A study by a team of scientists at the Uganda National Institute of Public Health reveals that most of the early cases of Mpox who sought care at private health facilities were misdiagnosed.
More than half of the first confirmed patients initially sought care from private clinics, where 85 percent were wrongly treated and sent home, allowing transmission to continue. In contrast, public hospitals were more likely to isolate suspected cases, helping to limit the spread.
Health experts warn that weak regulation and poor disease reporting by private facilities could undermine Uganda’s response to future outbreaks if not urgently addressed.
Delayed detection weakens disease surveillance and allows infections to spread rapidly before authorities can respond.
Dr Olive Namakula, a Field Epidemiologist and Fellow at the institute, said they found more than half of the first 200 patients to be confirmed for Mpox first sought care at private health facilities, and eighty-five percent of them were misdiagnosed and treated for either cellulitis, chickenpox, or worm infestation.
Public health experts warn that misdiagnosis of Mpox, poses a major risk to outbreak control, as patients who are incorrectly treated and sent home continue to unknowingly transmit the virus.
There is a human cost to misdiagnosis of diseases like MPOX. Most often, patients whose illnesses are misdiagnosed tend to spend money treating the wrong illness and return to care when symptoms worsen. They face stigma once a disease like Mpox is finally confirmed, and they risk long-term complications.
Namakula, who led the outbreak investigation in the Kampala metropolitan area, says they analyzed each of these laboratory-confirmed cases to establish where the patients had been receiving treatment from before being confirmed for the viral disease.
They found that only about ten percent of sufferers who went to public or government-run health facilities between July 2024 and January 2025 were initially misdiagnosed.
She explains that, different from private hospitals, which were treating and letting people go home, government hospitals initially held some suspect cases in isolation units, which helped cut transmission.
According to Namakula, the disease predominantly affected young adults, and most of the 300 fully investigated case-patients were male who acquired Mpox through sexual transmission, mainly through sex work.
When these findings were presented to officials in the Ministry of Health, they expressed the need for strengthening the regulation of private health facilities.
Dr Daniel Kyabayinze, the Director of Public Health in the ministry, said private facilities tend to make rushed decisions in diagnosis, often driven by profit motives and at times due to a lack of the requisite equipment for specific tests.
Specifically, for Mpox, Kyabayinze says when they got alerts that some private hospitals were encountering challenges, they sent out teams to train health workers and also asked them to report to the ministry all their surveillance data, as they are already required to do just as public hospitals.
However, the report shows the majority of private health facilities were not reporting as required.
While globally, Mpox was first declared a Public Health Emergency of International Concern in July 2022 and reinstated in August 2024, Uganda’s first confirmed case was reported on July 24, 2024, and by December 15, 2024, 2,000 confirmed Mpox cases had been registered.
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