Epidemiological Analysis of Monkeypox in Northeastern Brazil: Sex, Race, Age and STIs with SINAN Data (2022–2025) ^†

Introduction: Monkeypox (mpox) is a viral zoonosis that, by early 2025, surpassed 134,000 confirmed cases worldwide. In Brazil, first case was detected in 2022, and by January 2024 over 10,000 infections and five deaths were reported. Transmission occurs through direct contact with lesions or body fluids, with sexual transmission recognized as a route. Rising incidence poses challenges for public health systems due to rapid spread and effects on vulnerable populations. We analyzed mpox prevalence in northeastern Brazil, considering distribution by age, sex, race, and associations with sexually transmitted infections (STIs). Methodology: An epidemiological, observational, and descriptive study was conducted using secondary data from the Notifiable Diseases Information System (SINAN), covering 2022–2025. Variables included age, race, gender, and STI coinfection. Results: A predominance was observed among males (987), with highest burden in the 20–40 age group (1060). Mixed-race individuals accounted for most cases (879). Ceará recorded largest number (384), followed by Pernambuco (349). Associations with STIs were notable, with HIV (1719) and HTLV (941) most frequent, along with syphilis (126), genital herpes (8), gonorrhea (7), HPV (3), and chlamydia (2). Conclusions: Mpox shows higher prevalence among young men, particularly of mixed race, with emphasis on the association with HIV and HTLV. These findings underscore the relevance of sexual transmission and STI coinfection and indicate the need for targeted strategies. Priority should be given to combined prevention, early diagnosis, integration of STI/HIV and HTLV services, health education, and active surveillance to reduce spread and mitigate social and health impacts in northeastern Brazil.