. (2022) remarked that agriculture, different marketplaces and tourism can face difficulties such as supply chain disruptions and trade barriers when the majority of people fail to work which leads to a loss of income in many families. It noticed that an outbreak of Mpox can raise healthcare costs by affecting private healthcare systems.

Conversely, the clinics and hospitals are submerged in some cases that shift the resources from crucial services. Hardman et al. (2021) said that overburdening can contribute to hindering the treatment process regarding health conditions which is non-Mpox-related by increasing the health burden throughout the population. Therefore, the social and psychological effect highlights the social scandal and fear of infection throughout the Mpox that leads towards a breakdown in community solidarity, social isolation, and significant mental health challenges. According to the figure, the European region was reached approx.30,000 cases between July to October 2022 whereas the Western Pacific Region highlights cases of approx.1000 in July 2023 (Openaccessgovernment.org, 2024).

Figure 8: MPOX

(Source: Openaccessgovernment.org, 2024)

It confirmed that the scandal cannot influence the individuals from effective care which leads towards delay in treatment and diagnosis. Edwards-Fapohunda and Adediji (2024) expressed that education systems also faced difficulty in operating within limited situations that hindered the accessibility of children's education. However, its significant effect shows the major factors that foster socio-economic development across the Uganda for the long term.

Recommendations to integrate appropriate strategies and policies to address the outbreak of Mpox 

In the case of Mpox outbreaks, it needs to implement effective policies and strategies which is important for eliminating the economic, health, and social effects. The study by Chakraborty (2024) highlighted that healthcare facilities are required to increase their diagnostics capacity with useful tools such as rapid antigen tests and portable PCR machines which contribute to diagnosing early. Alternatively, it needs to invest in the healthcare systems of Uganda's rural areas to enhance diagnostic abilities and surveillance and provide training to healthcare workers to control Mpox. Biesty et al. (2024) asserted that it can empower communities regarding prevention measures and symptoms of Mpox by driving public awareness campaigns for decreasing scandal and fostering healthcare facilities timely. Therefore, it needs to improve regional collaboration with healthcare originations such as WHO that confirm a combined response such as surveillance insights, shared resources, and expertise. However, these effective measures can support maintaining the outbreaks of Mpox significantly through enhancing public health.

Dissemination of research findings

In order to disseminate the research findings a multifaceted approach will be taken that are listed below

First this research will be submitted to the University to ensure it reaches the scientific community that will be helpful in tackling the social concerns and problems that generally impact the lives of people both locally and globally. For this research peer-reviewed articles and journals will be prioritised focusing on infectious diseases and epidemic for providing detailed information of monkeypox and its related complex cases like myocarditis which can cause cardiogenic shock, atrioventricular block and heart failure among medical professionals and researchers (Ahmed et al. 2023). For enhancing the awareness regarding the impact of Mpox seminars and workshops will be organised by making partnerships with local health organisations, NGOs and government to effectively manage Mpox and enhance coordination, preparedness and response against this virus. This step will not only help in presenting the result findings but also helpful in presenting public health policies and strategies of communities to deal with this infectious virus.

In order to decrease the outbreaks of Mpox, people need to avoid the use of materials and objects of a person who is dealing with Mpox as well as avoid wild animal areas from which generally the outbreaks of Mpox happen regularly (Biesty et al. 2024). In this advanced digital age, the increased due the increased engagement of people on social media platforms like Facebook, these medias and health-focused blogs will be utilised for disseminating the information among wide range of people regarding the surge of myocarditis following monkeypox infection and socioeconomic impacts of its outbreaks in endemic regions like Uganda. The increased awareness and knowledge of monkeypox will be helpful in enhancing the capacity to quickly respond to the monkeypox cases and decrease its adverse impact. 

However as with virtually all areas of life, dissemination of research has been hindered by the internet and digital technologies. Therefore, strong collaboration with the local media outlets will be advantageous to foster the coverage of the findings of this research. In addition, informative articles and interviews with the researchers will also assist to consider the findings within the wider aspect of public health in endemic regions like Uganda. With the assistance of these combined efforts this public health research will not only reach to the academic community but also to the policymakers which will assist them to develop strategic and informed policies.

Conclusion

Summarising key findings

In conclusion, it can be stated that the surge of myocarditis following the monkeypox condition has become a global concern which needs to be carefully considered by governments, people, community and health organisations collectively. Myocarditis is an inflammation of heart muscle and the delaying diagnosis and treatment of this disease can enhance the risk of chronic heart damage and even death. However, by upgrading the treatment protocols, integrating advanced tools and giving supportive treatments like corticosteroids will be helpful to deal effectively with myocarditis and other and other severe diseases. Besides that, an outbreak of Mpox needs effective public health interventions like quarantine regarding disclosed individuals and community education efforts.

Through this study, more people will be aware about the prevalence of myocarditis among monkeypox patients and need for enhanced clinical surveillance. The outbreak of Mpox enhances the burden of additional cost in the healthcare system. Additionally, healthcare workers suffer from increased stress and risk of burnout due to the raised workload and the adverse outcomes of this virus. Lockdowns, travel restrictions and quarantine ruin the local economy which negatively damage the development of the society. Here the data for collecting the Mpox outbreak in endemic region secondary data collection method has been used which helps in providing more credible and reliable data for this study. Collected qualitative data has been analysed by using thematic data analysis method as it helps in understanding the relationship among data as well as gives deep insights to improve findings of the study.

As this analysis method breaks the study into manageable steps it helps in enhancing the transparency of the overall study. Pepper ethics like GDPR Act 2018 have been followed here to maintain the integrity of the overall study. As the outbreaks of Mpox cause severe health concerns and hinder socio-economic development there is a need for the implementation of effective strategies. Rapid antigen tests and portable PCR machines are useful to diagnose early Mpox and provide proper treatment and vaccination for addressing its adverse impact on human health. Uganda by strengthening its health system, managing resources effectively and increasing awareness regarding the severity of Mpox can easily deal with this infectious disease.       

Importance of this research and its potential impact

The potential impact of this research goes beyond Uganda as it can increase awareness among researchers, medical professionals and the public about the Mpox virus’s transmission dynamics and high-risk populations who can be affected easily. Mpox enhances the risk of myocarditis which is much more deadly, however the adoption of effective prevention strategies and improving diagnosis is helpful in addressing the outbreak of this disease. The lessons learned from this study will force other endemic regions to address these issues effectively.

The risk of zoonotic diseases is enhanced due to the changes in climate and human activities which can pose severe threats on human health as well as can impose socio-economic challenges like travel restriction that impact the hospitality and tourism industry negatively. This research helps in finding the most essential methods like contact tracing and isolation of the monkeypox affected people that can be utilised by healthcare organisations to address its severe impact.

Researchers by developing targeted interventions like vaccination campaigns can decrease the transmission among high-risk groups. Monkeypox endemic regions like Uganda need to generate a strong surveillance system to track and monitor Mpox regularly and decrease the severity of its transmission among people.

As this research highlights the severity of Mpox it will be helpful in improving public health strategies and implementing strict policies to decrease its outbreaks. Besides that, a combined response such as surveillance insights, shared resources, and expertise will also be helpful in improving public health.