Most of Uganda’s early Mpox patients who sought care at private health facilities were misdiagnosed and sent home, allowing the virus to spread, according to a study by scientists at the Uganda National Institute of Public Health.
The study found that more than half of the first confirmed Mpox patients initially visited private clinics, where 85% were wrongly diagnosed and treated for other conditions, including cellulitis, chickenpox and worm infestations.
By contrast, public hospitals were more likely to isolate suspected cases, helping to limit transmission, the researchers said.
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 surveillance and allows infections to spread rapidly before authorities can respond,” said Dr. Olive Namakula, a field epidemiologist and fellow at the institute.
Namakula said researchers analyzed more than 200 laboratory-confirmed Mpox cases in the early phase of the outbreak to determine where patients first sought care. They found that only about 10% of patients who initially visited public health facilities between July 2024 and January 2025 were misdiagnosed.
Unlike many private clinics, government-run hospitals isolated suspected cases while awaiting confirmation, a measure that helped reduce transmission, Namakula said.
Public health experts said misdiagnosis poses a serious risk to outbreak control, as patients who are incorrectly treated and sent home may unknowingly infect others. Misdiagnosis also carries a human cost, forcing patients to spend money on ineffective treatment, face stigma once Mpox is confirmed and risk complications as symptoms worsen.
The study found that Mpox predominantly affected young adults, with most of the nearly 300 fully investigated cases occurring among men. Transmission was largely linked to sexual contact, including sex work, Namakula said.
Following presentation of the findings, Ministry of Health officials acknowledged the need to strengthen oversight of private health facilities.
Dr. Daniel Kyabayinze, the ministry’s director of public health, said private clinics often make rushed diagnostic decisions, sometimes driven by profit and compounded by limited access to specialized testing.
Kyabayinze said the ministry deployed teams to train private health workers after receiving alerts of diagnostic challenges and reminded facilities of their obligation to report surveillance data. However, the study found that most private clinics were not reporting as required.
Mpox was first declared a global public health emergency in 2022 and reinstated in 2024. Uganda confirmed its first case on July 24, 2024, and had recorded 2,000 confirmed cases by mid-December.
